| 1. |
- Blom Johansson, Monica, 1965-, et al.
(författare)
-
Self-reported changes in everyday life and health of significant others of people with aphasia : a quantitative approach
- 2022
-
Ingår i: Aphasiology. - : Taylor & Francis. - 0268-7038 .- 1464-5041. ; 36:1, s. 76-94
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Changes in the everyday life and health of the significant others (SOs) of people living with stroke sequalae have been widely investigated. However, information regarding the frequency of the changes in daily life and the variables most associated with these perceived life changes is limited. Aims: To examine the extent to which SOs of persons with aphasia (PWAs) experience changes in everyday life and health after the stroke event and how they evaluate these changes and to identify which variables are associated with these perceived life changes. Methods & Procedures: A study-specific questionnaire about perceived changes in everyday life and health was completed by 173 SOs of PWAs living in Sweden (response rate 67.8%). The items concerned the SO’s working and financial situation, leisure time and social life, relationship with the PWA, household work and responsibility, and health and quality of life. Outcomes & Results: The everyday life and health of the SOs were greatly affected by the stroke event. The changes the SOs experienced were mainly appraised negatively. The relationships with the PWA and immediate family were least affected by the stroke. The perceived existence and severity of physical, cognitive, and language impairments of the PWA were the variables most strongly associated with the everyday life situation of the participants. The sex and age of the participants and the nature of the relationship with the PWA were only marginally associated with the experience of the situation. Conclusions: SOs’ perceptions of the PWA’s stroke-related disabilities and need for assistance may be a key factor in identifying SOs who may require support and guidance to help them cope with their new life situation.
|
|
| 2. |
- Olsson, Camilla, 1971-, et al.
(författare)
-
Relations between executive function, language, and functional communication in severe aphasia
- 2019
-
Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 33:7, s. 821-845
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Intervention in severe aphasia often means aiming for access to meaningful social interaction in spite of linguistic barriers that might not be treatable. This demands knowledge about the different factors that influence functional communication. Apart from linguistic ability, executive functions are thought to play an important role.Aims: To expand the understanding of the relations of executive functions and linguistic ability to functional communication in severe aphasia.Methods and Procedures: Executive functions, linguistic ability, and functional communication were assessed in 47 participants with severe aphasia. The results were analysed for the total sample and for a verbal and a nonverbal subgroup.Outcomes and Results: Impairment of executive function was found in 79% of the participants. There were moderate to strong correlations between all subtests of executive functions and linguistic ability. In the total sample, significant partial correlation was found between functional communication and verbal output. In the nonverbal subgroup, there was a significant partial correlation between executive function and functional communication, when controlling for linguistic ability. In the verbal subgroup, no relations were found between executive functions or language and functional communication.Conclusions: Impairments of executive functions are common in people with severe aphasia, and executive function and linguistic ability are closely related. The ability to produce verbal output is strongly related to functional communication, but in people with extreme limitation or total absence of verbal output, executive functions seem to be an important factor for functional communication. There is a large variation of executive functions and functional communication in people with severe aphasia, especially in the nonverbal subgroup. It is important that people with severe aphasia are given a complete and proper evaluation of their abilities, and that the possible importance of executive function to communication is considered in communication intervention.
|
|
| 3. |
- Persson, Klara Josefina, et al.
