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From the introduction: "There are two variants of fronto-temporal dementia: a behavioral variant (behavioral FTD, bvFTD, Neary et al. (1998)), which causes changes in behavior and personality but leaves syntax, phonology and semantics relatively intact, and a variant that causes impairments in the language processing system (Primary Progessive Aphasia, PPA (Gorno-Tempini et al., 2004). PPA can be subdivided into subtypes fluent (fluent but empty speech, comprehension of word meaning is affected / `semantic dementia') and non-fluent (agrammatism, hesitant or labored speech, word finding problems). Some identify logopenic aphasia as a FTD-variant: fluent aphasia with anomia but intact object recognition and underlying word meaning."
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Objective The first objective was to assess the psychometric properties of the 92-item Dutch Naming Test (DNT-92), developed to assess word finding difficulties in people with aphasia, using Item Response Theory (IRT). The second objective was to select suitable items for a short version with a discriminative purpose. Method This study has a retrospective, psychometric research design, in which 510 DNT-92-forms of people with aphasia and 192 DNT-forms of healthy participants were used for analyses. An IRT analysis was performed and information on the item- and person parameters was obtained. Item selection for the short version was based on a combination of the discriminative ability of the items and their estimated theta or difficulty. Items with the highest information load, and a difficulty parameter in the range of overlap between the sample of people with aphasia and healthy participants were selected. Results A 2-PL IRT analysis showed best fit to the data. Assumptions of unidimensionality, local independence, and monotonicity were met. Items were removed incrementally, whilst checking sensitivity and specificity of the remaining short form. A selection of six items proved optimal in terms of sensitivity and specificity, with an area under the curve value of 0.85. Differences were found between participants younger than 70 and older. Conclusions The IRT assumptions for the DNT-92 were met, indicating that the test has good psychometric properties. A reduction of items to just six items proved possible, leading to a reliable six item short form with a discriminatory purpose.
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Patients with poststroke aphasia have higher mortality rates and worse functional outcome than patients without aphasia. Nurses are well aware of aphasia and the associated problems for patients with stroke because they have daily contact with them. The challenge is to provide evidence-based care directed at the aphasia. Although rehabilitation stroke guidelines are available, they do not address the caregiving of nurses to patients with aphasia. The aim of this study was to explore the evidence on rehabilitation of stroke patients with aphasia in relation to nursing care, focusing on the following themes: (1) the identification of aphasia, (2) the effectiveness of speech-language interventions.The findings of this study can be used to develop nursing rehabilitation guidelines for stroke patients with aphasia. Further research is necessary to explore the feasibility of using such guidelines in clinical nursing practice and to examine the experiences of patients with nursing interventions directed at aphasia.