Developing and evaluating the validity and reliability of the quality-of-life questionnaire of Stroke-induced aphasia-Persian (QOLSA-P)

Background Aphasia quality of life (QOL) questionnaire already exists in Persian [Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39)], yet cultural considerations may limit its adequacy for Persian-speaking populations. Besides, it lacks a specific linguistic focus and aphasia-friendly visual supports.Aims This study aimed to: 1) develop the Quality-of-Life Questionnaire for Stroke-Induced Aphasia in Persian (QOLSA-P) based on the International Classification of Functioning, Disability, and Health (ICF) framework; and 2) examine its psychometric properties of validity and reliability.Methods & procedures The study involved 125 Persian-speaking people with aphasia (53 females, 72 males; age range = 30–90 years, M = 59.6; post-stroke duration: M = 17.8, range: 1–132 months), eight primary communication partners (proxies), and 35 experts. A pool of 772 items was generated, which was reduced to 54 items after face and content validation. The pictographic version of the QOLSA-P incorporated images and was evaluated for validity and reliability. The 16-item short form (QOLSA-P-16) was derived through exploratory factor analysis (EFA).Outcomes & Results The final 36-item questionnaire (QOLSA-P-36), demonstrated strong correlation with the Persian SAQOL-39 (r = 0.61, p < 0.001), reflecting good convergent validity. Significant differences were observed between mild and severe aphasia groups (F = 3.998, p < 0.05), revealing sufficient known-group validity. The QOLSA-P-36 showed good internal consistency (α = 0.78–0.89, ω = 0.78–0.88) and moderate to good test-retest reliability (ICC = 0.60–0.84). The EFA extracted four factors of communication, support and relationships, self-care, and emotions – and the results explained 50.8% of the total variance. QOLSA-P-16 demonstrated good internal consistency and test-retest reliability (α = 0.73–0.84; ICC = 0.53–0.84).Conclusions The QOLSA-P was proven to be a valid, reliable, and culturally appropriate instrument for assessing quality of life in Persian-speaking people with aphasia, suitable for both clinical and research applications.