A Single Case Narrative of Spirituality Following Aphasia from Traumatic Brain Injury: Findings about Forgiveness and Freedom Using WELLHEAD and SHALOM

Abstract

Rehabilitation has neglected the spirituality of people with aphasia, a neurogenic impairment of language for communication and thought processes. Aphasia reduces scope for adjustment processes where words are normal currency, such as forgiveness and reconciliation. A single case narrative was generated from a case series exploring the feasibility of spiritual health assessment in aphasia. The individual had traumatic brain injury, with the primary symptom of aphasia, giving the first detailed account of its kind. The WELLHEAD spirituality toolkit provided a structured interview approach, exploring spirituality in terms of ‘meaning and purpose’ within four dimensions, WIDE, LONG, HIGH and DEEP, incorporating patient-reported outcome measures and goal-setting, with feedback interviews. Spiritual Health and Life Orientation Measure (SHALOM) generated a comparator spiritual health assessment. The quantitative feedback measures and self-reported outcomes were complemented by detailed qualitative interview transcripts subject to systematic thematic analysis in NVivo. The findings were co-constructed and systematically verified. This non-religious narrative evidenced the accessibility, acceptability, and impact of the resources. Self-forgiveness was paramount for freedom to journey into the unknown beyond self with ‘Calm’, towards helping others and accepting help. Religion, Faith and Belief were reconceptualised. Forgiveness of self and others was integral and instrumental in recovery, offering avenues for further investigation and application.

Religiosity, Spirituality, Healthcare, and Aphasia Rehabilitation

“…In a series of studies and perspectives, MacKenzie and Mumby along with colleagues have developed a line of inquiry exploring religion and spirituality in persons with aphasia (MacKenzie, 2016;MacKenzie & Marsh, 2019;Mumby, 2019;Mumby & Grace, 2019;Mumby & Roddam, 2021;MacKenzie & Mumby, 2022). For instance, MacKenzie and Mumby (2023, p. 65) provided accounts from age and occupation-diverse persons with aphasia, noting that religion and spirituality are not the same thing.…”

Aphasia and Spirituality: the feasibility of assessment and intervention using WELLHEAD and SHALOM

“…Confidential one-to-one liaison concerning specific results was provided by email with prior consent, and in a limited way in private one-to-one conversations at the feedback sessions. Participants were encouraged to take a role in wider dissemination (contribution to conference presentations, feedback to local stroke-related groups, input into drafting papers where feasible), as exemplified in Mumby (2019).…”

“…The third phase of analysis used additional transcription of the WELLHEAD interviews to provide more extensive thematic exploration concerning individual spirituality in comparison with the summaries. (An example of a Phase 3 narrative may be found in Mumby, 2019). This description of Phase 3 here is important as it gives appropriate fuller context to the participant feedback.…”