Living successfully with aphasia: A qualitative meta-analysis of the perspectives of individuals with aphasia, family members, and speech-language pathologists

Brown, Kyla; Worrall, Linda; Davidson, Bronwyn; Howe, Tami

doi:10.3109/17549507.2011.632026

Cited by 148 publications

(100 citation statements)

References 55 publications

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“…The clinician perspectives were then included in a meta-analysis of perceptions of persons with aphasia and family members. 10 Although some perspectives were similar, the meta-analysis highlighted the different perspectives clinicians may have and the importance of exploring the perspectives of all stakeholders.…”

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confidence: 99%

Clinician Perspectives of an Intensive Comprehensive Aphasia Program

Babbitt

Worrall

Cherney

2013

Topics in Stroke Rehabilitation

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Background: Intensive comprehensive aphasia programs (ICAPs) have increased in number in recent years in the United States and abroad. Objective: To describe the experiences of clinicians working in an ICAP. Methods: A phenomenological approach was taken. Seven clinicians from 3 ICAPs were interviewed in person or on the phone. Their interviews were transcribed and coded for themes relating to their experiences. Results: Clinicians described 3 major themes. The fi rst theme related to the intensity component of the ICAP that allowed clinicians to provide in-depth treatment and gave them a different perspective with regard to providing treatment and the potential impact on the person with aphasia. The second theme of rewards for the clinicians included learning and support, seeing progress, and developing relationships with their clients and family members. Third, challenges were noted, including the time involved in learning new therapy techniques, patient characteristics such as chronicity of the aphasia, and the diffi culty of returning to work in typical clinical settings after having experienced an ICAP. Conclusions: Although there is a potential for bias with the small sample size, this pilot study gives insight into the clinician perspective of what makes working in an ICAP both worthwhile and challenging.

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confidence: 99%

Clinician Perspectives of an Intensive Comprehensive Aphasia Program

Babbitt

Worrall

Cherney

2013

Topics in Stroke Rehabilitation

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“…Previous work has identified several overarching themes to successfully living with aphasia, which include; participation, meaningful relationships, support, communication, positivity, independence and autonomy, and succeeding as a journey over time (Brown, Worrall, Davidson & Howe, 2012). Some of these themes are evident in the experiences of these two individuals.…”

Section: Patterns In the Individual Performance Of Participants With mentioning

confidence: 99%

Performance-based measurement of participation for people with aphasia: using an iPhone application to measure talking time in everyday life

Brandenburg

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People with aphasia often experience reduced participation in life roles as a result of their communication disorder. The aims of this thesis were to 1) develop an iPhone application (CommFit™) which measures talk time and was easily used by people with aphasia, and 2) to use the app to explore talk time as a possible performance based indicator of participation, as a supplement to currently used self-report measures. This thesis used the International Classification of Functioning, Disability and Health (ICF) as a framework for defining participation and structuring the research.The first (preparatory) phase of this thesis involved reviewing the current state of research in the areas of participation assessment and mobile technology use, in order to inform development of the CommFit™ app. In the first stage of preparation, the concept of participation was reviewed and current self-report measures of participation restriction were crosswalked to ICF categories. Ninety instruments (2,426 items) were coded and of these, 29 instruments contained over 50% participation items. The crosswalk showed that many of the current measures for this population are not participation focused, according to the operational definition of participation developed in this thesis. The Subjective Index of Physical and Social Outcome (SIPSO) emerged from this study as a measure which contained mostly participation content, had been validated with a stroke population, and was appropriate in both format and time required to be used by people with language difficulties. Thus, the SIPSO chosen as the measure of participation for use in the second phase of this research.The second stage of the preparatory phase consisted of a review of the use of mobile technology by people with aphasia, stroke survivors and elderly people. The review focused on synthesising the literature into a list of technology design features that facilitate technology use for this population.These features were; use of multimodal communication, utilisation of aphasia-friendly text features, large buttons, stable interface, simple navigation and lack of visual clutter. These features were integrated into the design and development of an iPhone app which measured talk time-the CommFit™ app.The last stage of the preparatory phase involved a small but in depth study investigating the development and accuracy of CommFit™. The iterative process of developing the CommFit™ app to be aphasia-friendly was described in detail. In the accuracy study, the talk time logged by the app was compared to talk time obtained from a continuous recording. Three non-neurologically ii impaired participants who recorded their daily talk for a total of 10 hours in different environments.Accuracy of the app was found to be satisfactory at ±4% of the true talking time in ideal or silent environments and ±13% in everyday environments. The end result of the preparatory phase was a valid, usable app for counting talk time.The second phase of this research explored the use of CommFit™ to count ...

