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

Abstract

Background: Spiritual aspects of aphasia rehabilitation are poorly understood, though identified within adjustment. Existing spiritual health assessments have not been used with people with aphasia, and no structured program to facilitate intervention has been documented, despite acknowledgments that spirituality is important in health and wellbeing and distinct from quality of life and mental health.Aims: Mixed methods were used to investigate the accessibility and acceptability of a spiritual health assessment (SHALOM) and WELLHEAD, a toolkit originated by Mumby for spiritual health assessment and intervention, using the religiously neutral dimensions of 'WIDE, LONG, HIGH and DEEP'. Method: A Steering group (five people with aphasia) shaped the feasibility study cyclically, agreeing that 'Meaning and purpose' defined spirituality, and selecting SHALOM. WELLHEAD was modified collaboratively with the Steering group and Hospital Chaplain. A convenience sample of 10 people with aphasia (discharged from therapy) represented diverse aphasia histories, ages and religious backgrounds. Participants completed a two-hour session using SHALOM, the WELLHEAD toolkit and a feedback questionnaire within videorecorded interviews. Quantitative results from all three components were integrated with a qualitative thematic analysis in NVivo 11 including numerical and descriptive summaries verified by the participants, feedback interview transcripts and field notes with reflections. The thematic analysis was systematically and independently verified by a co-researcher. Feedback from participants was further verified by incorporating their comments from reviewing the overall findings. Results: Quantitative and qualitative feedback evaluated the materials positively. Thematic analysis provided evidence of the accessibility, acceptability and positive impact of WELLHEAD irrespective of aphasia severity or aetiology, and religious background. 'Belief', 'Faith' and 'Religion' were disambiguated. 3 SHALOM was also linguistically and cognitively accessible with communication support even for those with severe aphasia. Scores from WELLHEAD and SHALOM were compared and set into the context of wider standardisation of SHALOM, providing the first evidence of spiritual health measures in participants with aphasia. Conclusions: This preliminary work lays foundations for spiritual assessment and intervention in aphasia. Establishing the psychometric properties of SHALOM and WELLHEAD in people with aphasia requires a larger sample. Additional study of intervention is proposed, with clear potential for wider application of WELLHEAD in diverse settings and populations.

Characterizations of Resilience in Poststroke Aphasia

“…Twenty research reports described qualitative research, eight of which used a phenomenological approach (Brown et al, 2010(Brown et al, , 2011a(Brown et al, , 2011bGrohn et al, 2012Grohn et al, , 2014Lanyon et al, 2018;Panda et al, 2021;Pringle et al, 2010). Two articles reported on mixed-methods research (Bronken et al, 2012;Mumby & Roddam, 2021).…”

“…Of the 31 final articles reviewed, four articles were found using the search term "resilience" (Dietz et al, 2020;Hunting Pompon et al, 2018;Moss et al, 2021;Panda et al, 2021). Thirteen articles were found using "adaptation" (Brown et al, 2010(Brown et al, , 2011a(Brown et al, , 2011bDonnellan et al, 2012;Grohn et al, 2012;Hinckley, 2015;Laures-Gore et al, 2020;Moss et al, 2021;Northcott et al, 2021;Pringle et al, 2010;Wray et al, 2019Wray et al, , 2020Wray & Clarke, 2017), 14 articles were found using "adjustment" (Bronken et al, 2012;Grohn et al, 2012Grohn et al, , 2014Laures-Gore et al, 2020;Moss et al, 2021;Mumby & Roddam, 2021;Mumby & Whitworth, 2013;Musser et al, 2015;Nätterlund, 2010;Sherratt & Simmons-Mackie, 2016;Tregea & Brown, 2013;Wray et al, 2019Wray et al, , 2020Wray & Clarke, 2017), and 11 articles were found using "coping" (Armstrong et al, 2015;Bragstad et al, 2020;Dietz et al, 2020;DuBay et al, 2011;Harmon, 2020;Hjelle et al, 2019;…”

“…Eight articles focused on resilience and/or related terms as a primary aim of the study TOPICS IN LANGUAGE DISORDERS/JULY-SEPTEMBER 2022 (Bronken et al, 2012;Dietz et al, 2020;Donnellan et al, 2012;DuBay et al, 2011;Kirkevold et al, 2018;Moss et al, 2021;Mumby & Whitworth, 2013;Wray et al, 2019). For 13 articles, resilience and/or similar terms were part of an associated aim (Bragstad et al, 2020;Brown et al, 2010Brown et al, , 2011aBrown et al, , 2011bGrohn et al, 2012Grohn et al, , 2014Harmon, 2020;Hjelle et al, 2019;Hunting Pompon et al, 2018;Laures-Gore et al, 2020;Musser et al, 2015;Nätterlund, 2010;Wray et al, 2020), and 10 articles included these terms in tertiary findings or discussion (Armstrong et al, 2015;Hinckley, 2015;Lanyon et al, 2018;Mumby & Roddam, 2021;Northcott et al, 2021;Panda et al, 2021;Pringle et al, 2010;Sherratt & Simmons-Mackie, 2016;Tregea & Brown, 2013;Wray & Clarke, 2017).…”

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

“…A feasibility study of the WELLHEAD spirituality toolkit using a case series of 10 people with aphasia was conducted in a health service outpatient setting in accordance with health research authority ethical approval (Study reference: IRAS id 216 799 https://www.hra.nhs.uk/planning-and-im proving-research/application-summaries/research-summaries/aphasia-and-spirituality-toolkit-pilot -study-version-1/). The overarching findings are being reported in detail elsewhere, (Mumby and Roddam 2019; see also Mumby and Roddam 2018) with the focus here upon in-depth dialogue with a participant with TBI. Prior to the study, a steering group of people with aphasia collaborated with the researcher to select the spiritual health assessment, Spiritual Health and Life Orientation Measure (SHALOM (Fisher 2010)), from the existing published resources.…”

“…The measurements gathered using WELLHEAD supplemented the qualitative analysis, but they did not stand alone, being part of a prototype. The measures will form part of a larger data set concerning aphasia (including findings from the feasibility study being reported by Mumby and Roddam (2019)). Preliminary comparisons of SHALOM and WELLHEAD indicated that they were mutually compatible (see Section 3.4), and that the WELLHEAD interview provided rich data about personal perceptions and the processes involved in spirituality; not accessible from measurements alone.…”