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Sökning: WFRF:(Saldert Charlotta 1966)

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1.
  • Bloch, Steven, 1965, et al. (författare)
  • Problematic topic transitions in dysarthric conversation
  • 2015
  • Ingår i: International Journal of Speech-Language Pathology. - : Informa UK Limited. - 1754-9507 .- 1754-9515. ; 17:4, s. 373-383
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: This study examined the nature of topic transition problems associated with acquired progressive dysarthric speech in the everyday conversation of people with motor neurone disease. Method: Using conversation analytic methods, a video collection of five naturally occurring problematic topic transitionswas identified, transcribed and analysed. These were extracted from a main collection of over 200 other-initiated repair sequences and a sub-set of 15 problematic topic transition sequences. The sequences were analysed with reference to how the participants both identified and resolved the problems. Result: Analysis revealed that topic transition by people with dysarthria can prove problematic. Conversation partners may find transitions problematic not only because of speech intelligibility but also because of a sequential disjuncture between the dysarthric speech turn and whatever topic has come prior. In addition the treatment of problematic topic transition as a complaint reveals the potential vulnerability of people with dysarthria to judgements of competence. Conclusion: These findings have implications for how dysarthria is conceptualized and how specific actions in conversation, such as topic transition, might be suitable targets for clinical intervention.
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3.
  • Ferm, Ulrika, 1966, et al. (författare)
  • Negotiating disagreement in picture symbol supported decision making
  • 2015
  • Ingår i: Journal of Interactional Research in Communication Disorders/Equinox. - : Equinox Publishing. - 2040-5111 .- 2040-512X. ; 6:2, s. 131-156
  • Tidskriftsartikel (refereegranskat)abstract
    • This study explores how meaning is co-constructed and negotiated when couples affected by Parkinson’s disease use a symbol supported decision making process (Talking Mats) to talk about their daily lives. Interaction data from three couples of men with Parkinson’s disease, their female partners and a facilitator were examined using Conversation Analysis (CA). Three negotiation sequences in which the partners disagreed regarding the ability of the person with Parkinson’s disease were used to explore the management of divergent views. Negotiation was an individualized process in which the men with Parkinson’s disease were at risk of not being fully involved. Negative assessment and disagreement were displayed in different ways. Strategies such as the use of pronouns and proper names seemed to play important functions in negotiation. Use of pictures such as with Talking Mats may support the handling of different views but partners need to be aware of the potential difficulties involved.
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5.
  • Saldert, Charlotta, 1966, et al. (författare)
  • Combining methods in the assessment and analysis of communication in aphasia: Benefits and shortcomings of different approaches
  • 2012
  • Ingår i: Journal of Interactional Research in Communication Disorders. - : Equinox Publishing. - 2040-512X .- 2040-5111. ; 3:2, s. 141-169
  • Tidskriftsartikel (refereegranskat)abstract
    • In this case study the benefit of using analysis of conversational interaction in clinical assessment of communication is explored. A diagnostic test revealed a severe global aphasia in a man. However, according to a questionnaire filled out by the wife, her husband had some functional communication. The description of the consequences of aphasia in this man was further modified and enriched by analyses of conversational interaction between the man and his spouse. The Measure of Participation in Conversation and the Measure of Skill in Supported Conversation show that the couple has strategies that facilitate communication. Activity-based Communication Analysis provides information about how the strategies are used and about the influence of different factors brought into the interaction by the situation and the individuals involved. Thus, although time consuming, analysis of natural conversations provide valid information that is of importance in assessment of communication and implementation of intervention that can have an impact on everyday life in persons with aphasia and their conversation partners.
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6.
  • Saldert, Charlotta, 1966, et al. (författare)
  • Huntington’s disease
  • 2021
  • Ingår i: Handbook of Pragmatic Language Disorders. Complex and Underserved Populations. - Cham : Springer. - 9783030749842 ; , s. 461-494
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
    • Huntington’s disease is a neurodegenerative disorder with progressive motor, cognitive, and neuropsychiatric impairments. There is evidence that problems in both motor speech and language affect individuals’ ability to use language for active participation in everyday communication. Impaired non-verbal language use and comprehension deficits as well as lexical-semantic issues with word-finding difficulties impact the communicative interaction. As the disease progresses, discourse may be restricted by latencies and short, less elaborated utterances with an insufficient level of detail. Speech may become effortful, variable, and difficult to understand. This affects turn-taking along with topic management and also leads to an increased need for repair and adjustment from the communication partner. In this chapter, we adopt an emergentist perspective on pragmatic ability. Research on impairments in several different basic motor and cognitive systems and the effect of these impairments on pragmatic aspects of everyday communication will be presented along with snapshots from lived experiences of Huntington’s disease. Assessment methods used in the investigation of pragmatic aspects of communicative impairment in Huntington’s disease, as well as current communication interventions that may be beneficial, will also be described.
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7.
  • Saldert, Charlotta, 1966, et al. (författare)
  • Semantic trouble sources and their repair in conversations affected by Parkinson's disease
  • 2014
  • Ingår i: International journal of language and communication disorders. - : Wiley. - 1368-2822. ; 49:6, s. 710-721
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: It is known that dysarthria arising from Parkinson’s disease may affect intelligibility in conversational interaction. Research has also shown that Parkinson’s disease may affect cognition and cause word-retrieval difficulties and pragmatic problems in the use of language. However, it is not known whether or how these problems become manifest in everyday conversations or how conversation partners handle such problems. Aims: To describe the pragmatic problems related to the use of words that occur in everyday conversational interaction in dyads including an individual with Parkinson’s disease, and to explore how interactants in conversation handle the problems to re-establish mutual understanding. Methods & Procedures: Twelve video-recorded everyday conversations involving three couples where one of the individuals had Parkinson’s disease were included in the study. All instances of other-initiated repair following a contribution from the people with Parkinson’s disease were analysed. Those instances involving a trouble source relating to the use of words were analysed with a qualitative interaction analysis based on the principles of conversation analysis. Outcomes & Results: In 70% of the instances of other-initiated repair the trouble source could be related to the semantic content produced by the individual with Parkinson’s disease. The problematic contributions were typically characterized bymore or less explicit symptoms of word search or use of atypicalwording.The conversation partners completed the repair work collaboratively, but typically the non-impaired individual made a rephrasing or provided a suggestion for what the intended meaning had been. Conclusions & Implications: In clinical work with people with Parkinson’s disease and their conversation partners it is important to establish what type of trouble sources occur in conversations in a specific dyad. It may often be necessary to look beyond intelligibility and into aspects of pragmatics to understand more fully the impact of Parkinson’s disease on everyday conversational interaction.
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8.
  • Ahlsén, Elisabeth, 1951, et al. (författare)
  • Activity-based communication analysis - focusing on context in communication partner training
  • 2018
  • Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 32:10, s. 1145-1165
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: There is an increased awareness of contextual influence on communication involving persons with aphasia (PWA) and there is a need for frameworks addressing how to analyse contextual factors and address them in, for example, communication partner training (CPT). Activity-based communication analysis (ACA) is a theoretically based method providing a vocabulary and a structure for analysing the influence of context in interaction and how it relates to communication. Aims: The purpose of this paper is to present the framework of ACA as a means of stimulating further enrichment of CPT practices. Methods and Procedures: The paper provides a brief background to the ACA approach, including examples, as well as a checklist and a model for analysis and assessment of intervention addressing communication involving PWA. Outcomes and Results: This approach enables an explicit account of different contextual factors and how they relate to communication and may, thus, guide the design of CPT for particular participants and motivate behavioural change. Conclusions: ACA is a framework that addresses the influence of context on communicative interaction and provides a way of including contextual factors in a systematic way when analysing communication involving PWA. In this way, it can contribute to a richer analysis and intervention and is clearly applicable for CPT
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9.
