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Sather TW, Strong KA. Supporting Participation Through Project-Based Intervention: A Tutorial for Working With People With Aphasia in Individual Sessions. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-14. [PMID: 39240835 DOI: 10.1044/2024_ajslp-24-00094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2024]
Abstract
PURPOSE Participation is an integral focus of services to people with aphasia and is considered best practice within the scope of practice for speech-language pathology. The Life Participation Approach to Aphasia encourages meaningful participation in life for people living with aphasia. In theory, providing participation-based services to people with aphasia seems logical; however, embedding these constructs of participation into practice can be challenging for speech-language pathologists (SLPs). Project-based intervention (PBI) provides an authentic opportunity to target participation and support identity reformulation in aphasia intervention. Historically, projects have been provided primarily in group-based settings, which may be difficult for the majority of SLPs who primarily offer individual sessions due to reimbursement. This tutorial provides a framework for using PBI in individual sessions for clients with aphasia using five evidence-based components: (a) shared decision making, (b) patient-reported outcomes, (c) goal setting, (d) the project, and (e) ongoing evaluation. Evidence-based tools and a case example are provided to support each component. CONCLUSIONS Projects and PBI provide tangible means of placing participation at the center of intervention while also providing opportunities to target language impairments, identity reconstruction, and various environments in a meaningful and personalized way. Projects can be scaled to the client's needs and abilities as well as to the constraints and options of the service delivery setting.
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Affiliation(s)
- Thomas W Sather
- Department of Communication Sciences and Disorders, University of Wisconsin-Eau Claire
| | - Katie A Strong
- Department of Communication Sciences and Disorders, Central Michigan University, Mount Pleasant
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Wong MNK, Cheung MKT, Ng YM, Yuan HL, Lam BYH, Fu SN, Chan CCH. International Classification of Functioning, Disability, and Health-based rehabilitation program promotes activity and participation of post-stroke patients. Front Neurol 2023; 14:1235500. [PMID: 38020626 PMCID: PMC10657202 DOI: 10.3389/fneur.2023.1235500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Background The International Classification of Functioning, Disability, and Health (ICF) model has been applied in post-stroke rehabilitation, yet limited studies explored its clinical application on enhancing patients' Activity and Participation (ICF-A&P) level. Purpose This study gathered evidence of the effects of an ICF-based post-stroke rehabilitation program (ICF-PSRP) in enhancing community reintegration in terms of ICF-A&P of post-stroke patients. Methods Fifty-two post-stroke patients completed an 8 to 12 weeks multidisciplinary ICF-PSRP after setting personal treatment goals in an outpatient community rehabilitation center. Intake and pre-discharge assessments were administered for primary outcomes of Body function (ICF-BF; e.g., muscle strength) and ICF-A&P (e.g., mobility), and secondary outcomes of perceived improvements in ability (e.g., goal attainment and quality of life). Results There were significantly higher levels in the ICF-BF and ICF-A&P domains, except cognitive function under the ICF-BF. Improvements in the primary outcomes predicted corresponding secondary outcomes. Firstly, expressive and receptive functions (ICP-BF) were mediated by the everyday language (ICF-A&P) which predicted patients' satisfaction with the language-related quality of life. Secondly, upper extremity function (ICP-BF) was mediated by the lower extremity mobility (ICF-A&P) predicting work and productivity-related quality of life. Content analyses showed that combined ICF-BF and ICF-A&P contents throughout the ICF-PSRP contributed to the positive treatment effects. Conclusion The ICF-PSRP was effective in promoting body function, and activity and participation levels of post-stroke patients. Positive treatment effects are characterized by goal-setting process, cross-domain content design, and community-setting delivery.Clinical trial registration: https://clinicaltrials.gov/study/NCT05941078?id=NCT05941078&rank=1, identifier NCT05941078.
