ABSTRACT

Background

Definitions reflect the current state of knowledge about a health condition. An agreed definition of aphasia is central to the progression of the science and clinical practice relevant to aphasia.

Aim

To establish consensus on a definition of aphasia.

Methods & Procedures

A three-round modified e-Delphi study was conducted with aphasia researchers who were members of the Collaboration of Aphasia Trialists (CATs). In round one, participants were provided with a draft definition developed by the Societal Impact and Reintegration Working Group of CATs. Participants were asked whether they agreed with the definition and were asked to comment on any aspects that they perceived to require amendment. Comments were collated and analysed using inductive content analysis. In round two, participants were presented with the collated and de-identified results of the first round and the participants were asked to vote “yes/no” on two contentious aspects of the definition. In round three, agreement on the revised definition was again sought using closed “yes/no” voting. Consensus was defined a priori as at least 70% agreement by 80% of all CATs members. CATs membership fluctuated across the study period and ranged between 131 and 141 members.

Outcomes & Results

The proposed definition was Aphasia is a communication disability due to an acquired impairment of language modalities caused by focal brain damage. Aphasia may affect participation and quality of life of the person with aphasia as well as their family and friends. Aphasia masks competence and affects functioning across relationships, life roles and activities, thereby influencing social inclusion, social connectedness, access to information and services, equal rights, and wellbeing in family, community and culture.

Two main categories of proposed amendments to the definition were identified: (1) definition of aphasia as a communication disability versus a language impairment; and (2) definition of aphasia as being the result of a focal and/or diffuse lesion. After three rounds of surveys, consensus was unable to be achieved with an almost even split across participants on both amendment issues.

Conclusion

Further debate about the use of the term communication disability to describe aphasia and whether aphasia is a result of focal or diffuse lesions is required before consensus is again attempted.

中文翻译：

---

就失语症的定义达成共识：国际失语症研究人员的 e-Delphi 研究

摘要

背景

定义反映了有关健康状况的当前知识状态。失语症的公认定义对于与失语症相关的科学和临床实践的进展至关重要。

目的

就失语症的定义达成共识。

方法和程序

与失语症试验者合作组织 (CATs) 成员的失语症研究人员进行了三轮改进的 e-Delphi 研究。在第一轮中，向参与者提供了由 CAT 的社会影响和重新融入工作组制定的定义草案。参与者被问及他们是否同意该定义，并被要求对他们认为需要修改的任何方面发表评论。使用归纳内容分析对评论进行整理和分析。在第二轮中，向参与者展示了第一轮的整理和去识别的结果，并要求参与者就定义的两个有争议的方面投票“是/否”。在第三轮中，再次使用封闭的“是/否”投票寻求就修订定义达成一致。共识是先验的80% 的 CAT 成员至少 70% 同意。CATs 成员在整个研究期间波动，范围在 131 到 141 之间。

结果和结果

提出的定义是失语症是由于局灶性脑损伤引起的语言方式获得性损伤导致的交流障碍。失语症可能会影响失语症患者及其家人和朋友的参与和生活质量。失语症掩盖了能力并影响跨关系、生活角色和活动的功能，从而影响社会包容、社会联系、获取信息和服务、平等权利以及家庭、社区和文化中的福祉。

确定了对定义的两大类拟议修订：（1）将失语症定义为沟通障碍与语言障碍；(2) 将失语症定义为局灶性和/或弥漫性病变的结果。经过三轮调查，未能达成共识，参与者在两个修正案问题上几乎均分。

结论

在再次尝试达成共识之前，需要进一步辩论使用术语交流障碍来描述失语以及失语是局灶性还是弥漫性病变的结果。