  • Bauer, Malin, 1990, et al. (författare)
  • Complex oral semantic verbal fluency in non-brain-damaged adults and individuals with multiple sclerosis and subjective anomia
  • 2020
  • Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 34:12, s. 1471-1486
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Many neurologic conditions, for example multiple sclerosis (MS), are associated with subtle communication and language difficulties. To detect such difficulties, there is a need for valid and reliable methods. While standard aphasia test batteries have been found insufficient, more complex language tasks are believed to be able to distinguish more subtle language difficulties from normal variation in communicative ability. Aims: The aim of this study was to: (1) explore the influence of demographic variables on the results of a novel complex oral semantic fluency task with multiple restrictions in non-brain-damaged (NBD) adults, (2) investigate the construct validity and reliability of the method, and (3) compare the results of NBD individuals and individuals with MS. Method and procedure: One hundred and ten NBD individuals performed the complex task and three standard fluency tasks with single restrictions. Regression analyses were run to assess the influence of demographic factors. Furthermore, 16 individuals with MS and subjective anomia performed the complex task and the results were compared with those for a matched group of NBD individuals. Outcome and results: Age and education influenced the NBD individuals’ scores on the complex task. The NBD individuals’ results on the complex task correlated with those on the three standard fluency tasks. Furthermore, the subgroup of 16 pair-matched NBD individuals produced statistically significantly more adequate responses in the complex task than the group of individuals with MS. However, on an individual level some of the participants with MS performed at level with, or even better than the pair-matched NBD individuals. Provision of scoring guidelines yielded high interrater-reliability. Conclusions: The results illustrate the challenge in attempts to provide formal measures of subtle language disorders. Still, the complex task is a promising assessment tool which may be a complement to existing standard word fluency tasks, although future studies are required to establish the validity and ability to detect subtle language difficulties in different clinical groups.
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10.
  • Bloch, Steven, et al. (författare)
  • Person Reference as a Trouble Source in Dysarthric Talk-in-Interaction
  • 2020
  • Ingår i: Atypical Interaction. The Impact of Communicative Impairments within Everyday Talk. Ray Wilkinson, John P. Rae, Gitte Rasmussen (red.). - London : Palgrave Macmillan. - 9783030287986 ; , s. 347-372
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)
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11.
  • Carlsson, Emilia, 1983, et al. (författare)
  • Communicative strategies used by spouses of individuals with communication disorders related to stroke-induced aphasia and Parkinson's disease
  • 2014
  • Ingår i: International journal of language and communication disorders. - : Wiley. - 1368-2822. ; 49:6, s. 722-735
  • Tidskriftsartikel (refereegranskat)abstract
    • Abstract Background: A communicative disability interferes with the affected person’s ability to take active part in socialinteraction, but non-disabled communication partners may use different strategies to support communication.However, it is not known whether similar strategies can be used to compensate for different types of communicative disabilities, nor what factors contribute to the development of a particular approach by communication partners. Aims: To develop a set of categories to describe the strategies used by communication partners of adults who have problems expressing themselves due to neurogenic communicative disabilities. The reliability of assessment was a particular focus. Methods&Procedures: The material explored consisted of 21 video-recorded everyday conversations involving seven couples where one spouse had a communicative disability. Three of the dyads included a person with dysarthria and anomia related to later stages of Parkinson’s disease, while four of them included a person with stroke-induced aphasia involving anomia. First a qualitative interaction analysis was performed to explore the strategies used by the communication partners when their spouses had problems expressing themselves. The strategies were then categorized, the reliability of the categorizations was explored and the relative frequency of the various strategies was examined. Outcomes & Results: The analysis of the conversational interactions resulted in a set of nine different strategies used by the communication partners without a communicative disability. Each of these categories belonged to one of three overall themes: No participation in repair; Request for clarification or modification; and Providing candidate solutions. The reliability of the categorization was satisfactory. There were no statistically significant differences between diagnoses in the frequency of use of strategies, but the spouses of the persons with Parkinson’s disease tended to use open-class initiations of repair more often than the spouses of the persons with aphasia. Conclusions & Implications: The types of strategies used by spouses of persons with neurogenic communicative disabilities seem to be more strongly associated with individual characteristics of communicative ability than with the type of disorder involved. The set of categories developed in this study needs to be trialled on larger groups of participants, and modified if and as necessary, before it can be regarded as a valid system for the description of such strategies in general. Once this has been done it may become a useful instrument in the assessment of the strategies used by communication partners of individuals with communicative disabilities
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12.
  • Eriksson, Karin, 1965, et al. (författare)
  • Aspects of rating communicative interaction: Effects on reliability and agreement
  • 2014
  • Ingår i: Journal of Interactional Research in Communication Disorders/Equinox. - : Equinox Publishing. - 2040-5111 .- 2040-512X. ; 5:2, s. 245-267
  • Tidskriftsartikel (refereegranskat)abstract
    • Communication partner training can be effective in improving communication in aphasia. However, further research is needed on how to measure the outcome of such interventions. In this paper we discuss the phenomenon of reliability in assessments in relation to the results of analyses using a rating scale designed to measure the ability to support a person with aphasia in natural conversational interaction. The scale was used by four assessors to rate 45 video recordings. Calculations of reliability and agreement produced varying results but were mostly satisfactory. However, the results highlight how interaction between factors such as complexity of assessments; design of the rating scale; factors inherent in the individual assessor; and the statistical measures used to analyse the outcome may result in a conflict between aspects of validity and reliability. Interpretations of outcome obtained with rating scales thus need to be based on knowledge about factors influencing the results.
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13.
  • Eriksson, Karin, 1965, et al. (författare)
  • Communication partner training of enrolled nurses working in nursing homes with people with communication disorders caused by stroke or Parkinson's disease
  • 2016
  • Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 38:12, s. 1187-1203
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To evaluate the effect of a communication partner training programme directed to enrolled nurses working with people with communication disorders in nursing homes, using an individualised approach. Method: Five dyads consisting of a person with stroke-induced aphasia (n = 4) or Parkinson’s disease (n = 1) living in different nursing homes and his/her enrolled nurse participated in the study, which had a replicated single subject design with multiple baselines across individuals. The main element of the intervention was supervised analysis of video-recorded natural interaction in everyday nursing situations and the formulation of individual goals to change particular communicative strategies. Results: Outcome was measured via blinded assessments of filmed natural interaction obtained at baseline, intervention and follow-up and showed an increased use of the target communicative strategies. Subjective measures of goal attainment by the enrolled nurses were consistent with these results. Measures of perceived functional communication on behalf of the persons with communication disorders were mostly positive; four of the five participants with communication disorders and two of five enrolled nurses reported improved functional communication after intervention. Conclusions: The use of an individualised communication partner training programme led to significant changes in natural interaction, which contributes importantly to a growing body of knowledge regarding communication partner training.
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16.
  • Eriksson, Karin, 1965, et al. (författare)
  • Conversation partner training with a professional caregiver of a person with aphasia - Effects on everyday interaction
  • 2013
  • Ingår i: Konferens: "Atypical Interaction: Conversation Analysis and Communication Impairments", 130627-130628, University of Sheffield.
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Introduction One aspect of the concept of functional communication is the focus on ability to get information across and conversation partners may be trained to support communication in relation to communication disorders (Simmons-Mackie et al., 2010). However, if the main aim for an interaction is to get a message across it may have consequences for the amount of repair needed to accomplish the goal. As frequent and prolonged repair sequences may be seen as revealing incompetence in participants in interaction, such goals may be in conflict with goals related to the notion of face (Goffman, 1955; Wilkinson et al, 2003). The aim of this study is to describe the effects of a communication partner training program on everyday interaction between a person with aphasia and a professional carer at a nursing home. Method The study presented here is a case study with a time series design supplemented with conversation analysis. At each of seven baseline sessions and eight training sessions a sample of natural conversational interaction between the person with aphasia and his carer was video-recorded. Outcome of intervention was assessed with a rating scale by an assessor, blinded to where in the process of intervention the recordings were obtained. The scale is measuring the caregivers’ ability to apply strategies to support communication with this particular person with aphasia. The result from this quantitative measure is supplemented with qualitative analysis of the effects from the training on repair sequences in the interaction. Results and discussion Analyses of data are presently being performed and results will be discussed and related to a potential conflict between aspects of the concept of functional communication versus the concept of face in interaction in relation to communication disorders. References Goffman, E., (1955). On Face-work: An Analysis of Ritual Elements of Social Interaction. Psychiatry: Journal for the Study of Interpersonal Processes 18(3), 213-231. Simmons-Mackie, N., Raymer, A., Armstrong, E., Holland A., and Cherney, L.R. (2010) Communication partner training in aphasia: A systematic review. Archives of Physical Medicine and Rehabilitation, 91, 1814-1837. Wilkinson, R., Beeke, S. & Maxim, J., (2003). Adapting to conversation. In: Goodwin (Ed), Conversation and Brain Damage. New York: Oxford university press, pp 59-89.
