Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Aphasia and Communication in Everyday Life: Experiences of persons with aphasia, significant others, and speech-language pathologists
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aims of this thesis were to describe the experiences of persons with aphasia and their significant others of their conversations and use of communication strategies, examine current practice of family-oriented speech-language pathology (SLP) services, and test a family-oriented intervention in the early phase of rehabilitation.

The persons with aphasia valued having conversations despite perceiving their aphasia as a serious social disability. They acknowledged the importance of the communication partners’ knowledge and understanding of aphasia and their use of supporting conversation strategies. Their own use of communication strategies varied considerably. The persons with aphasia longed to regain language ability and to be active participants in society.

A majority of the significant others perceived their conversations with the person with aphasia as being less stimulating and enjoyable than conversations before stroke onset. Aphasia was considered a serious problem. The significant others took on increased communicative responsibility, where two thirds had changed their communicative behaviour to facilitate conversations. Type and severity of aphasia were especially related to the communicative experiences of the significant others and their motivation to be involved in SLP services.

Thirty percent of the speech-language pathologists worked with people with aphasia and typically met with their families. They considered the involvement of significant others in SLP services as very important, especially in providing information about aphasia and communication partner training (CPT). However, involvement of significant others was restricted because of a time shortage and perceived limited skills and knowledge. In addition, there were national differences regarding aphasia rehabilitation services.

The intervention consisted of three sessions directed to significant others (primarily emotional support and information) and three directed to the dyads (a person with aphasia and a significant other) (primarily CPT). All six participants (three dyads) felt that their knowledge and understanding of aphasia had increased and that their conversations had improved. These improvements were also evident to some extent with formal assessments.

These results suggest the following: CPT should be an integral part of SLP services, national clinical guidelines are needed, and further education of speech-language pathologists and implementation of new knowledge into clinical practice requires consideration.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. , 101 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 776
Keyword [en]
Aphasia, Significant others, Interpersonal communication, Communication strategies, Communication partner training, Speech-language pathology services
National Category
Medical and Health Sciences
Research subject
Medical Science
Identifiers
URN: urn:nbn:se:uu:diva-173130ISBN: 978-91-554-8372-2 (print)OAI: oai:DiVA.org:uu-173130DiVA: diva2:516701
Public defence
2012-06-08, Gustavianum, Akademigatan 3, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2012-05-16 Created: 2012-04-19 Last updated: 2012-08-01Bibliographically approved
List of papers
1. Communication difficulties and use of communication strategies: from the perspective of individuals with aphasia
Open this publication in new window or tab >>Communication difficulties and use of communication strategies: from the perspective of individuals with aphasia
2012 (English)In: International journal of language and communication disorders, ISSN 1368-2822, E-ISSN 1460-6984, Vol. 47, no 2, 144-155 p.Article in journal (Refereed) Published
Abstract [en]

Background:

To enhance communicative ability and thereby the possibility of increased participation of persons with aphasia, the use of communication strategies has been proposed. However, little is known about how persons with aphasia experience having conversations and how they perceive their own and their conversation partner's use of communication strategies.

Aims:

To explore how people with aphasia experience having conversations, how they handle communication difficulties, and how they perceive their own and their communication partners’ use of communication strategies.

Methods & Procedures:

Semi-structured interviews were conducted with four women and seven men with chronic aphasia (n = 11). Interviews were video-recorded, transcribed verbatim and analysed by qualitative content analysis.

Outcomes & Results:

Informants appreciated having conversations despite the fact that they perceived their aphasia as a serious hindrance. Different factors related to the informants, the conversation partners, the conversation itself and the physical environment were perceived to impact on conversations. The importance of the communication partners’ knowledge and understanding of aphasia and their use of supporting conversation strategies were acknowledged by the informants. The informants’ views on using communication aid devices or strategies varied considerably. Four themes that characterized the informants’ narratives were: loss and frustration, fear and uncertainty, shared responsibility based on knowledge, and longing for the past or moving forward.