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Affiliation(s)
- Mabel Ngai-Kiu Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Department of Psychology, The Education University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Mike Kwun-Ting Cheung
- Centre on Research and Advocacy, The Hong Kong Society of Rehabilitation, Hong Kong, Hong Kong SAR, China
| | - Yuk-Mun Ng
- Rehabilitation Division, The Hong Kong Society for Rehabilitation, Hong Kong, Hong Kong SAR, China
| | - Huan-Ling Yuan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Bess Yin-Hung Lam
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, Hong Kong SAR, China
| | - Siu Ngor Fu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Chetwyn Che Hin Chan
- Department of Psychology, The Education University of Hong Kong, New Territories, Hong Kong SAR, China
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Talbot KJ, Krüger E, Pillay BS. Experiences of acquired brain injury one-month post-discharge from acute hospitalisation. Afr J Disabil 2023; 12:1037. [PMID: 36876022 PMCID: PMC9982487 DOI: 10.4102/ajod.v12i0.1037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 12/12/2022] [Indexed: 02/24/2023] Open
Abstract
Background Healthcare professionals may have a preconceived idea about life after an acquired brain injury (ABI). Understanding lived experiences of individuals with ABI and their significant others, post-hospitalisation, may improve communication between healthcare professionals and individuals directly influenced by the ABI. Objective To describe perceived experiences of individuals with ABI, and their significant others, regarding rehabilitation services and returning to daily activities, one-month post-discharge from acute hospitalisation. Method Semi-structured interviews, via an online platform, expanded on the experiences of six dyads (individuals with an ABI and their significant others). Data were thematically analysed. Results Six main themes emerged that best described participants' experiences; two of which were shared between individuals with ABI and their significant others (SO). Individuals with an ABI acknowledged recovery as their priority and highlighted the importance of patience. The need for counselling and additional support from healthcare professionals and peers arose. The SO expressed a need for written information, improved communication from healthcare professionals, and education regarding the implications of an ABI. The coronavirus disease 2019 (COVID-19) pandemic negatively influenced all participants' overall experiences, mainly because of termination of visiting hours. Psychosocial intervention would have been beneficial to all participants. Faith influenced most participants' attitudes towards recovery and adapting post-ABI. Conclusion Most participants accepted their new reality but required additional support to cope emotionally. Individuals with an ABI would benefit from opportunities to share experiences with and learn from others in a similar situation. Streamlined services and improved communication may alleviate anxiety among families during this crucial transitional period. Contribution This article provides valuable information on the perspectives and experiences of individuals with ABI and their significant others during the transition from acute hospitalisation. The findings can assist with the continuity of care, integrative health and supportive strategies during the transition period post-ABI.
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Affiliation(s)
- Kirsten J Talbot
- Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
| | - Esedra Krüger
- Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
| | - Bhavani S Pillay
- Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
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Charalambous M, Kountouri A, Phylactou P, Triantafyllidou I, Annoni JM, Kambanaros M. The views of people living with chronic stroke and aphasia on their potential involvement as research partners: a thematic analysis. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:48. [PMID: 36064623 PMCID: PMC9446531 DOI: 10.1186/s40900-022-00379-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 08/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Patient and Public Involvement (PPI) is the active partnership between researchers, patients and laypeople in the process of creating research. PPI in stroke aphasia research aims to ensure equal opportunities for informed decision-making and guarantee democratic representation of patient partners within the research team. Yet, little is known about the factors that hinder and/or promote the autonomous involvement of people with aphasia in stroke and aphasia PPI projects. This study aimed to explore the views and perspectives of people who live with chronic stroke, with and without aphasia, with experience in research prior to stroke, on their potential involvement as research partners. METHODS The research team included a PPI partner with chronic stroke-induced aphasia. Semi-structured interviews were conducted online with people with chronic stroke (n = 8), four with aphasia and four without. Interviews were subject to thematic analysis. RESULTS Inductive thematic analysis generated four themes: (1) the kinds of Restrictions that make involvement in research difficult, (2) the preferred levels and ways of Involvement during the research process, (3) the Support required for active and collaborative involvement, and (4) the Impact of their involvement and how it benefits the study's outcomes. CONCLUSION People experiencing chronic stroke and aphasia are willing to be involved as PPI partners if the research team provides the necessary support. Recommendations for researchers to consider before commencing co-produced research with people with stroke and aphasia are provided.