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17.
  • Eriksson, Karin, 1965, et al. (författare)
  • On the diverse outcome of communication partner training of significant others of people with aphasia: an experimental study of six cases
  • 2016
  • Ingår i: International journal of language and communication disorders. - : Wiley. - 1368-2822. ; 51:4, s. 402-414
  • Tidskriftsartikel (refereegranskat)abstract
    • Abstract Background: Communication partner training (CPT) has been shown to improve the communicative environment of people with aphasia. Interaction-focused training is one type of training that provides an individualized intervention to participants. Although shown to be effective, outcomes have mostly been evaluated in nonexperimental case studies. Aims: The aim of the controlled experimental intervention study was to evaluate an individualized approach in a CPT programme directed to significant others of people with aphasia. Specifically the effects on conversation partners’ ability to support the person with aphasia in conversation and on the individuals with aphasias’ perception of their functional communication were explored. Methods & Procedures: Six dyads consisting of a person with aphasia and a significant other were included in a replicated single-subject design with multiple baselines across individuals. The intervention followed the interaction-focused communication training programme included in Supporting Partners of People with Aphasia in Relationships and Conversation (SPARRC). The main elements of the training consisted of supervised viewing of the couples’ own video-recorded natural interaction and the formulation of individual goals for the adaptation of particular communicative strategies. Outcome was measured via blinded ratings of filmed conversational interaction obtained once a week throughout the different phases of baseline, intervention and follow-up. A rating scale to assess overall quality of conversation was used, taking into account both transfer of information and social aspects of conversation. Measures of perceived functional communication in the persons with aphasia were also collected from the individuals with aphasia and their conversation partners. Outcomes & Results: The results were mixed, with two of the six participants showing small improvements in ability to support their partner with aphasia in conversation. Half the participants with aphasia and half the significant others reported improvements on perceived functional communication in the person with aphasia after intervention, but no changes were statistically significant. Conclusions & Implications: This study adds to the growing body of research concerning CPT by pinpointing the importance of careful consideration regarding set-up of training, suitability of participants and evaluation of outcome.
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18.
  • Eriksson, Karin, 1965, et al. (författare)
  • Participant characteristics and observed support in conversations involving people with communication disorders
  • 2016
  • Ingår i: International Journal of Speech-Language Pathology. - : Informa UK Limited. - 1754-9507 .- 1754-9515. ; 18:5, s. 429-449
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: Communication partner training is an increasingly common approach to improve the possibilities for people with communication disorders to participate in everyday interaction. So far, though, little is known about what conversation partner characteristics might influence the ability to be a supportive partner in conversation. The current study explored possible associations between the observed skill to support a person with communication difficulties in conversation and the following characteristics of the conversation partner; executive function, inference ability, age, education level and relationship to the person with communication disorder. The impact of the aetiology of the communication difficulties was also explored. Method: Thirty-five dyads participated: 23 people with aphasia along with 18 significant others and five enrolled nurses and 12 people with Parkinson’s disease along with 10 significant others and two enrolled nurses. Result: Only tendencies of associations were found between observed skill to support conversation and executive function for the significant others and inference ability for the enrolled nurses. Conclusion: Although type of activity involved in the conversation may be a key factor, the results indicate that executive function and ability to make mental inferences may matter for the ability to support a person with communication disorder in conversation.
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19.
  • Forsgren, Emma, 1982, et al. (författare)
  • Communicative barriers and resources in nursing homes from the enrolled nurses’ perspective: a qualitative interview study
  • 2016
  • Ingår i: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489. ; 54, s. 112-121
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and objectives: Managing communicative disability is a pervasive issue in long-term care facilities. The aim of this study was to explore how enrolled nurses experience their everyday interactions with residents in nursing homes, particularly focusing on interactions with residents with communicative disability. Design: A qualitative exploratory design including content analysis was used. Participants and setting: Eight individuals working at six nursing homes in western Sweden were interviewed. Method: The interviews were semi-structured with questions about the participants’ experiences in communicating with residents, feelings associated with interactions involving residents with communicative disability, meaning ascribed to interactions, and factors influencing interactions. The interviews were analysed using content analysis. Results: A dynamic interplay between interpersonal relations, daily interactions and the managing of communicative disability was revealed. The enrolled nurses had good knowledge of supportive strategies and an awareness of the importance of the development of personal relationships with residents in order to facilitate interaction. However, factors in the environment presented barriers to communication. Conclusions/Implications: The organisation and physical environment of nursing homes prevent the enrolled nurses from taking full advantage of the communicative resources they have in interaction with residents with communicative disability, hence affecting staff-resident relationships and the delivery of person-centred care.
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20.
  • Forsgren, Emma, 1982, et al. (författare)
  • Exploring communication strategies for the facilitation of person-centred care: a comparison of three methods for analysis
  • 2017
  • Ingår i: Journal of Interactional Research in Communication Disorders/Equinox. - : Equinox Publishing. - 2040-5111 .- 2040-512X. ; 8:2, s. 220-245
  • Tidskriftsartikel (refereegranskat)abstract
    • This method study compares the results yielded by using three different methods of examining how communication strategies may facilitate person-centred care in longterm residential care. The analysis involved two quantitative coding systems, which rated language-based and person-centred communication strategies, and a qualitative analysis based on Conversation Analysis. The data consisted of a video-recorded conversation that took place between an enrolled nurse and a resident with dementia in a long-term residential care facility in western Sweden. The qualitative analysis sheds light on several shortcomings in the two quantitative coding systems. Although both coding systems revealed that the enrolled nurse used many facilitating strategies, only one of the systems captured problems in the interaction. The conclusion of this study is that context as well as paralinguistic aspects in communication should be considered in the development and use of quantitative coding systems.
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21.
  • Forsgren, Emma, 1982, et al. (författare)
  • Implementation of communication routines facilitating person-centred care in long-term residential care: A pilot study
  • 2022
  • Ingår i: Health Expectations. - : Wiley. - 1369-6513 .- 1369-7625. ; 25:6, s. 2982-2991
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Specific routines such as the development of personal communication plans can improve the interaction between people with communication disorders and healthcare staff. Objective: This pilot study explores a model for implementing communication routines including personal communication plans in long-term residential care. Design, Setting and Participants This multiple case study includes two residential care facilities that differ in size and the number of languages spoken. Intervention or main variables studied implementation strategies involved workshops, individual coaching and follow-up visits. Main outcome measure implementation was assessed using goal attainment measurements, and the staff's views about facilitators and barriers to implementation were explored through structured interviews using the Theoretical Domains Framework. Results The overall implementation success rate for the facilities was moderate, and one of the facilities showed promising results related to personal communication plans. Both facilities experienced barriers to implementation, including management problems and a lack of reminders. However, the two facilities seem to have different motivations for change. Discussion and Conclusions Regardless of the features of the facility, successful implementation requires stable and committed leadership. Moreover, experiences with language diversity may motivate staff to implement communication routines. Patient or Public Contribution The content of the implementation model used (i.e., choice of specific routines and implementation strategies) was coproduced by staff, managers and the researchers involved in this project. The staff and managers were responsible for the implementation of the new routines under the supervision of the researchers.
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22.
