‘You needed to rehab … families as well’: family members’ own goals for aphasia rehabilitation

Howe, Tami; Davidson, Bronwyn; Worrall, Linda; Hersh, Deborah; Ferguson, Alison; Sherratt, Sue; Gilbert, Jocelyn

doi:10.1111/j.1460-6984.2012.00159.x

Cited by 100 publications

(73 citation statements)

References 27 publications

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“…Therefore, knowledge of the nature of services could determine if all areas of the ICF are being addressed. For instance, services directed toward the environment such as providing communication partner training [12,13] and disseminating information to families [14,15] form an important part of aphasia intervention. Nevertheless, while speech pathologists acknowledge that family involvement and support are significant factors for people with aphasia to live successfully [16], involvement of families in actual practice may be limited [17].…”

Section: Introductionmentioning

confidence: 99%

Speech pathology services for people with aphasia: what is the current practice in Singapore?

Guo

Togher

Power

2013

Disability and Rehabilitation

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This research reveals several findings with considerable implications for practice planning and future direction in aphasia rehabilitation. There is a need for the development of locally relevant aphasia resources to enable comprehensive provision of aphasia services. In addition, further investigation is required to tackle the resource challenges faced by the profession and improve community support for people with aphasia. Implications for Rehabilitation Speech pathology services for aphasia in Singapore This article has identified the challenges of providing aphasia services in the Singapore context. Further investigation is required to address the key issues to improve aphasia services in Singapore. This includes developing locally relevant resources, looking at means like telerehabilition to tackle resource challenges, and improving community support for people with aphasia.

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Section: Introductionmentioning

confidence: 99%

Speech pathology services for people with aphasia: what is the current practice in Singapore?

Guo

Togher

Power

2013

Disability and Rehabilitation

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“…This figure underlines the extent of the burden of care that partners carry [26] [27]. Particularly partners who face the loss of communication abilities in their family member due to aphasia may struggle [28]. PWA are affected in language expression and /or language comprehension, both in spoken and in written language modalities, after acquired brain injury.…”

Section: Rationale For the Implementation Of A Cpt Programmementioning

confidence: 99%

ImPACT: a multifaceted implementation for conversation partner training in aphasia in Dutch rehabilitation settings

Wielaert

Sandt-Koenderman

Dammers

et al. 2016

Disability and Rehabilitation

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ImPACT: a multifaceted implementation for conversation partner training in aphasia inDutch rehabilitation settings. AbstractPurpose: Exploration of the clinical uptake of a novel conversation partner training (CPT) programme in aphasia in ten Dutch rehabilitation facilities and identification of its perceived facilitators and barriers in service providers, and the evaluation of the implementation methods used. Method:Ten rehabilitation centres took part in a multifaceted implementation of conversation partner training over thirteen months. Each centre selected two speech and language therapists to act as knowledge brokers whose role it was to raise awareness of CPT in the team and to facilitate getting partners of people with aphasia into the programme. The implementation was evaluated using analysis of recruitment data and questionnaires, supplemented by consensus data and scrutiny of implementation plans.Results: Successful implementation was described as 1) four dyads included during the intervention period, 2) two more dyads included after the intervention period, before the end of the study and 3) inclusion of Partners of Aphasic Clients Conversation Training (PACT) in a description of the logistics of local stroke care (stroke care pathway). Seven centres were successful in reaching the target inclusion of 6 dyads in total. Only one centre had care pathways in place. From a recruitment pool of 504 dyads, 41 dyads were recruited and 34 partners completed the implementation of PACT study (ImPACT). Observed facilitators included the motivation to engage partners in the rehabilitation process and the perceived added value of PACT. The perceived barriers focused on time limitations within current systems to discuss the consequences of PACT with relevant professionals and to establish allocated time for PACT within existing care routines. Conclusions:The motivation of professionals to involve partners in the rehabilitation process assisted with the introduction of PACT in practice. The main barrier was time, linked to the requirement to think through integration of this innovation within existing care. Longer term evaluation would ascertain how centres sustain uptake without support.

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“…53 Howe and colleagues interviewed family members of persons with aphasia and found numerous themes that described what was important to them in caring for the person with aphasia to be: included in rehabilitation, provided with hope and positivity, given information and support, to communicate with their family member, and to look after their own psychosocial health. 54 Ulatowska and associates analyzed narratives of persons with aphasia and found that the theme of family support was discussed often. Since that time, in 11 subsequent programs, almost all programs have had 10 participants and a wait list of potential participants.…”

Section: Comprehensiveness Of Aphasia Treatmentmentioning

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%

“…159,160 Interviews revealed changed interpersonal relationships, loss of autonomy, a need for respite and support, and a need to process their own grief. 6,54,[161][162][163] Given the impact aphasia has on family members, it is important to gain insight into family members' perceptions of an ICAP as well because ICAPS typically include the family member and, to some extent, address their needs too.…”

Section: Introductionmentioning

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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‘You needed to rehab … families as well’: family members’ own goals for aphasia rehabilitation

Cited by 100 publications

References 27 publications

Speech pathology services for people with aphasia: what is the current practice in Singapore?

Speech pathology services for people with aphasia: what is the current practice in Singapore?

ImPACT: a multifaceted implementation for conversation partner training in aphasia in Dutch rehabilitation settings

Outcomes of an Intensive Comprehensive Aphasia Program

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