The Long-Time Effects of Group Therapy Intervention on Marriage Communication Between Fluent and Non-Fluent Aphasic Patients and Their Spouses: Who Benefits the Most?

Abstract

Our study aims to assess the long-time effects of group therapy intervention on marriage communication between fluent and non-fluent aphasic patients and their spouses. From the initial cohort of 150 couples four experimental groups have been selected, each comprising 20 subjects: (1) patients with fluent aphasia (FAP) (2) patients with fluent aphasia spouses (FAPS) (3) patients with non-fluent aphasia (NFAP) (4) patients with non-fluent aphasia spouses (NFAPS). All aphasic patients had mild or moderate fluent or nonfluent aphasia, as confirmed by the Cracow Neuropsychological Battery for Aphasia Examination – CNBA (Pąchalska, 1999). To assess the 3 aspects of interactions between spouses: support, engagement and depreciation we use the Communication in Marriage Questionnaire – KKM scores (Kaźmierczak, Plopa, 2008). These patients attended the groups sessions administered according to Pąchalska’s Model of Aphasia Group Therapy (1991a; 1991b) . It was found that after the long-time group intervention the experimental and the control groups of aphasic patients as well as their spouses differ one from another. NFAP as well as FAP therapy patients had higher KKM scores in the support received from their spouses and their spouses engagement in communication and lower scores in depreciation in their spouses’ behavior than did the controls. Also NFAPS evaluated support and engagement expressed by their aphasic partner higher than the control group. However FAPS and the control group KKM scores were quite similar, except for the support expressed by their aphasic partner. Long-time group therapy for patients with aphasia with the presence of caregivers not only improves the communication with significant others but also it is associated with better marital interactions and communication after therapy as reflected in the KKM scores than in the case of the controls, and improves the patient’s and caregivers’ perception of quality of life.

Systematic Review of the Evidence for Stroke Family Caregiver and Dyad Interventions

“…40 Aside from the largest study with 349 caregivers, 24 there were 5 studies with over 100 caregivers or dyads 19,26,28,33,34 ; however, 2 of the studies reported findings using the same sample. 33,34…”

“…40 Aside from the largest study with 349 caregivers, 24 there were 5 studies with over 100 caregivers or dyads 19,26,28,33,34 ; however, 2 of the studies reported findings using the same sample. 33,34 Interventions Detailed descriptions of content and procedures for the intervention and control conditions were provided in each of the 18 articles. Only 1 study reported blinding of participants to the type of intervention they received.…”

“…Smaller pilot studies typically lack power for hypothesis testing and result in questionable effect size estimates for larger studies, and are prone to type I errors if results are significant, or type II errors if results are not significant. 40 Aside from the largest study with 349 caregivers, 24 there were 5 studies with over 100 caregivers or dyads 19,26,28,33,34 ; however, 2 of the studies reported findings using the same sample. 33,34 Interventions Detailed descriptions of content and procedures for the intervention and control conditions were provided in each of the 18 articles.…”

Couple and family interventions for high mortality health conditions: A strategic review (2010–2019)

“…The remaining nine studies were categorized as experimental interventions (Attard et al, 2018; Karahan et al, 2014; Kim et al, 2012; Mackenzie et al, 2012; Malini, 2015; Mores et al, 2018; Orłowska et al, 2018; Saldert et al, 2015; Song et al, 2011). Most of these interventions were created for couples and families but did not have clear descriptions of or strong foundations for their couple or family intervention.…”

“…Most of these interventions were created for couples and families but did not have clear descriptions of or strong foundations for their couple or family intervention. Whether possibly efficacious or experimental, the studies that comprised high family inclusion ( n = 13; see Table S2g) revealed improved family functioning (Bishop et al, 2014; Cheng et al, 2018), less criticism (Bishop et al, 2014), better social support (Cheng et al, 2018; Ostwald et al, 2014), lower caregiver burden (Kim et al, 2012; Mei et al, 2018; Mores et al, 2018), more frequent sexual activity (Song et al, 2011), and improved communication (Orłowska et al, 2018; Saldert et al, 2015) and family strengths (Malini, 2015). Even those with moderate family inclusion ( n = 6; see Table S2g) showed at least some positive results for both stroke survivors and caregiver/family members, including psychological benefits (e.g., reduced depression, anxiety, caregiver burden/stress, or improved positive coping skills) and physical health improvements (e.g., health status).…”