  • Forsgren, Emma, 1982, et al. (författare)
  • Improving medical students’ knowledge and skill in communicating with people with acquired communication disorders
  • 2017
  • Ingår i: International Journal of Speech-Language Pathology. - : Informa UK Limited. - 1754-9507 .- 1754-9515. ; 19:6, s. 541-550
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To explore the effects of an interactive workshop on medical students’ knowledge and skill in communicating with people with acquired communication disorders. Method: Sixty-nine medical students received a lecture on acquired communication disorders. Thirty-six of these students also participated in a workshop where they practised using supportive strategies in interaction with a simulated patient with aphasia. All students completed a questionnaire exploring attitudes, confidence in knowledge and ability to suggest suitable supportive strategies pre- and post-lecture/workshop and 15 students were video recorded when interacting with a simulated patient pre- and post-workshop. Result: The results show no change in attitude in either student group, but both groups rated their confidence in knowledge as higher post-lecture/workshop. The students’ ability to suggest supportive strategies post training was significantly higher only in the workshop group. Comparing post training results regarding knowledge and ability to suggest supportive strategies between the groups, higher ratings were found for the workshop group. The analysis of video recordings indicated that the students also used new supportive strategies and used strategies more frequently after the workshop. Conclusion: An interactive workshop can improve medical students’ knowledge and skills in communicating with people with acquired communication disorders.
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23.
  • Forsgren, Emma, 1982, et al. (författare)
  • Improving medical students’ knowledge and skill in communication with people with speech-language disorders
  • 2016
  • Ingår i: Poster presentation, International Forum on Quality and Safety in Healthcare, Gothenburg, Sweden, 2016-04-14.
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Background: Person-centered care (PCC) has been shown to contribute to better agreement between care provider and patient on treatment plans, better health outcomes as well as increased patient satisfaction(1). This pinpoints the importance of communication skills among healthcare providers. Meanwhile, hundreds of thousands of adult persons suffer from neurogenic communication disorders such as aphasia and dysarthria resulting in difficulties to speak or to understand language. It has been shown that physicians find it hard to diagnose and inform patients with communication disorders (2), and that patients with communication disorders are more likely to suffer accidents and medical mistreatment as compared to patients without communication difficulties (3). Aim: Study the effects of an interactive workshop on medical students’ attitudes and knowledge regarding communication in the presence of speech-language disorders as well as their use of conversational strategies in interaction. Method: 69 medical students received a lecture about communication disorders which was part of their regular curriculum. 33 of these students also participated in a workshop with mixed format. The workshop which has previously been used with good results (4) included theoretical elements and practical training in the use of supportive conversational strategies such as to use letter-boards, pictures or writing in interaction with a simulated patients (speech-language pathology students). All medical students completed a 9-item questionnaire exploring knowledge and attitude towards communication before and after the lecture or the workshop. 15 students were video-recorded in interaction with a simulated patient before and after the workshop. The interaction was assessed with a checklist by two independent, blinded raters. Results: Questionnaires - Both the students who only received a lecture and the students who in addition participated in the workshop rated their confidence of their knowledge about communication in speech-language disorders higher after the training. However, assessments of ability to suggest suitable communicative strategies after the training were only significantly higher within the workshop group. Video-recordings - There was a statistically significant increase in the use of important strategies after training: encourages the use of gestures, uses writing and encourages the use of a calendar. Other strategies such as to talk about one thing at a time, to draw or use drawn pictures, to use a letter-board and to use a calendar also increased after the workshop, yet not to a statistically significant degree. Conclusions: The present study adds to the evidence that interactive training of medical students can improve communication in the presence of speech-language disorders. Take home message: An interactive workshop can increase medical students’ knowledge and skill in communication in speech and language disorders which facilitates safe and person-centred healthcare. References: (1) Olsson, L-E., Jakobsson Ung, E., Swedberg, K., & Ekman, I. (2013). Efficacy of person-centred care as an intervention in controlled trials – a systematic review. Clinical Nursing, 22, 456-465. (2) Ziviani, J., Lennox, N., Allison, H., Lyons, M., & Del Mar, C. (2004). Meeting in the middle: improving communication in primary helath care consultations with people with an intellectual disability. Journal of Intellectual and Developmental Disability, 29, 211-225. (3) Bartlett, G., Blais, R., Tamblyn, R., Clermont, RJ., & McGibbon, B. (2008). Impact of patient communication problems on the risk of preventable adverse events in acute care settings. Canadian Medical Association Journal , 178, 1555-1562. (4) Saldert, C., Forsgren, E., & Hartelius, L. (2016). Teaching medical students about communication in speech-language disorders: Effects of a lecture and a workshop. International Journal of Speech-Language Pathology, doi: 10.3109/17549507.2016.1143975
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24.
  • Forsgren, Emma, 1982, et al. (författare)
  • Improving medical students’ knowledge and skill in communication with people with speech-language disorders
  • 2016
  • Ingår i: Poster presentation, American Speech-Language-Hearing Association (ASHA), Philadelphia, USA, 2016-11-17.
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Background: In order to ensure safe and person-centered care to all patients, including people with acquired communication disorders, healthcare providers need to have specific skills in interaction (1,2,3). Communication training explicitly focusing on interaction involving people with communication disorders is not common today in medical education (2). Still, recent research has shown that a 2.5 hour interactive workshop, inspired by Yorkston and colleagues (4), increased medical students’ knowledge and affected their attitude towards communication involving people with speech-language disorders (3). The aim of this study (5) was to further explore the effects of the previously trialed interactive workshop on medical students attitudes and knowledge regarding communication in the presence of speech-language disorders, and also to explore the students use of conversational strategies in interaction. Method: Thirty-three medical students received a lecture about communication disorders as part of their regular curriculum (the lecture group). Thirty-six students, in addition to participating in the lecture also participated in a workshop with mixed format (the workshop group). The workshop included both theoretical elements and practical training in the use of supportive conversational strategies in interaction with simulated patients (speech-language pathology students). All medical students completed a 9-item questionnaire exploring knowledge and attitude towards communication before and after the lecture or the workshop. Fifteen students in the workshop group were video-recorded in interaction with a simulated patient before and after training in order to explore the use of conversational strategies. The interactions was assessed with a checklist by two independent, blinded raters. Results: Knowledge and attitude - Both the students in the lecture group and the workshop group rated their confidence of their knowledge about communication in speech-language disorders higher after the training. However, the assessment of ability to suggest suitable communicative strategies after training were only significantly higher within the workshop group. Use of conversational strategies - There was a statistically significant increase in the use of important strategies after training such as: encourages the use of gestures, uses writing and encourages the use of a calendar. Other strategies such as to talk about one thing at a time, to draw or use drawn pictures, to use a letter-board and to use a calendar also increased after the workshop, yet not to a statistically significant degree. Conclusion: The results from the present study adds to the evidence that interactive training of medical students can improve communication involving people with speech and language disorders. (1) Bartlett et al. (2008). Impact of patient communicationproblems on the risk of preventable adverse events in acute care settings. Canadian Medical Association Journal, 178(12) (2) Burns et al. (2012). Training Healthcare Providers in Patient-Provider Communication: What Medical Education and Speech-Language Pathology Can Learn from One Another. Aphasiology, 26(5), 673-688. (3) Saldert et al. (2016). Teaching medical students about communication in speech-language disorders: Effects of a lecture and a workshop. International Journal of Speech-Language Pathology, Published online 16 march 2016. (4) Yorkston et al. (2015). Medical Education: Preparing Professionals to Enhance Communication Access in Healthcare Settings. In Blackstone S., Beukelman D., & Yorkston K. (Eds.), Patient Provider Communication: Roles of Speech-Language Pathologists and Other Health Care Professionals (pp. 37–72). San Diego, CA: Plural Publications. (5) Forsgren et al. (2016). Improving medical students knowledge and skill in communication with people with acquired communication disorders. International Journal of speech Language Pathology. Published online 31 august 2016
  •  
25.
