Aphasia, Stroke, Acute
Conditions
Brief summary
Quality of care depends strongly on oral communication with patients. Stroke patients, who have language disorders, have understanding difficulties, but also have difficulties in expressing their needs and in being understood. Available tools do not allow a professional consensus on the assessment of patients' ability to answer reliably to questions asked by caregivers. The investigators propose an answer reliability assessment tool based on yes or no questions. The goal of the present study is to define an optimal score for defining the test positivity, as a compromise between sensitivity and specificity, and by emphasizing the negative predictive value.
Detailed description
In France, about 130,000 persons per year are victims of stroke. Thirty percent of the victims suffer from aphasia during the acute phase. These language impairments have an impact on caregiving. In the context of post-stroke aphasia, the most relevant means of verbal communication is closed-ended questioning. However, the available tools do not allow a professional consensus and the comprehensive assessment tools for aphasia do not provide any indication of the reliability of patients' answers. The investigators have developed a tool, the yes/no questionnaire that consists of 10 closed-ended questions designed to assess the patient's ability to provide a coherent answer. During one year, successive patients taken care in the neurovascular unit at la Rochelle hospital will be assessed for eligibility to the study and their relative will be informed and ask for consent. Aphasic patients will therefore answer the yes/no questionnaire. Based on the speech therapist evaluation, patients will be classified as reliable respondent or unreliable respondent.
Interventions
Yes/no questionnaire used in order to identify reliable respondent and unreliable respondent
Sponsors
Study design
Eligibility
Inclusion criteria
* Over 18 years old * Left-sided stroke * Right-handed * Mother language: French * Hospitalized in neurovascular unit or neurology department * NIHSS score over 25
Exclusion criteria
* Deaf * Psychiatric history * Stroke history * Dementia or pre-stroke cognitive impairment * Under guardianship * Refusal to participate (relatives)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| YNQ Score | measured within 7 in-hospital days | The Yes/No questionnaire consists in 10 closed-ended questions designed to assess the patient's ability to provide a coherent answer. It was designed with questions that are very easy to answer, with the following constraints: * The questionnaire use only the auditory/verbal channel . * The questions ask only about personal data because they are less ambiguous. * The syntactical construction of the questions is very simple. * Apart from the use of personal data very familiar to the participants, the other nouns in the closed questions are very frequent (according to a lexical database). * The length of the questions was limited to seven words. * With the exception of two questions, each yes-response question had a no-response equivalent, as in some existing tests. A score of zero indicates a wrong answer to all questions. A score of ten indicates a correct answer to all questions. |
Countries
France
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Reliable Patients who respond reliably to closed questions, according to the speech therapist classification | 123 |
| Unreliable Patients who do not respond reliably to closed questions, according to the speech therapist classification | 29 |
| Total | 152 |
Baseline characteristics
| Characteristic | Reliable | Unreliable | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 98 Participants | 22 Participants | 120 Participants |
| Age, Categorical Between 18 and 65 years | 25 Participants | 7 Participants | 32 Participants |
| Age, Continuous | 72.3 years STANDARD_DEVIATION 12.8 | 75.4 years STANDARD_DEVIATION 14.7 | 72.8 years STANDARD_DEVIATION 13.2 |
| Diagnostic Combination of both stroke subtypes | 3 Participants | 1 Participants | 4 Participants |
| Diagnostic Hemorrhagic stroke | 11 Participants | 4 Participants | 15 Participants |
| Diagnostic Ischemic stroke | 109 Participants | 24 Participants | 133 Participants |
| Race and Ethnicity Not Collected | — | — | 0 Participants |
| Region of Enrollment France | 123 participants | 29 participants | 152 participants |
| Sex: Female, Male Female | 57 Participants | 17 Participants | 74 Participants |
| Sex: Female, Male Male | 66 Participants | 12 Participants | 78 Participants |
| Thrombolysis No thrombolysis | 94 Participants | 23 Participants | 117 Participants |
| Thrombolysis Thrombolysis | 29 Participants | 6 Participants | 35 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 123 | 0 / 29 |
| other Total, other adverse events | 0 / 123 | 0 / 29 |
| serious Total, serious adverse events | 0 / 123 | 0 / 29 |
Outcome results
YNQ Score
The Yes/No questionnaire consists in 10 closed-ended questions designed to assess the patient's ability to provide a coherent answer. It was designed with questions that are very easy to answer, with the following constraints: * The questionnaire use only the auditory/verbal channel . * The questions ask only about personal data because they are less ambiguous. * The syntactical construction of the questions is very simple. * Apart from the use of personal data very familiar to the participants, the other nouns in the closed questions are very frequent (according to a lexical database). * The length of the questions was limited to seven words. * With the exception of two questions, each yes-response question had a no-response equivalent, as in some existing tests. A score of zero indicates a wrong answer to all questions. A score of ten indicates a correct answer to all questions.
Time frame: measured within 7 in-hospital days
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Reliable | YNQ Score | YNQ score = 3 | 0 Participants |
| Reliable | YNQ Score | YNQ score = 6 | 0 Participants |
| Reliable | YNQ Score | YNQ score = 2 | 0 Participants |
| Reliable | YNQ Score | YNQ score = 4 | 1 Participants |
| Reliable | YNQ Score | YNQ score = 7 | 1 Participants |
| Reliable | YNQ Score | YNQ score = 1 | 0 Participants |
| Reliable | YNQ Score | YNQ score = 8 | 0 Participants |
| Reliable | YNQ Score | YNQ score = 9 | 0 Participants |
| Reliable | YNQ Score | YNQ score = 5 | 0 Participants |
| Reliable | YNQ Score | YNQ score = 10 | 121 Participants |
| Reliable | YNQ Score | YNQ score = 0 | 0 Participants |
| Unreliable | YNQ Score | YNQ score = 10 | 5 Participants |
| Unreliable | YNQ Score | YNQ score = 0 | 1 Participants |
| Unreliable | YNQ Score | YNQ score = 1 | 1 Participants |
| Unreliable | YNQ Score | YNQ score = 2 | 0 Participants |
| Unreliable | YNQ Score | YNQ score = 3 | 2 Participants |
| Unreliable | YNQ Score | YNQ score = 4 | 1 Participants |
| Unreliable | YNQ Score | YNQ score = 5 | 4 Participants |
| Unreliable | YNQ Score | YNQ score = 8 | 4 Participants |
| Unreliable | YNQ Score | YNQ score = 6 | 4 Participants |
| Unreliable | YNQ Score | YNQ score = 7 | 5 Participants |
| Unreliable | YNQ Score | YNQ score = 9 | 2 Participants |