Researchers from three disciplines at Canada’s University of Alberta – Speech-Language Pathology, Physical Therapy, and Nursing – studied the effects of participation in group therapy on the health-related quality of life in persons with aphasia. The goals were to establish, on the basis of a scoping review of published research, current evidence regarding 2 questions: [1] What measure are used to report health-related quality of life (HRQL)?; and [2] How does HRQL change as a result of participation in group therapy? In general, scoping reviews precede systematic reviews, and seek to identify, summarize, and appraise the research tools, materials, and methodologies of a given area.
The current investigators searched five medical databases to identify peer-reviewed articles that met three criteria: (1) they reported on adults with acquired aphasia; (2) the subjects needed to be participating in group therapy; and (3) reported outcomes needed to include at least 1 metric regarding health-related quality of life. Candidate studies were assessed for methodological soundness and quality of evidence. The thirteen studies that met inclusion criteria comprised two randomized controlled trials, eight case studies, and three qualitative studies. They constituted a heterogeneous group, differing in methodologies, types of intervention employed, and HRQL instruments utilized.
In answer to the first question – what measures were used to report health-related quality of life – these studies used tools drawn from four complementary domains. 1. Language and communication assessment instruments included the Western Aphasia Battery–Revised, the Communicative Effectiveness Index, the Comprehensive Aphasia Test, and the Philadelphia Naming Test. 2. HRQL metrics were drawn – in two cases – from established instruments, namely the World Health Organization Quality of Life – BREF and the EuroQOL assessment, otherwise relying on indirect measurements or qualitative descriptions. 3. Mood and personality instruments included – in four cases – the Rosenberg Self-Esteem Scale. 4. Social involvement was assessed – in three cases – using such instruments as the MOS-Social Support Survey or the Social Networks Communication Inventory. Only the first category – language and communication – was reported in all studies, and in only this area was there some widespread agreement on tools to be used.
In answer to the second question, the researchers did find – in association with group therapy – improved outcomes in metrics tracked formally, with subjects concurring in subjective reports. Given the relatively sparse evidence available, the authors point to the need for additional focus on this area.
For further reading: C. Wilson, A. Jones, K. Schick-Makaroff, & E. S. KIm, 2021, Understanding the impact of group therapy on health-related quality of life of people with aphasia: a scoping review. Speech, Language, and Hearing, 14 pp. https://doi.org/10.1080/2050571X.2021.1917216