  • Forsgren, Emma, 1982, et al. (författare)
  • Person‐centred care in speech‐language therapy research and practice for adults: A scoping review
  • 2022
  • Ingår i: International journal of language and communication disorders. - : Wiley. - 1368-2822 .- 1460-6984. ; 57:2, s. 381-402
  • Forskningsöversikt (refereegranskat)abstract
    • Background: Person-centred care (PCC) has shown positive effects in various health-care settings and therefore is desirable in clinical work. However, as PCC is still being developed, the literature reflects a heterogeneous use of both terminology and conceptualisation. This lack of consistency hinders the implementation or adaptation of PCC in general and in select fields of practice such as speech-language therapy (SLT). Aims: To describe how the concept of PCC manifests in current speech and language therapy research and practice for adult patients. Methods & Procedures: Searches for published literature were conducted in five databases (PubMed, Scopus, CINAHL, PsychINFO, and Linguistics and Language Behaviour Abstracts) using search terms related to PCC and SLT. Records were included if they involved an adult population, were written in English, and focused on PCC and SLT irrespective of year of publication. Main Contribution: A total of 134 records published 1996–2020 were included in this review. Many of these records were discussion papers that described how speech-language therapists (SLTs) can or should work in a person-centred way. The search did not find any records that explore the implementation, effects, or patients’ views of person-centred SLT. This literature review revealed that person-centred SLT practice mainly relates to the International Classificationof Functioning, Disability, and Health framework, and the Life Participation Approach to Aphasia. Studies incorporating exploration of proposed clinical routines of PCC demonstrate specific context dependant aspects including barriers to eliciting a patient narrative, involving patient and family members, and documenting SLT. Conclusions & Implications: This study provides information that can beused to implement person-centred care in SLT education, clinical practice, and research by providing an inventory of the current knowledge and the existing gaps.
  •  
26.
  • Forsgren, Emma, 1982, et al. (författare)
  • Training conversation partners of persons with communication disorders related to Parkinsons disease - a protocol and a pilot study
  • 2013
  • Ingår i: Logopedics, Phoniatrics, Vocology. - : Informa UK Limited. - 1401-5439 .- 1651-2022. ; 38:2, s. 82-90
  • Tidskriftsartikel (refereegranskat)abstract
    • This paper reports on the adaptation of a training programme for conversation partners of persons with Parkinson's disease, and a protocol for assessment of possible changes in conversational interaction as a result of intervention. We present data from an explorative multiple case study with three individuals with Parkinson's disease and their spouses. Repeated analysis of natural conversational interaction and measures of the participants’ perception of communication as well as measures of different cognitive abilities were obtained. The results show that the communication in all three dyads was affected by both speech and language problems and that the conversation training model and the assessment protocol may work well after minor adjustments. Influence of different aspects of cognition on communication is discussed.
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27.
  • Hartelius, Lena, 1957, et al. (författare)
  • Perceived changes in communicative interaction in atypical Parkinsonism
  • 2011
  • Ingår i: ISRN Neurology. - : Hindawi Limited. - 2090-5505 .- 2090-5513. ; 2011:Article ID 256406
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to examine if atypical parkinsonism affects the communicative ability in conversational interaction. Fifteen persons close to individuals with atypical parkinsonism answered a questionnaire, “Assessment of Change in Communicative Interaction” (ACCI), estimating perceived change in interactive skills compared to before the onset of the disease. The study also examined if perceived change correlated with disease duration. The results showed that at group level, the participants experienced change in many aspects of conversational interaction, particularly regarding the affected person's speech, body communication, response latency, phrase length, word finding, and ability to make themselves understood. There was no correlation between perceived change and disease duration. In conclusion, results indicated that the communicative interaction of individuals with atypical parkinsonism is significantly affected and that information elicited from significant others can help define specific problem areas or foci of concern that need to be targeted in communicative intervention or at least considered in interaction with these persons.
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28.
  • Hedman, Eli, et al. (författare)
  • Word-finding difficulties in Parkinson's disease: Complex verbal fluency, executive functions and other influencing factors
  • 2022
  • Ingår i: International journal of language and communication disorders. - : Wiley. - 1368-2822 .- 1460-6984. ; 57:3, s. 565-577
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Persons with Parkinson's disease (PD) frequently report word-finding difficulties. Many of the established tests are, however, insufficient in detecting mild cases of such symptoms. Results from earlier research have suggested that controlled oral word association tests (COWATs) with high demands on cognitive processing resources could prove helpful in detecting the more subtle (language-related) problems seen in neurological disorders such as PD. Aims First, to examine whether persons with PD (PwPD) differ in performance on different types of COWATs compared with non-brain-damaged controls. Second, to investigate possible relationships between executive functions and the novel complex oral semantic fluency (COSEF) task performance scores in the PwPD group. Third, to investigate whether age, years of education, severity of motor symptoms and self-perceived severity of word-finding difficulties influenced the COSEF task results. Methods & Procedures A total of 17 PwPD participated in the study. Their results were compared with a matched control group (n = 17) at both group and individual levels. One phonemic and two types of semantic COWATs were used. Correlations between the COSEF task and executive function results, age, education and severity of motor symptoms were analysed in the PwPD group. Outcomes & Results The PwPD group had significantly lower scores on the COSEF task compared with the control group, but not on the other COWATs. A variation in the results was seen on an individual level. In the PwPD group, large significant correlations were seen between the COSEF task and verbally based tasks measuring working memory and cognitive flexibility. Both age and education, but neither self-perceived severity of word-finding difficulties nor motor symptoms, were correlated with the COSEF task result in the group of PwPD. Conclusions & Implications The results are in line with the predictions that a relatively more cognitive demanding COWAT such as the COSEF task could prove valuable when assessing word-finding difficulties in PD in research and clinical assessment. What this paper adds What is already known on the subject Varying degrees of word-finding difficulties are a common symptom in PD and may affect everyday communication. Discreet word-finding difficulties can be hard to detect with the established language assessment tools. What this paper adds to existing knowledge This study adds insights into how PwPD perform on different types of COWATs compared with a control group. It also sheds light on the relationships between a novel, more cognitive complex COWAT and executive functions in PD. What are the potential or actual clinical implications of this work? More cognitively complex COWATs can contribute significantly to the assessment of discreet word-finding difficulties, but it is important to include a thorough anamnesis regarding language and communication in PwPD.
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29.
  • Henriksson, Ingrid, 1961, et al. (författare)
  • Public awareness of aphasia – results of a Swedish sample
  • 2019
  • Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 33:1
  • Tidskriftsartikel (refereegranskat)abstract
    • © 2018 Informa UK Limited, trading as Taylor & Francis Group Background: Public awareness of a condition like aphasia may affect service provision and everyday life communication for people affected by the condition. Nevertheless, studies have shown that the public awareness of aphasia is low in many countries. Aims: This study explores awareness and knowledge of aphasia among the general public in Sweden. Methods & Procedures: We describe two surveys on the public awareness of aphasia undertaken using convenience samples in four different cities in southern Sweden. The questionnaire was closely based on those used in previous studies of aphasia awareness around the world. A total of 372 participants were recruited. Results are presented in terms of whether participants had heard of aphasia or not, and in the case that they had heard of it, whether they had a basic knowledge of the condition. Further analyses were undertaken on these three groups of participants: their gender and age distributions, educational background, what they knew about aphasia, and where they had learnt about it. Outcomes & Results: The results are discussed in comparison with similar surveys elsewhere, and we note the comparatively high percentage of participants who have heard of aphasia in our survey though, mirroring previous surveys, the amount of knowledge was often limited or incorrect. Unlike in other surveys, no clear relation was found between gender and awareness of aphasia, or education and awareness of aphasia. Age profiles and the source of participants’ information about aphasia were similar to earlier studies: that is, older people seem to have more aphasia awareness than younger people do. Further, media like TV, radio, newspapers, and magazines were the most often reported source for knowledge of aphasia. Conclusions: There is a need for further work to increase public awareness of aphasia and different forms of public media may play an important role in this endeavour.
