Preliminary outcomes from a pilot study of personalised online supported conversation for participation intervention for people with Aphasia

Abstract

Background: Aphasia negatively impacts face-to-face social participation and the difficulties that people experience using the phone exacerbate these challenges in staying in touch with family and friends. Videoconferencing enables multimodal communication, and teamed with supported conversation, could facilitate access to conversation and thereby increase social participation for people with chronic aphasia. Aims: This pilot study examined whether supported conversation provided over Skype could improve people's social participation. It reports on preliminary outcomes of this intervention on people's social network, communication confidence, aphasia-related quality of life and mood. Methods & Procedures: 29 participants with chronic aphasia received an initial 2-hour technology training session followed by 16hours of online supported conversation for participation intervention provided by qualified or student speech and language therapists. Intervention was personalised by individualising goals in technology, communication and participation. An observational prospective cohort study design was used with baseline, immediately post-intervention, and 8-week follow-up assessments. Measures of social network and communication confidence (primary outcome measures), and aphasia-related quality of life, life participation, and mood (secondary outcome measures) were undertaken. Shapiro-Wilk tests were conducted to examine normality of distributions of each of the variables. Where data were normally distributed, one-way repeated measures ANOVAs were used to examine the effect of time. Where data were not normally distributed, Wilcoxon Signed Ranks test was used.Outcomes & Results: 27 participants completed the intervention. As a group, participants reported significantly more social contacts, more life participation, and higher aphasia-related quality of life post-intervention, which were maintained. There was a group gain on the measure of communication confidence post-intervention, although this was not maintained. As a group, participants' mood did not significantly change through intervention and follow-up. Individual variability was noted across all outcome measures.Conclusions: These preliminary findings suggest that relatively low dose and non-intensive online supported conversation for participation intervention delivered by qualified or student speech and language therapists improved social participation in some people with aphasia and improved their quality of life. Communication confidence also improved for some, although benefits were short-term. Findings make novel contributions to the existing supported conversation evidence base with positive social participation and quality of life outcomes, likely achieved by the explicit participation focus. Whilst preliminary findings are positive, study limitations need addressing. Further investigations are merited to refine the intervention and outcome measure choice, and capture feasibility data. Finally, a definitive controlled trial is needed to explore clinical e...

Coproducing Knowledge of the Implementation of Complex Digital Health Interventions for Adults with Acquired Brain Injury and their Communication Partners: Protocol for a Mixed Methods Study

“…Communication partners, clinicians and industry or research experts were emailed a link to complete electronic participant information and consent forms. Participants with ABI were invited to provide informed written consent using accessible, plain English participant information and consent forms that were adapted to incorporate visual supports and explained via video call by a qualified speech-language pathologist using supported communication strategies [ 41 ]. Screening for the capacity to consent is described in the inclusion criteria (the screening protocol is also included as Multimedia Appendix 1 ) [ 42 ].…”

“…Supporting videos explaining each question are available in Multimedia Appendices 3 - 9 . Author MRW, who has living experience of ABI, notes “the video clips that were provided meant we were able to watch it repeatedly to get our ideas out.” Clinician coauthor MW notes that the adaptations made to ensure the accessibility of surveys and videos reflects “the critical nature of these supports in enabling participants with unique needs secondary to ABI to be involved in this research.” For participants with ABI, this survey was administered by a speech-language pathologist (MM) via video teleconference, using supported communication techniques [ 41 ].…”

“…To coproduce knowledge of each of the above priority domains, author MM synthesized and presented the stakeholders with (1) relevant preliminary research findings from a concurrent systematic review underpinned by the NASSS framework [ 52 ] and (2) relevant qualitative data from the prioritization survey, based on deductive content analysis [ 51 ] using the NASSS framework [ 46 ] ( Multimedia Appendix 10 ). All information was presented using visual supports and scaffolds via Microsoft PowerPoint (Microsoft Corporation) in plain English using supported communication techniques [ 41 ]. Author BM notes from living experience that the “acknowledgement and unhurried language” of these communication techniques allows “for more candid, useful answers.” Author MRW also reflects “the slide meant you were able to understand what the study was all about.”…”

Allied health professionals: A promising ally in the work against health inequalities- A rapid review

“…However, given that policies vary across countries and patients' groups, AHP services are not universally accessible, and it has been found that socio-economic deprivation is associated with barriers in access to AHP services even in contexts where there is universal access to healthcare overall [ 9 , 10 ]. Furthermore, AHP services when provided without serious consideration of the recipients' needs can in their turn increase inequalities [ [11] , [12] , [13] ]. Such findings obscure the landscape around the role of AHPs in reducing health inequalities and stress the need for comprehensive evidence.…”

Medidas de Calidad de Vida en Personas con Afasia. Revisión Sistemática

“…Unido a la importante afectación del lenguaje y la comunicación, con consecuencias duraderas según , las PWA informan de diferentes condiciones negativas derivadas de la afasia y que interfieren en su vida cotidiana: una menor participación y disminución de la satisfacción en las relaciones y actividades sociales, aislamiento, dificultad para controlar sus emociones, dificultad con las actividades de autocuidado diario, dependencia física, pérdida de autonomía, cambios en la dinámica y roles familiares y en general, una disminución en la calidad de vida (CdV) , Cruice, Woolf, Caute, Monnelly, Wilson y Marshall, 2020Fotiadou, Northcott, Chatzidaki y Hilari, 2014). Además, estas condiciones afectan en mayor proporción a las PWA que a los supervivientes de ACV sin afasia (Mizoon, Lyden, Brady y VISTA, 2015).…”