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Affiliation(s)
- Marina Charalambous
- Laboratory of Cognitive and Neurological Sciences, Faculty of Science and Medicine, University of Fribourg, Chemin du Musée 8, 1700 Fribourg, Switzerland
- Department of Rehabilitation Sciences, Cyprus University of Technology, 30 Arch. Kyprianos Str. 3036, Limassol, Cyprus
| | - Alexia Kountouri
- Solidarity Network Nicosia In Action” (NicInAct), Multifunctional Foundation, Nicosia Municipality, Eptanisou 11, 1016 Nicosia, Cyprus
| | - Phivos Phylactou
- Department of Rehabilitation Sciences, Cyprus University of Technology, 30 Arch. Kyprianos Str. 3036, Limassol, Cyprus
| | - Ioanna Triantafyllidou
- Department of Rehabilitation Sciences, Cyprus University of Technology, 30 Arch. Kyprianos Str. 3036, Limassol, Cyprus
| | - Jean-Marie Annoni
- Laboratory of Cognitive and Neurological Sciences, Faculty of Science and Medicine, University of Fribourg, Chemin du Musée 8, 1700 Fribourg, Switzerland
| | - Maria Kambanaros
- Allied Health and Human Performance, University of South Australia, Adelaide, SA Australia
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Nash J, Krüger E, Vorster C, Graham MA, Pillay BS. Psychosocial care of people with aphasia: Practices of speech-language pathologists in South Africa. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 24:330-340. [PMID: 34637656 DOI: 10.1080/17549507.2021.1987521] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose: The study aimed to explore the practices of a sample of South African speech-language pathologists (SLPs) in providing psychosocial care to people with aphasia. People with aphasia are at risk of adverse psychosocial disruptions and access to appropriate support may be particularly challenging for individuals with compromised communication abilities. The study considered the multilingual and multicultural context of South Africa. By understanding current practices, direction for improved psychosocial care to clients as well as support to SLPs is highlighted.Method: A 20-item previously published online survey was completed by 56 South African SLPs. Purposive and snowball sampling were used to recruit participants. Descriptive and inferential statistics, and qualitative content analysis, were used.Result: Respondents recognised addressing psychosocial wellbeing to be very important. A variety of psychosocial approaches were used in practice. However, 67.9% of the sample felt ill-equipped to provide psychosocial care to people with aphasia. Further barriers included: time/caseload pressures (60.7%) and feeling out of their depth (48.2%). Enablers were: access to more training opportunities (89.3%), adequate time (62.5%), and ongoing support from skilled professionals (55.4%). The majority of respondents also perceived mental health professionals to have limited expertise in working with people with aphasia, making onward referral challenging.Conclusion: Respondents support people with aphasia's psychosocial wellbeing by employing counselling strategies, including family, and person-centred goal-setting. However, many challenges to the provision of psychosocial care to people with aphasia were identified. To improve services, more training opportunities, improved role definition and interprofessional collaboration, are required.
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Affiliation(s)
- Jordan Nash
- Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
| | - Esedra Krüger
- Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
| | - Carlien Vorster
- Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
| | - Marien Alet Graham
- Department of Science, Mathematics and Technology Education, Faculty of Education, University of Pretoria, Pretoria, South Africa
| | - Bhavani Sarveshvari Pillay
- Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
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Cherney LR, Carpenter J. Behavioral interventions for poststroke aphasia. HANDBOOK OF CLINICAL NEUROLOGY 2022; 185:197-220. [PMID: 35078599 DOI: 10.1016/b978-0-12-823384-9.00010-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
There is a long history of behavioral interventions for poststroke aphasia with hundreds of studies supporting the benefits of aphasia treatment. However, interventions for aphasia are complex with many interacting components, and no one treatment is appropriate for all persons with aphasia. We present a novel, simple framework for classifying aphasia interventions. The framework is incorporated within the overarching International Classification of Functioning, Disability, and Health (ICF) model and is consistent with the commonly-held definition that aphasia is a multimodality disorder that impairs, in varying degrees, the understanding and expression of both oral and written language modalities. Furthermore, within the language impairment level, it distinguishes between the linguistic areas of phonology, semantics, and syntax that may be impaired individually or in combination. We define the terminology of the proposed framework and then categorize some common examples of behavioral interventions for post-stroke aphasia. We describe some of these interventions in greater detail to illustrate the extensive toolbox of evidence-based treatments for aphasia. We address some key issues that clinicians, usually speech-language pathologists, consider when selecting interventions for their specific patients with aphasia, including dose. Finally, we address various models of service delivery for persons with aphasia such as Intensive Comprehensive Aphasia Programs (ICAPs) and Aphasia Centers.
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Affiliation(s)
- Leora R Cherney
- Center for Aphasia Research and Treatment, Shirley Ryan AbilityLab, Chicago, IL, United States; Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, IL, United States; Department of Communication Sciences & Disorders, Northwestern University, Chicago, IL, United States.
| | - Julia Carpenter
- Center for Aphasia Research and Treatment, Shirley Ryan AbilityLab, Chicago, IL, United States
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