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30.
  • Kristensson, Joana, 1972, et al. (författare)
  • Anomia in left hemisphere stroke, multiple sclerosis and Parkinson's disease - a comparative study
  • 2023
  • Ingår i: Disability and Rehabilitation. - 0963-8288 .- 1464-5165.
  • Tidskriftsartikel (refereegranskat)abstract
    • PurposeTo explore quantitative and qualitative features of anomia in participants with left-hemisphere stroke, Parkinson's disease, or multiple sclerosis.Materials and methodsThis descriptive cross-sectional study compares signs of anomia within and across participants (n = 87), divided into four groups; moderate to severe anomia after stroke (MSAS, n = 19), mild anomia after stroke (MAS, n = 22), PD (n = 19) and MS (n = 27). Aspects analysed include naming accuracy and speed, the nature of incorrect responses, semantic and phonemic verbal fluency, information content in re-telling, and the relationship between test results and self-reports on word-finding difficulties and communicative participation.ResultsAll groups had impaired verbal fluency, prolonged response times and reduced information content in re-telling. The MSAS group had significantly more signs of anomia than the other groups. Results from the other groups overlapped on a MAS-PD-MS continuum. Both semantically and phonologically incorrect responses were common in the stroke groups, while semantically incorrect ones predominated in the PD and MS groups. All four groups reported a similar negative impact on self-perceived communicative participation. Correlations between self-reports and test results were inconsistent.ConclusionsAnomia features have quantitative and qualitative similarities and differences across neurological conditions.
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31.
  • Kristensson, Joana, 1972, et al. (författare)
  • Effects on communication from intensive treatment with Semantic Feature Analysis in aphasia
  • 2015
  • Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 29:4, s. 466-487
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Anomia, a persistent and frequent symptom of aphasia after stroke, obstructs the transfer of information in conversation, which can have serious consequences for participation in everyday social interaction with significant others and in society. Aims: This study aimed to replicate the findings of Coelho and his colleagues, as well as Boyle, and Wambaugh and Ferguson regarding the use of semantic feature analysis (SFA) for individuals with aphasia after stroke. Its main purpose was to explore whether intervention could (1) increase the ability to participate in conversation and (2) lead to positive changes in functional communication as perceived by the participants themselves and their significant others. Methods & Procedures: In this multiple-baseline across-subjects-design study, three participants with chronic aphasia were treated with intensive training using SFA. Treatment outcome was assessed with repeated measures of confrontation naming of actions and objects and with quantitative ratings of the quality of speech as well as communicative participation in conversation. The ratings were made by independent assessors blinded as to what phase of the study the data were obtained from. In addition, a questionnaire measuring perceived functional communication as reported by the participants and their significant others was administered before and after the training as well as at a follow-up session 10–12 weeks after the training was completed. Outcome & Results: Only minor treatment outcomes were apparent in this study. Visual inspection of the results showed a slight increase in the ability to participate in conversation for two of the three participants as well as a fall in the number of complex paraphasias for one of them and an increase in self-corrections for two. There was no improvement in the participants’ confrontation-naming ability. Two of the three participants rated their own functional communication skills higher at follow-up than before training while the third participant reported no change. As regards the ratings by significant others at follow-up versus before training, there was one slight decrease, one slight increase, and one considerable increase. Conclusions: Treatment with SFA might improve communicative skills and increase participation in everyday conversation despite not having a measurable effect on confrontation-naming ability in a formal assessment situation. Further research is needed to identify the individuals with aphasia who can benefit from treatment with SFA and to determine the nature of its impact on communicative participation.
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32.
  • Kristensson, Joana, 1972, et al. (författare)
  • Evaluation of treatment effects of semantic feature analysis on mild anomia in multiple sclerosis
  • 2022
  • Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 36:6, s. 706-731
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Multiple sclerosis (MS) commonly includes anomia and other communicative deficits that affect communicative participation and quality of life. Anomia treatment in MS is currently unexplored. Owing to the degenerative nature of MS, compensatory treatment might be preferable to restorative treatment. Semantic feature analysis (SFA) has been reported to have a treatment effect in aphasia and traumatic brain injury, and it can also be used as a compensatory word-finding strategy. SFA might therefore be effective on anomia in MS. Aims: The aim of this study was to evaluate the treatment effects of SFA on mild anomia in MS. Hypotheses were that, if used as a strategy, SFA may improve word-retrieval ability in connected speech, reduce self-perceived word-finding difficulties and increase communicative participation. Methods & Procedures: Two participants (one with relapsing-remitting MS, one with progressive MS) experiencing anomia and reduced communicative participation took part in this early-phase study with a single-case experimental design (SCED). Outcome measures included accuracy and speed in confrontation naming of treated items, correct information units (CIUs) in a re-telling task, self-reported strategy use in everyday communication, self-reported occurrence of anomia and related nuisance, and self-reported communicative participation. Measurements were carried out before treatment, at the beginning of every third treatment session, once directly after treatment, repeatedly during a maintenance phase, and once at a follow-up session ten weeks after treatment. Outcomes & Results: No treatment effects on confrontation-naming ability, re-telling ability or self-reported measures were evident in either participant after treatment with SFA. Effects of repeated measures appeared as reduced response time in confrontation naming. Conclusions: SFA as the sole element of treatment may not be sufficient to obtain treatment effects on mild anomia in MS. Further research is warranted. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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33.
  • Kristensson, Joana, 1972, et al. (författare)
  • Naming of Objects and Actions after Treatment with Phonological Components Analysis in Aphasia
  • 2018
  • Ingår i: Clinical Archives of Communication Disorders. - : Korean Academy of Speech-Language Pathologies. - 2508-5948. ; 3:2, s. 137-150
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: To explore the effects of intensive treatment with phonological components analysis on naming of both objects and actions. Methods: Phonological components analysis (PCA) was used to treat two individuals with moderate or severe aphasia after stroke. A single case study design with chronological time series analysis was employed to explore the effects of treatment for a total of up to 20 hours comprising the naming of self-chosen objects and actions. Changes in confrontation naming ability were assessed repeatedly. In addition, generalisation of training effects was examined in connected speech in a picture description task as well as in ratings of functional communication skills as perceived by the participants and their next of kin. Results: An increase in correctly produced words for treated items with some generalisation to untreated items was demonstrated post-treatment in a participant with moderate mixed fluent aphasia and mostly phonological errors. Number of words and degree of informativeness in the picture description task also increased. Results remained at a 10-week follow-up. A participant with severe conduction aphasia and mainly semantic errors in the pre-training assessment also demonstrated a small increase in correct confrontation naming post-treatment. Some aspects of functional communication skills were rated slightly higher, but both participants perceived the negative impact of the aphasia to be greater post-treatment. Conclusions: Phonological component analysis may be used in training of both objects and actions. However, aphasia severity and underlying deficits most likely influence the results and further research is warranted to explore the training effects.
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34.
  • Kristensson, Joana, 1972, et al. (författare)
  • Naming vs. non-naming treatment in aphasia in a group setting–A randomized controlled trial
  • 2022
  • Ingår i: Journal of Communication Disorders. - : Elsevier BV. - 0021-9924 .- 1873-7994. ; 97
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Anomia affects numerous persons with aphasia. Treatment effects of anomia group therapy have been reported, but the evidence is not comprehensive. This study aimed to explore treatment effects of a naming treatment compared with a non-naming treatment delivered in a group setting. Methods: In a randomized controlled trial, 17 participants with chronic poststroke aphasia underwent group therapy, 2 hours a session, 3 times per week, for a total of 20 hours. The treatment given in the naming group was modified semantic feature analysis (SFA). Treatment content in the non-naming group comprised auditory comprehension, copying text, and reading. The primary outcome measure was accuracy in confrontation naming of participant-selected trained nouns and verbs. Generalization effects were evaluated in single-word naming, connected speech, and everyday communication. Results: Participants in both groups significantly improved their naming of trained items. There were no differences between the groups. The treatment effect did not remain at follow-up 10 weeks after therapy. No other statistically significant changes occurred in either group. Conclusions: Group intervention can improve naming ability in individuals with chronic aphasia. However, similar treatment effects can be achieved using a non-naming treatment as using a naming treatment, such as modified SFA. Further research is warranted to identify the most important elements of anomia group therapy.