Conclusions & Implications:

The informants longed to regain their former language ability and role as an active participant in society. To enhance participation of persons with aphasia, it is suggested that communication partner training should be an important and integral part of aphasia rehabilitation. Important elements of such training are reflecting on communication behaviours, training in real-life situations, and acknowledging each individual's special needs and preferences. To deal with the consequences of aphasia, counselling and psychological support may be needed.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-159493 (URN)10.1111/j.1460-6984.2011.00089.x (DOI)000300772000003 ()
Available from: 2011-10-03 Created: 2011-10-03 Last updated: 2017-12-08Bibliographically approved
2. Communication changes and SLP-services according to significant others of persons with aphasia
Open this publication in new window or tab >>Communication changes and SLP-services according to significant others of persons with aphasia
2012 (English)In: Aphasiology, ISSN 0268-7038, E-ISSN 1464-5041, Vol. 26, no 8, 1005-1028 p.Article in journal (Refereed) Published
Abstract [en]

Background: Significant others are important to persons with aphasia. For several reasons they should be involved in speech-language pathology (SLP) services, including acquiring facilitating communicative strategies and receiving support. In order to further adapt SLP services there is a need to know the perceptions and views of the significant others. Little is known about how they perceive changes in communication as well as received SLP services and in what way they want to be involved in these services.

Aims: The study aimed to investigate which communicative changes significant others of persons with aphasia had experienced after a stroke event and to what extent these changes were experienced. A further aim was to describe the significant others’ experiences of SLP services and their motivation to participate in these services. Finally, the significant others’ experiences were compared in terms of sex, age, type of relationship, time since stroke onset, and type and severity of aphasia.

Methods & Procedures: An 80-item study-specific questionnaire was answered by 173 significant others of persons with aphasia living throughout Sweden (response rate 69%). Of these, 33% were male and 67% female. Mean age was 64.2 years (range 33–87 years) and 85.5% of the participants were a cohabiting partner to a person with aphasia.

Outcomes & Results: A total of 64% of participants perceived their conversations as being less stimulating and enjoyable compared with conversations before stroke onset. Aphasia was considered a substantial or very substantial problem by 64%. The participants took on an increased communicative responsibility, and 70% had changed their communicative behaviour in order to facilitate conversations. A total of 75% (n = 130) had met with the SLP of the person with aphasia. Of those, 63% perceived their own support from SLP services to be adequate; 87% considered language ability training as the most important SLP service. Type and severity of aphasia were especially related to the communicative experiences of the participants and their motivation to be involved in SLP services.

Conclusions: The substantial decrease from pre- to post-stroke regarding enjoyment and meaningfulness of conversations suggests the need to further improve SLP services in order to help the people in question communicate at an optimal level. We suggest that clinicians should put more emphasis on explaining the benefits and availability of different kinds of aphasia rehabilitation services, such as functional communication training and communication partner training in addition to language ability training.

Keyword
Aphasia, Significant others, Interpersonal communication, Communication strategies, Speech-language pathology services
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-170408 (URN)10.1080/02687038.2012.671927 (DOI)000306607000003 ()
Available from: 2012-03-12 Created: 2012-03-12 Last updated: 2017-12-07Bibliographically approved
3. Working with families of persons with aphasia: a survey of Swedish speech and language pathologists
Open this publication in new window or tab >>Working with families of persons with aphasia: a survey of Swedish speech and language pathologists
2011 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 33, no 1, 51-62 p.Article in journal (Refereed) Published
Abstract [en]

Purpose:The overall aim was to investigate how speech and language pathologists (SLPs), in Sweden are working with people with aphasia and their families and what their professional experiences are.

Method:A cross-sectional study with a descriptive and comparative design. An 84-item study-specific questionnaire was sent to all Swedish SLPs, affiliated to SLOF (the Swedish professional association and trade union).