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“…The importance of addressing the activity/participation level has been influenced by concepts embedded within the life participation approach and the challenge of living successfully with aphasia. 47, 48 Brown et al found that persons with aphasia reported several themes related to living successfully with aphasia, including the importance of meaningful relationships and its sub-themes of "acceptance and understanding" and "social companionship." 49 An ICAP addresses these sub-themes by bringing together a cohort, a group of participants who begin and end the program together.…”

Section: Comprehensiveness Of Aphasia Treatmentmentioning

confidence: 99%

“…Other qualitative and quantitative research has found that participants and family members endorse the importance of social networks and that a lack of social networks/support can lead to poor psychosocial health and poor quality of life. 12,48,68,117,172,193,194 …”

Section: Therapeutic Milieumentioning

confidence: 99%

“…The Director discusses suitability for the program, the structure of the day and the therapy that is provided. Participants are required to send in an application with a medical doctor's diagnosis of aphasia (and medical clearance to participate for the four weeks), most recent speech therapy notes, and intake information about current physical abilities, medications, work and education background, 4,48,54,[65][66][67] In one study,…”

Section: Comprehensiveness Of Aphasia Treatmentmentioning

confidence: 99%

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Outcomes of an Intensive Comprehensive Aphasia Program

Babbitt¹

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Intensive comprehensive aphasia programs (ICAP) have increased over the last decade in the US and abroad. The increase in the number of clinical programs has outpaced the research that is necessary to establish the efficacy and effectiveness of these specialized treatment programs. The ICAP model incorporates principles from neuroplasticity, that is, intensive treatment provides a platform for the massed practice and repetition required to change the brain. It also incorporates comprehensive treatment that addresses not only impairment-based language deficits but also personal goals related to participation.Programs which offer intensive comprehensive treatment can provide up to 120 hours of treatment over several weeks (e.g., six hours a day, five days a week for four weeks). ICAPs are different from other types of aphasia services which generally provide two to three hours of therapy a week. This thesis examined one ICAP in depth to describe the structure, process, and outcomes using Donabedian's model of health care evaluation. This thesis also described the experiences of the ICAP from the perspectives of the primary stakeholders.Study One (Chapter Two) was a retrospective quantitative study using behavioral measures from an existing database that documented the outcomes of participants with aphasia. It found that first-time participants improved significantly in impairment-and participationbased measures, demonstrating moderate to large effect sizes. Participant characteristics were examined to determine if improvements were related to age, time post-onset, or type and severity of aphasia. None of these factors had an impact on the amount of change measured. Given that some participants did not make significant gains on a primary outcome measure, the Western Aphasia Battery -Revised Aphasia Quotient (WAB-R AQ), Study Two (Chapter Three) examined whether participant characteristics at baseline could predict who would make significant gains on the WAB-R AQ. Age and months post-onset were significantly different between the responder and the non-responder groups. Those who showed most gains on average were younger and a longer time post-onset. A logistic regression was performed and results indicated that only age (younger participants) predicted who would respond to treatment. Time post-onset, type and severity of aphasia, naming, non-verbal cognition, and communication confidence did not show significance in a predictive model. Studies Three and Four were qualitative studies involving interviews with therapists (Chapter Four) and people with aphasia and their families (Chapter Five). Both studies were 3 conducted using a phenomenological approach which allowed for the interviewees to describe their experiences in a semi-structured interview. The clinicians described the intensity of the therapy, the rewards, and challenges of the program. Therapists also considered that the ICAP model of service delivery had several positive benefits for them, but acknowledged that the intensity of therapy was challe...

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Living successfully with aphasia: A qualitative meta-analysis of the perspectives of individuals with aphasia, family members, and speech-language pathologists

Cited by 148 publications

References 55 publications

Clinician Perspectives of an Intensive Comprehensive Aphasia Program

Clinician Perspectives of an Intensive Comprehensive Aphasia Program

Performance-based measurement of participation for people with aphasia: using an iPhone application to measure talking time in everyday life

Outcomes of an Intensive Comprehensive Aphasia Program

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