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35.
  • Saldert, Charlotta, 1966, et al. (författare)
  • An interaction-focused intervention approach to training everyday communication partners: A single case study
  • 2015
  • Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 29:3, s. 378-399
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Communication partner training appears to be a growing area within aphasiology. Much of the work carried out so far has focused on training volunteers to have conversations with people with aphasia in order to improve communication and the person with aphasia’s (PWA’s) psychosocial well-being and/or improving the ability of significant others to communicate information with the PWA within clinical tasks. In this paper we present the results of a single-case intervention study which used an interaction-focused approach to target the conversational behaviours of the significant other of a PWA with the aim of improving the dyad’s everyday conversations within the home environment. Aims: To discuss the targeting, implementation and evaluation of an interaction-focused intervention programme for a significant other of a person with aphasia. Methods & Procedures: Conversation Analysis was used both to guide choice of individualised target behaviours for the intervention and to explore changes in the conversational interaction between a woman with mild-moderate aphasia and her life partner. Three samples of video-recorded natural conversational interaction from before and after the partner took part in a six session long group intervention were analysed. The evidence for change that emerged from qualitative analysis of the conversational data was further analysed by an independent, blinded, assessor doing quantitative comparisons. Outcomes & Results: There was qualitative and quantitative evidence that two of three targeted conversational behaviours had changed following the intervention programme. Following the completion of the intervention the dyad spent significantly less time in pedagogic activities. Furthermore, the significant other showed an increased attention towards PWA’s conversational contributions. The combination of qualitative and quantitative analyses also revealed that post-intervention the communication partner displayed changes in an interactional behaviour which was not targeted in the intervention i.e. dismissive language towards the person with aphasia. Conclusions: This study adds to the existing literature in presenting positive results from an intervention which used an interaction-focused approach, here targeted towards the everyday communication partner of a PWA. Notably, this study supplemented qualitative outcomes with blinded and statistical quantitative analyses. Also, the fact that no transcriptions were used during the intervention process and that therapy was delivered via group intervention shows the feasibility of this form of communication partner training in clinical settings. Furthermore, the study suggests that intervention programmes targeting the behaviours of a communication partner may produce positive change in conversational behaviours that have not been directly targeted in the intervention.
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36.
  •  
37.
  •  
38.
  • Saldert, Charlotta, 1966, et al. (författare)
  • Complexity in measuring outcomes after communication partner training: Alignment between goals of intervention and methods of evaluation
  • 2018
  • Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 32:10, s. 1167-1193
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Researchers are currently discussing the need for consensus on a core set of outcome measures to assess interventions in aphasia. For indirect, environmental approaches to aphasia intervention, such as communication partner training (CPT), the roadmap to obtaining consensus on core outcome measures seems especially complex. While the purpose of CPT is to improve communication for people with communication disorders, the intervention is aimed at the communication partner. There is also a variety of goals, activities, and possible settings for CPT. This complexity increases the risk of a mismatch between the goals and content of the intervention and measures used to evaluate the outcome.Aims: The purpose of this paper is to describe the complexity of measuring outcomes from CPT. The aim is to enable clinicians and researchers to reflect on the outcomes to be measured and also on how different types of measures may or may not be aligned with the goals and content of a specific CPT intervention.Main contribution: The current proliferation of outcome measures used in CPT is considered in the light of a survey of general factors to be considered in evaluating intervention outcomes. The complexity of measuring outcomes in CPT is illustrated and the importance of alignment of main objectives, intervention tasks, and projected outcomes is exemplified by referencing two common types of CPT approaches. Objectives relating to knowledge of aphasia, interactional behaviour, and feelings and attitudes are considered in relation to specific outcome measurements. It is suggested that both study-specific and more general measures are needed for capturing and comparing outcomes. The measurement of relevant outcome in CPT is discussed along with implications for future research and clinical practice.Conclusions: Different CPT approaches share the same purpose of facilitating communication in aphasia, but their application in research studies or in the clinic, is specific to the particular context. Special care must thus be taken in both clinical practice and research to safeguard the alignment between objectives, tasks, and projected intervention outcomes and the actual measures used. Further, it is concluded that there is a need for the development of new measures based on a consensus on key outcomes to be measured in CPT.
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39.
  • Saldert, Charlotta, 1966, et al. (författare)
  • Comprehension of complex discourse in different stages of Huntington's disease.
  • 2010
  • Ingår i: International journal of language & communication disorders / Royal College of Speech & Language Therapists. - : Wiley. - 1460-6984. ; 45:6, s. 656-69
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Huntington's disease not only affects motor speech control, but also may have an impact on the ability to produce and understand language in communication. Aims: The ability to comprehend basic and complex discourse was investigated in three different stages of Huntington's disease. Methods & Procedures: In this experimental group study, 18 patients with Huntington's disease completed a test that assessed basic language abilities as well as tests from a battery of tasks that explored the ability to comprehend more complex information. The test battery assessed the ability to comprehend logico-grammatical sentences, ambiguous information and inferred meaning on sentence and discourse levels. Outcomes & Results: In comparison with results from pair-matched participants in a control group, matched for gender, age and education, the group of individuals with Huntington's disease had significantly more problems with all tasks requiring more complex cognitive processing. There was a correlation, as well as tendencies towards correlations, between results in the group of individuals with Huntington's disease and stage of the disease. However, results within the stage groups were heterogeneous, and some individuals in an early stage of the disease sometimes performed as well as others in a late stage. Conclusions & Implications: It is likely that, in complex discourse tasks, individual differences in cognitive capacity may contribute and override other differences related to stage of disease. These results indicate that it is important to assess comprehension even in early stages of Huntington's disease, with tests that are sensitive to subtle language disorders, to reduce communication problems for the individuals concerned and their conversational partners.
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40.
  • Saldert, Charlotta, 1966, et al. (författare)
  • Conversation partner training with spouses of persons with aphasia : A pilot study using a protocol to trace relevant characteristics
  • 2013
  • Ingår i: Aphasiology. - Abingdon : Routledge. - 0268-7038 .- 1464-5041. ; 27:3, s. 271-292
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Conversation partner training can be effective in improving communication in aphasia. However, there is a need for further research about effects of specific training programmes as well as about the relevant characteristics of the conversation partners who are to be candidates for training.Aims: This pilot study explores the applicability of an adaptation of a conversation partner training programme. In addition, a protocol for assessment of variables relating to the person with aphasia and the conversation partner that may be involved in changes in conversational interaction is examined.Methods & Procedures: Three dyads with persons with aphasia and their spouses participated in this explorative study with a case-series design. The training outcome was monitored with measures of perceived functional communication and analysis of multiple video-recorded natural conversations obtained at baseline, post intervention, and at a 12-week follow-up. Repeated measures of comprehension, word fluency, and psychological well-being were obtained as well as descriptive measures of the executive function and a profiling of attitudes and behaviour in communication in the spouses.Outcomes & Results: All three persons with aphasia and two of the spouses reported a slight improvement in the measure of perceived functional communication. This perception of improvement was also reflected in blinded, independent assessments of ability to support communication in conversations for the two spouses who reported improvement. The profiling of the third spouse indicated problems in attitudes to communication and also in aspects of executive function, and may account for the lack of intervention effects seen in the third dyad.Conclusions: The results show that intervention with the adapted training programme may be effective. It might be argued that the outcome measures as well as other measures fulfil their purpose. The profiling of relevant traits in the conversation partner may be useful, although the prognostic validity of the instruments needs to be further evaluated. © 2013 Copyright Taylor and Francis Group, LLC.
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41.
  • Saldert, Charlotta, 1966, et al. (författare)
  • Echolalia or functional repetition in conversation - a case study of an individual with Huntington's disease
  • 2011
  • Ingår i: Disability & Rehabilitation. - 0963-8288. ; 33:3, s. 253-260
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: In this case study, we investigated the use of repetition in an individual with a neurogenic communication disorder. Method: We present an analysis of interaction in natural conversations between a woman with advanced Huntington’s disease (HD), whose speech had been described as sometimes characterised by echolalia, and her personal assistant. The conversational interaction is analysed on a sequential level, and recurrent patterns are explored. Results: Although the ability of the person with HD to interact is affected by chorea, word retrieval problems and reduced comprehension, she takes an active part in conversation. The conversational partner’s contributions are often adapted to her communicative ability as they are formulated as questions or suggestions that can be elaborated on or responded to with a simple ‘yes’ or ‘no’. The person with HD often repeats the words of her conversational partner in a way that extends her contributions and shows listenership, and this use of repetition is also frequent in ordinary conversations between non-braindamaged individuals. Conclusions: The results show that the conversation partners in this case cooperate in making the conversation proceed and evolve, and that verbal repetition is used in a way that works as a strategy for compensating for the impairment.
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42.
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43.
  • Saldert, Charlotta, 1966 (författare)
  • Högerhemisfärskador
  • 2007
  • Ingår i: Logopedi. - Lund : Studentlitteratur. - 9789144038865 ; , s. 207-212
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)
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44.
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45.
  • Saldert, Charlotta, 1966 (författare)
  • Inference and conversational interaction. Pragmatic language disturbances related to stroke. [Ny], rev. [ed.]
  • 2006
  • Bok (övrigt vetenskapligt/konstnärligt)abstract
    • Language use at a discourse level, or in conversational interaction, puts high demands on human cognition. Brain damage can often result in pragmatic language disturbances, even if different language functions taken separately seem to be intact. In this thesis, post-stroke pragmatic ability in inferencing and in conversational interaction is explored. The ability to make inferences for comprehension and its association with sustained attention and verbal working memory capacity are studied in two experimental group studies with 14 right-hemisphere-damaged (RHD) individuals, 14 left-hemisphere-damaged (LHD) individuals, and a control group consisting of 14 non-brain-damaged individuals, matched for age, sex, education and reading habits. Change in the ability to interact in conversation and the degree of negative impact of this change are also investigated in a group study, using a questionnaire distributed to the brain-damaged individuals and their conversational partners (CP). The impact of pragmatic language disturbances at the individual level is explored in four case studies where the quantitative and qualitative results of the experimental cognitive tasks and the questionnaire are supplemented by an analysis of video-recorded natural conversation. The key findings show that the groups have somewhat different patterns of results in the inference tasks. The LHD group primarily had trouble with tasks requiring an ability to revise inferences, and their results on those tasks tended to be associated with verbal working memory. The RHD group also had problems with tasks requiring the ability to revise inferences, but their results were associated with sustained attention. The RHD subjects also had problems making inferences about characters’ attitudes or motives but no associations were seen between results on these tasks and verbal working memory or sustained attention. It was found that the LHD individuals and their CP tended to report more post-stroke changes and negative impact of these changes in conversational interaction than the RHD subjects and their CP. However, several of the RHD subjects and their CP who did report changes perceived a high degree of negative impact of these changes. The LHD and RHD groups often reported similar pragmatic areas as being affected in conversation and this was observed in the video-recorded conversational interaction as well. It is inferred from the results that expressions of pragmatic disorders post-stroke may be subtle and expressed in ways that are not traditionally related to language disturbances. Furthermore, even subtle pragmatic language disorders have an impact on, and also depend on, the role of the conversational partner. The results are approached from a perspective in which pragmatic ability in association with brain damage is seen as the outcome of interaction between several different cognitive functions, personality and compensatory strategies in the brain-damaged individual as well as in his or her conversational partners.
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46.
  • Saldert, Charlotta, 1966, et al. (författare)
  • Inference in right hemisphere damaged individuals’ comprehension: The role of sustained attention.
  • 2007
  • Ingår i: Clinical Linguistics and Phonetics. - : Informa UK Limited. - 1464-5076 .- 0269-9206. ; 21:8, s. 637-655
  • Tidskriftsartikel (refereegranskat)abstract
    • The ability to make inferences for the purposes of comprehension is considered an important factor in pragmatic ability. In this experimental group study with stroke patients, the ability to make inferences and its associations with sustained attention and verbal working memory were explored. A group of 14 left‐hemisphere‐damaged individuals had more difficulty with tasks requiring the ability to revise inferences than a matched control group. Their results on those tasks tended to be associated with verbal working memory capacity. A group of 14 right‐hemisphere‐damaged (RHD) individuals also had problems in revising inferences, but their results were associated with sustained attention. In addition, the RHD subjects had problems in making inferences about characters' attitudes or motives. A lack of significant differences in results on tasks between the groups of brain damaged individuals indicate that comprehension of complex information might be impaired post stroke, irrespectively of whether the damage is to the left or right hemisphere. The results suggest that sustained attention, whilst not being a solitary sufficient factor, might somehow be involved in comprehension problems related to RHD. Implications for further research and clinical management of these sometimes subtle problems are discussed.
  •  
47.
  • Saldert, Charlotta, 1966, et al. (författare)
  • Interaction between nursing staff and residents with aphasia in long-term care: A mixed method case study
  • 2018
  • Ingår i: Nursing Research and Practice. - : Hindawi Limited. - 2090-1437 .- 2090-1429. ; 2018
  • Tidskriftsartikel (refereegranskat)abstract
    • Thousands of individuals with communication disorders live in long-term residential care. Nursing staff are often their primary communication partners. The positive effects of social interaction and person-centred care have been recognised but there remains a paucity of research on the content and quality of communicative interaction between long-term care staff and residents with aphasia. This mixed method study investigates the discourse in interaction between nursing staff and residents with aphasia. Methods. A routine care activity was explored in 26 video-recordings featuring four enrolled nurses and four elderly persons with severe aphasia. Factors such as goals and roles in the activity weremapped out and a qualitative discourse analysis was performed. Based on the findings a coding scheme was constructed and the amount of time spent in different interactional foci of discourse was explored. Results. Fromthe qualitative findings three broad, but distinct, foci in the nurse-initiated interaction could be distinguished: (1) a focus on getting the task done with minimum interaction; (2) topics related to the task, but not necessary to get the task done; and (3) personal topics related to themes beyond the caring task.The analysis of distribution of time revealed that althoughmost of the interaction was focused on themain care activity, between 3 and 17% of the time was spent in either task-related or non task-related interaction. The distribution varied between dyads and could not be related to the residents’ severity of aphasia nor the activity as such. Conclusions. An endeavour to interact socially with the residents with aphasia influences the nurses’ foci of interaction. Contextual and personal factors of the residents and nurses need to be considered in clinical work as well as research on how communicationmay be supported to facilitate social interaction and person-centredness in long-term care of people with aphasia.
  •  
48.
  • Saldert, Charlotta, 1966, et al. (författare)
  • Interaction in conversation in Huntington´s disease: An activity-based analysis and the conversation partner's view of change
  • 2010
  • Ingår i: Journal of Interactional Research in Communication Disorders. - 2040-5111. ; 1:2, s. 169-197
  • Tidskriftsartikel (refereegranskat)abstract
    • This study explores how conversational interaction is affected in a progressive neurological disease and what changes in the communication are reported by significant others in a questionnaire. Three dyads, each consisting of a person with Huntington’s disease and a conversational partner, were video-recorded, and the conversations were analysed with respect to the parameters in the questionnaire and also with the method Activity-based Communication Analysis. The analyses revealed that several important aspects of communication were affected by the disease in each of the three cases presented here. Most, but not all, of these changes in communication were also reported by the significant other in the questionnaire. These results show that it is important to look out for possible communication problems when managing individuals with Huntington’s disease. The questionnaire utilized in this study, with some modifications, seems to be a promising instrument for use in a clinical setting.
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49.
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50.
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