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Abstract

BACKGROUND: The international expert consensus core outcome set for post-stroke aphasia recommends the Stroke and Aphasia Quality of Life Scale - 39/generic (SAQOL-39g) for assessing patient-reported health-related quality of life. Cultural adaptations of the SAQOL-39g are mandatory in stroke rehabilitation.

AIM: We adapted the original English SAQOL-39g into German and evaluated its psychometric quality.

DESIGN: Evaluation of a self-report scale embedded in a prospective multicenter parallel group randomized waitlist-controlled trial on the effectiveness of intensive speech and language therapy.

SETTING: Nineteen in- and outpatient aphasia rehabilitation centers in Germany.

POPULATION: People with chronic post-stroke aphasia (N.=156) of all types and severity levels.

METHODS: We followed applicable guidelines for cross-cultural test adaptations and psychometric evaluations.
Psychometric analyses are based on the assessment before three weeks of intensive speech and language therapy (acceptability, internal consistency, validity; N.=156), on the assessments before and after three weeks of waiting in the control group (test-retest reliability; N.=78), and on the assessments before and after three weeks of intensive speech and language therapy (responsiveness; N.=156).

RESULTS: The German SAQOL-39g was feasible across all aphasia severity grades (no missing data; no floor/ceiling effects). Internal consistency was excellent (Cronbach’s α=0.90); test-retest reliability was moderate-to-good (intraclass-correlations: ICC=0.73 for single/0.85 for average measures). Both exploratory factor analyses and multidimensional scaling of proximity data/graphical network analysis supported the 3-dimensional structure (domains: physical, psychosocial, communication) of the English original version. Convergent (|r|=0.29 to 0.48) and discriminative (|r|=0.03 to 0.07) validities were acceptable. Responsiveness to intervention-induced change showed a small-to-medium treatment effect (group difference after intervention compared to waiting-list control: Cohen’s d=0.34).

CONCLUSIONS: The German SAQOL-39g is a reliable, valid and change-sensitive patient-reported outcome measure to assess the physical, communication and psychosocial quality of life in chronic post-stroke aphasia, with comparable psychometric properties and factorial structure to the original English version.

CLINICAL REHABILITATION IMPACT: The German SAQOL-39g is an easy-to-administer and -score patient-reported scale that can be used in rehabilitation settings to measure health-related quality of life and support patient-centered goal setting in people with chronic post-stroke aphasia of different ages, stroke durations, severity and type of aphasia.

Publication Type:	Article
Additional Information:	Copyright © 2025 THE AUTHORS This is an open access article distributed under the terms of the CC BY-NC-ND 4.0 license which allows users to copy and distribute the manuscript, as long as this is not done for commercial purposes and further does not permit distribution of the manuscript if it is changed or edited in any way, and as long as the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI) and provides a link to the license.
Publisher Keywords:	Stroke rehabilitation; Aphasia; Quality of life; Psychometrics
Subjects:	R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Allied Health
SWORD Depositor:	Symplectic Administrator

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