title: Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39): evaluation of acceptability, reliability, and validity.
abstract: OBJECTIVE
  Health-related quality of life (HRQL) is a key outcome in stroke clinical trials. Stroke-specific HRQL scales (eg, SS-QOL, SIS) have generally been developed with samples of stroke survivors that exclude people with aphasia. We adapted the SS-QOL for use with people with aphasia to produce the Stroke and Aphasia Quality of Life Scale (SAQOL). We report results from the psychometric evaluation of the initial 53-item SAQOL and the item-reduced SAQOL-39.
  
  
  METHODS
  We studied 95 people with long-term aphasia to evaluate the acceptability, reliability, and validity of the SAQOL and SAQOL-39 using standard psychometric methods.
  
  
  RESULTS
  A total of 83 of 95 (87%) were able to complete the SAQOL by self-report; their results are reported here. Results supported the reliability and validity of the overall score on the 53-item SAQOL, but there was little support for hypothesized subdomains. Using factor analysis, we derived a shorter version (SAQOL-39) that identified 4 subdomains (physical, psychosocial, communication, and energy). The SAQOL-39 demonstrated good acceptability, internal consistency (Cronbach's alpha=0.74 to 0.94), test-retest reliability (intraclass correlation coefficient=0.89 to 0.98), and construct validity (corrected domain-total correlations, r=0.38 to 0.58; convergent, r=0.55 to 0.67; discriminant, r=0.02 to 0.27 validity).
  
  
  CONCLUSIONS
  The SAQOL-39 is an acceptable, reliable, and valid measure of HRQL in people with long-term aphasia. Further testing is needed to evaluate the responsiveness of the SAQOL-39 and to investigate its usefulness in evaluative research and routine clinical practice.
authors.affiliation: Department of Language and Communication Science, Institute of Health, City University, Northampton Square, London EC1V 0HB, UK. k.hilari@city.ac.uk
authors.forename: Katerina
authors.initials: K
authors.lastname: Hilari
authors.forename: Sally
authors.initials: S
authors.lastname: Byng
authors.forename: Donna L
authors.initials: DL
authors.lastname: Lamping
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D001037:Aphasia / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D025341:Principal Component Analysis; D011594:Psychometrics / Q000379:methods; D011788:Quality of Life; D015203:Reproducibility of Results; D018434:Sickness Impact Profile; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D013995:Time