Results:The response rate was 72.5% (n = 758). Thirty per cent worked with people with aphasia and typically met with their families. The participants considered the involvement of families as very important, especially concerning providing information of aphasia and training of communication strategies. However, involvement of families was limited due to a shortage of time, but also to perceived limited skill and knowledge.

Conclusions:There was an evident discrepancy between what the participants claimed to be an important part of their work, and their actual practice. It is suggested that to facilitate family intervention, this should be explicitly expressed in both local and national guidelines. The content of the SLP education, and the need of further education and implementation of new knowledge into clinical practice also requires consideration.

Keyword
Aphasia services, speech-language pathology, family
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-134771 (URN)10.3109/09638288.2010.486465 (DOI)000284695100006 ()20455706 (PubMedID)
Available from: 2010-12-01 Created: 2010-12-01 Last updated: 2017-12-12Bibliographically approved
4. A multiple-case study of a family-oriented intervention practice in the early rehabilitation phase of persons with aphasia
Open this publication in new window or tab >>A multiple-case study of a family-oriented intervention practice in the early rehabilitation phase of persons with aphasia
2013 (English)In: Aphasiology, ISSN 0268-7038, E-ISSN 1464-5041, Vol. 27, no 2, 201-226 p.Article in journal (Refereed) Published
Abstract [en]

Background:

Having a family member with aphasia severely affects the everyday life of the significant others, resulting in their need for support and information. Family-oriented intervention programmes typically consist of support, information, and skill training, such as communication partner training (CPT). However, because of time constraints and perceived lack of skills and routines, such programmes, especially CPT, are not common practice among speech-language pathologists (SLPs).

Aims:

To design and evaluate an early family-oriented intervention of persons with stroke-induced moderate to severe aphasia and their significant others in dyads. The intervention was designed to be flexible to meet the needs of each participant, to emotionally support the significant others and supply them with information needed, to include CPT that is easy to learn and conduct for SLPs, and to be able to provide CPT when the persons with aphasia still have access to SLP services.

Methods & Procedures:

An evaluative multiple-case study, involving three dyads, was conducted no more than 2 months after the onset of aphasia. The intervention consisted of six sessions: three sessions directed to the significant other (primarily support and information) and three to the dyad (primarily CPT). The intervention was evaluated both qualitatively and quantitatively based on video recordings of conversations and self-assessment questionnaires.

Outcomes & Results:

The importance of emotional support as well as information about stroke/aphasia was clearly acknowledged, especially by the significant others. All significant others perceived increased knowledge and understanding of aphasia and related issues.

Communicative skills (as manifested in the video recordings) showed improvements from pre- to post-intervention.

Conclusions:

The results corroborate the need for individualised and flexible family-oriented SLP services that are broad in content. Furthermore, the results support the early initiation of such services with recurrent contact. The usefulness of CPT this early in the rehabilitation process was indicated but is yet to be proved.

Keyword
aphasia, significant others, interpersonal communication, communication strategies, communication partner training, speech-language pathology services
National Category
Medical and Health Sciences
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-173128 (URN)10.1080/02687038.2012.744808 (DOI)000316048700005 ()
Available from: 2012-04-19 Created: 2012-04-19 Last updated: 2017-12-07Bibliographically approved

Open Access in DiVA

fulltext(2515 kB)16182 downloads
File information
File name FULLTEXT01.pdfFile size 2515 kBChecksum SHA-512
c81ce839ef6281a0324c6f246c1d2c89577c47eadea237761337728625cc11e2af35400d93e576e913f29e7594ea2785fa87d0dd2fa3183f5176145fe3e84925
Type fulltextMimetype application/pdf
Buy this publication >>

Search in DiVA

By author/editor
Blom Johansson, Monica
By organisation
Research in Disability and Habilitation
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
Total: 16182 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

isbn
urn-nbn

Altmetric score

isbn
urn-nbn
Total: 6434 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf