Consequences of stroke and aphasia according to the ICF domains: Views of Portuguese people with aphasia, family members and professionals

Abstract

This is the accepted version of the paper.This version of the publication may differ from the final published version. Background: Addressing the long-term consequences of stroke is a top-ten research priority (Pollock, St George, Fenton, & Firkins, In Press), and understanding the views of different stakeholders is essential in designing appropriate patient-centred multidisciplinary rehabilitation. Permanent repository linkAims: This study reports on the perspectives of 38 individuals who live with or work with aphasia: people with aphasia (PWA), family members and friends (FM), and speech and language therapists (SLTs), about its consequences in the daily lives of people with aphasia. Method & Resources:Fourteen PWA, 14 FM, and 10 SLTs participated in the study. All participants were interviewed about the consequences of stroke and aphasia. Small focus groups were used with some participants. In-depth semi-structured interviews were used with other participants. Interviews were carried out in groups or individually in order to accommodate severe aphasic impairments, or respondents with fewer years of education. Interviews were video or audio-recorded. Verbal and non-verbal communication was transcribed and analysed qualitatively using content analysis. Data was coded and mapped onto the ICF framework. Outcomes & Results:All three groups reported consequences in Body Functions and Body Structures, primarily in Mental Functions (Specific Mental Functions and Global Mental Functions) Conclusions: PWA, FM and SLTs reported a considerable range of stroke and aphasia consequences in the daily life of those who live with it. They were concerned to different degrees with language, physical, and emotional changes, and impact on communication, mobility, self-care, relationships, leisure and work. Professionals' practices in Portugal need to be changed in order to consider these findings.Keywords: aphasia; consequences; ICF; family members; clinicians. INTRODUCTION BackgroundStroke is considered the third leading cause of death and permanent disability in developed countries (Direcção Geral de Saúde (DGS) -Portuguese "Central Health Agency" 2010). In Portugal, stroke is the first cause of death (DGS, 2008) and disability (DGS, 2010;Martins, 2006) and is therefore one of the most frequent diseases causing hospitalisation (Ferro & Pimentel, 2006). Aphasia is a common consequence of stroke, affecting one third of the stroke population (Darrigrand et al., 2011;Kelly, Brady, & Enderby, 2010), and has a significant onward impact on people's lives (Martin, Thompson, & Worrall, 2008). Addressing the long-term consequences of stroke is a top-ten research priority, and includes helping stroke survivors and their families cope with speech problems (Pollock et al., In Press).Qualitative interview-led research of the 1990s revealed diverse consequences of aphasia and stroke. People reported obvious difficulties associated with impaired language, including effort in communicating, and difficulties with speaking, speaking in a grou...

The Evidence of Interdisciplinary Teamwork in the Rehabilitation of Stroke Patients with Aphasia

“…In the assessment the main areas of language comprised; auditory, comprehension, [19]. However, such tools are not always appropriate for persons with aphasia.…”

“…Collaboration between SLTs, PWA and FMs is important for the provision of appropriate rehabilitation [18] [19].…”

“…The interdisciplinary team should cooperate and include FMs to contribute to improvements, even for chronically aphasic persons [19].…”

“…Assessment of activity, participation and environment is important [11] [14] [19]. A user-friendly Aldous et al…”

“…Assessment tools that explore the whole person are useful for the rehabilitation of lan- The ICF domains are fundamental for the development of new tools [19]. Assessment of activity, participation and environment is important [11] [14] [19].…”