Understanding the consequences of aphasia: Hungarian adaptation and validation of the AIQ-21

In Hungary, aphasia assessment relies primarily on impairment-based language measures. However, no aphasia-specific patient-reported outcome measure (PROM) is currently available to assess the impact of aphasia on everyday communication, participation, and psychological well-being. This study aimed to (1) adapt the Aphasia Impact Questionnaire-21 (AIQ-21) to Hungarian, (2) evaluate the content validity of the Hungarian version (AIQ-21-H), and (3) explore the impact of aphasia on communication, participation, and psychological well-being, and their associations with aphasia severity. Adaptation involved semi-structured interviews and focus groups with six people with aphasia (PWA). In the content validity phase, 13 PWA and 12 professionals rated relevance, comprehensibility, and comprehensiveness of the AIQ-21-H. Content validity indices ranged from 0.92-1.00 for PWA and 0.75-1.00 for professionals, indicating high content validity. Thirty-four PWA with chronic aphasia reported difficulties in communication (especially reading and writing), participation (everyday tasks, maintaining friendships), and emotional well-being (frustration, worry, helplessness, and anger). Communication and participation were strongly associated, psychological well-being was moderately associated with both domains, and greater aphasia severity was associated with greater difficulties across all AIQ-21-H domains. The AIQ-21-H is the first aphasia-specific, aphasia-friendly PROM in Hungarian and offers a much needed tool for clinical practice and research.