Nursing Care of Clients with Impaired Communication

Abstract

Communication is a universal, dynamic process by which human beings exchange ideas and express needs. Strokes are a major cause of impaired communication, and rehabilitation nurses work closely with these clients and their families to help them cope with deficits, especially aphasia. This article defines speech and language and their physiological and psychosocial aspects, as well as three types of aphasia. Finally, nursing interventions for clients with impaired communication are suggested.

Expressive aphasia in glioblastoma multiforme patients: An application of content methodology

“…Aphasia is impairment of the capacity to interpret and formulate language symbols (Boss, 1984a;Darley, 1982). It is caused by damage to the brain's dominant hemisphere (Adkins, 1991;Pimental, 1986), which may be of a vascular, neoplastic, traumatic, degenerative, metabolic or infectious origin (Boss, 1984a). The loss of language ability is multimodal (Adkins, 1991), incorporating verbal, written and gestural expression (Darley, 1982), and can range in severity from mild to severe (Adkins, 1991;Boss, 1984a;Pimental, 1986).…”

“…Patients with expressive aphasia manifest specific behaviours. They may demonstrate nonfluent, telegraphic speech patterns (Adkins, 1991;Boykin, 1984;Pimental, 1986;Sloman, 1981) and decreased overall verbal output (Blanco, 1982;Boss, 1984a;Pimental, 1986). The term telegraphic describes speech in which substantive content is expressed, but articles, prepositions and conjunctions may be omitted (Boss, 1984a) as in, for example, "Go bathroom" instead of "I need to go to the bathroom."…”

“…Copyright 1992 1993). The patient may not be able to name objects (Adkins, 1991;Boss, 1984a;Pimental, 1986), although Blanco (1982) has stated that patients' object naming may be better than their spontaneous speech. There are inconsistencies in the literature concerning the ability to repeat language.…”

“…Also, patients with expressive aphasia often recognize their mistakes and, therefore, may attempt to correct their language output (Boss, 1984a). However, the recognition of errors can cause them to feel frustration, depression, embarrassment, irritation and anger (Adkins, 1991;Boss, 1984a;Buckwalter, Cusack, Sidles, Wadle & Beaver, 1989;Keller, Tanner, Urbina & Gerstenberger, 1989). After reviewing the literature, the following working definition of expressive aphasia was developed: Expressive aphasia is the loss of language ability resulting from damage to the Broca's area of the brain, which affects verbal and written expression of feelings and needs.…”

“…Do not respond for the patient or finish his/her sentences. (Adkins, 1991) • Ask the patient only one question at a time. This allows for the time that the patient requires to answer.…”