Merske značilnosti slovenskega prevoda presejalnega testa ʺFrenchay aphasia screening test - FASTʺ

Hržič, Teja (author), Knavs, Suzana (author), Farago, Emica (mentor), Vidmar, Gaj (comentor)

Afazija je nevrološka motnja, ki vpliva na posameznikove sposobnosti sporazumevanja. Velikokrat nastane po možganski kapi kot posledica okvare govorno-jezikovnih področij v možganih. Težave pri osebi z afazijo je opaziti na področju izražanja, razumevanja, branja in pisanja. Za hitrejše prepoznavanje tovrstne motnje obstajajo presejalni testi. Z njimi lažje določamo potrebo po nadaljnjem logopedskem testiranju. Enderby idr. (1986) so za pomoč pri zgodnjem odkrivanju afazije zasnovali Frenchayski presejalni test za afazijo (angl. Frenchay Aphasia Screening Test, FAST). Ker v slovenskem kulturnem in jezikovnem prostoru ni nobenega standardiziranega presejalnega testa za afazijo, so se na Univerzitetnem rehabilitacijskem inštitutu Republike Slovenije – Soča odločili za prevod in prilagoditev testa FAST. Test je zasnovan tako, da oceni štiri glavne vidike jezika, ki so pogosto oškodovani pri osebah z afazijo. To so govor, razumevanje govora, branje in pisanje. Z magistrskim delom smo želeli preveriti merske značilnosti slovenskega prevoda presejalnega testa FAST. Preveriti smo želeli mejne vrednosti za določanje prisotnosti afazije na slovenski populaciji in ugotoviti, ali sta zanesljivost in veljavnost testa zadostni za uporabo FAST v slovenskem jezikovnem prostoru. Dodatno nas je zanimalo, ali sta spol in starost povezana z dosežki na testu. V raziskavo smo vključili 60 oseb iz splošne populacije, 35 oseb s kronično afazijo za preverjanje skladnosti med ocenjevalci in 50 hospitaliziranih oseb po možganski kapi za preverjanje sočasne veljavnosti. Rezultati so pokazali, da znotraj splošne populacije starejši udeleženci v povprečju dosegajo nižje število točk. Z enosmerno analizo variance smo potrdili, da povprečni dosežek med starostnimi skupinami statistično značilno linearno upada (p < 0,001), spol pa ni statistično značilno povezan z dosežki na testu FAST (p = 0,320). Najnižji dosežek pri testirancih, mlajših od 60 let, je znašal 28 točk, med starejšimi pa 25 točk. Preverili smo tudi ustreznost norm izvirne študije (Enderby idr., 1986), ki so se izkazale za ustrezne. Skladnost med ocenjevalci smo ocenili z intraklasnim korelacijskim koeficientom (ICC). Izkazala se je za skoraj popolno (ICC = 0,998; p < 0,001). Povprečne ocene ocenjevalcev so bile za skupni dosežek testa FAST med 18,7 in 18,8 točk. Vsebinsko veljavnost so potrdili trije strokovnjaki. Njihove ocene so pokazale, da sta sklopa govor in branje s tega vidika brezhibna, druga dva sklopa pa sta blizu temu. Za oceno sočasne veljavnosti smo rezultate FAST primerjali z zunanjo oceno logopeda, mestom možganske poškodbe in zdravnikovo napotitvijo bolnika na logopedski pregled. Rezultate smo ovrednotili s Cohenovim koeficientom κ. Izkazalo se je, da je FAST dosegel popolno občutljivost (100%) in najvišjo stopnjo skladnosti z zunanjo oceno logopeda (κ = 0,65; p ≤ 0,001), sledila je napotitev na logopedsko obravnavo (κ = 0,55; p ≤ 0,001). Pri kriteriju mesta možganske poškodbe je bila sočasna veljavnost najnižja (κ = 0,43; p ≤ 0,001). Specifičnost testa je bila najvišja pri napotitvi osebe na logopedsko obravnavo (82 %). Na podlagi rezultatov raziskave lahko sklenemo, da je FAST veljaven in zanesljiv za uporabo v slovenskem prostoru.

• Language: Slovenian
• Keywords: afazija
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: PEF - Faculty of Education
• Year: 2022
• PID: 20.500.12556/RUL-137554
• COBISS.SI-ID: 112323587
• Publication date in RUL: 23.06.2022

Secondary language

• Language: English
• Title: Measurement Characteristics of the Slovenian Translation of the Frenchay Aphasia Screening Test

Abstract

Aphasia is a neurological disorder that affects an individual’s ability to communicate. It often occurs after a stroke as a consequence of a damage to the speech-language areas in the brain. We observe problems in the areas of expression, comprehension, reading and writing in a person with aphasia. Screening tests have been developed for the purpose of faster identification of this type of disorder. By using them, it is easier to determine the need for further speech-language testing. Enderby et al. (1986) designed the Frenchay Aphasia Screening Test (FAST) to aid in the early detection of aphasia. As there is no standardised screening test for aphasia in the Slovenian cultural and linguistic space, the University Rehabilitation Institute in Ljubljana decided to translate and adapt the FAST test. The test is designed to assess four main aspects of language that are often impaired in people with aphasia: speaking, speaking comprehension, reading and writing. The aim of the thesis was to check the measurement characteristics of the Slovenian translation of the FAST screening test. We wanted to verify the thresholds for determining the presence of aphasia in the Slovenian population and to assess whether the reliability and validity of the test are sufficient for the use of FAST in the Slovenian language area. Additionally, we wanted to know whether gender and age are associated with the test scores. The study included 60 people from the general population, 35 people with chronic aphasia to assess inter-observer reliability, and 50 hospitalised people after stroke to assess concurrent validity. The results showed that within the general population, older participants scored less points on average. One-way analysis of variance confirmed that the average score statistically significantly decreased between age groups (p < 0.001), and gender was not statistically significantly associated with FAST scores (p = 0.320). The lowest test score in those under the age of 60 was 28 points, and among the elderly it was 25 points. We also checked the adequacy of the norms of the original study by Enderby et al. (1986), which proved to be appropriate. Agreement between assessors was estimated using intra-class correlation coefficient (ICC), and it proved to be almost perfect (ICC = 0.998; p < 0.001). The average scores of the assessors were between 18.7 and 18.8 points for the overall FAST score. Content validity was confirmed by three experts. Their ratings showed that the speech and reading sets are flawless in this regard, and the other two sets are close to that. To assess concurrent validity, FAST scores were compared to the external evaluation by a speech therapist, the location of the brain injury and the physician's referral of the patient to a speech therapy examination. The results were evaluated using Cohen κ coefficient. FAST was shown to achieve perfect sensitivity (100%) and a high degree of agreement with the external assessment of a speech therapist (κ = 0.65; p ≤ 0.001), followed by referral to speech therapy as the external criterion (κ = 0.55; p ≤ 0.001); using the site of brain injury as the criterion, concurrent validity was the lowest (κ = 0.43; p ≤ 0.001). The specificity of the test was the highest in the referral of a person to speech therapy (82%). Based on these results, we can conclude that FAST is valid and reliable for use in Slovenia.

• Keywords: aphasia