(författare)
-
Do best practice recommendations align with current aphasia practices in the Swedish care context : a national survey
- 2022
-
Ingår i: Aphasiology. - : Routledge. - 0268-7038 .- 1464-5041. ; 36:8, s. 903-920
-
Tidskriftsartikel (refereegranskat)abstract
- Background: For healthcare professionals, decision-makers and taxpayers, clinical guidelines and recommendations are tools for implementing interventions supported by research evidence. To ensure efficient, safe, and equal care for people with aphasia (PWA) in Sweden, it is vital that speech and language pathologists (SLPs) can work in accordance with evidence-based practice.Aim: To investigate to which degree the Best practice recommendations for aphasia (BPRA) are already well aligned with current practice in the management of aphasia and to what extent they would require adjustment to fit the Swedish care contexts.Methods and procedures: The BPRA were translated from English to Swedish according to steps 1 and 2 in the translation method recommended by the World Health Organization (WHO). A web-based questionnaire was used for data collection. All healthcare regions in Sweden were represented, and the study included a total of 109 SLPs. The participants' perceived knowledge and application of the recommendations and whether the recommendations can serve as a basis for national clinical guidelines were summarized quantitatively. The participants' comments on the applicability of the BPRA were analyzed with qualitative content analysis according to an established model.Outcomes and results: Only a few participants indicated they had good knowledge of the BPRA. The responses additionally showed that the application of the BPRA varied between the participants and across clinical settings. Lacking SLP resources was stated to be the main perceived barrier for complying with the recommendations. The participants also stated that the BPRA requires adjustment to provide a partial basis for national clinical guidelines for aphasia and the need for national clinical guidelines to be adjusted to prevalent SLP resources.Conclusions: There are challenges in following up on some of the interventions that, according to both multinational recommendations and Swedish guidelines, should be given priority in the care of PWA. The barriers that are stated to complicate Swedish SLPs' compliance with some of the multinational recommendations are similar to the barriers posed by SLPs in other national studies on the uptake of aphasia rehabilitation recommendations. In Sweden, SLPs experience a lack of resources of various kinds to be able to fully comply with the BPRA.
|
|
| 4. |
- Ali, M, et al.
(författare)
-
Protocol for the development of the international population registry for aphasia after stroke (I-PRAISE)
- 2022
-
Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 36:4, s. 534-554
-
Tidskriftsartikel (refereegranskat)abstract
- Background: We require high-quality information on the current burden, the types of therapy and resources available, methods of delivery, care pathways and long-term outcomes for people with aphasia.Aim: To document and inform international delivery of post-stroke aphasia treatment, to optimise recovery and reintegration of people with aphasia.Methods & Procedures: Multi-centre, prospective, non-randomised, open study, employing blinded outcome assessment, where appropriate, including people with post-stroke aphasia, able to attend for 30 minutes during the initial language assessment, at first contact with a speech and language therapist for assessment of aphasia at participating sites. There is no study-mandated intervention. Assessments will occur at baseline (first contact with a speech and language therapist for aphasia assessment), discharge from Speech and Language Therapy (SLT), 6 and 12-months post-stroke. Our primary outcome is changed from baseline in the Amsterdam Nijmegen Everyday Language Test (ANELT/Scenario Test for participants with severe verbal impairments) at 12-months post-stroke. Secondary outcomes at 6 and 12 months include the Therapy Outcome Measure (TOMS), Subjective Index of Physical and Social Outcome (SIPSO), Aphasia Severity Rating Scale (ASRS), Western Aphasia Battery Aphasia Quotient (WAB-AQ), stroke and aphasia quality of life scale (SAQoL-39), European Quality of Life Scale (EQ-5D), lesion description, General Health Questionnaire (GHQ-12), resource use, and satisfaction with therapy provision and success. We will collect demography, clinical data, and therapy content. Routine neuroimaging and medication administration records will be accessed where possible; imaging will be pseudonymised and transferred to a central reading centre. Data will be collected in a central registry. We will describe demography, stroke and aphasia profiles and therapies available. International individual participant data (IPD) meta-analyses will examine treatment responder rates based on minimal detectable change & clinically important changes from baseline for primary and secondary outcomes at 6 and 12 months. Multivariable meta-analyses will examine associations between demography, therapy, medication use and outcomes, considering service characteristics. Where feasible, costs associated with treatment will be reported. Where available, we will detail brain lesion size and site, and examine correlations with SLT and language outcome at 12 months.Conclusion: International differences in care, resource utilisation and outcomes will highlight avenues for further aphasia research, promote knowledge sharing and optimise aphasia rehabilitation delivery. IPD meta-analyses will enhance and expand understanding, identifying cost-effective and promising approaches to optimise rehabilitation to benefit people with aphasia.
|
|
| 5. |
- Blom Johansson, Monica, 1965-, et al.
(författare)
-
A multiple-case study of a family-oriented intervention practice in the early rehabilitation phase of persons with aphasia
- 2013
-
Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 27:2, s. 201-226
-
Tidskriftsartikel (refereegranskat)abstract
- Background:Having a family member with aphasia severely affects the everyday life of the significant others, resulting in their need for support and information. Family-oriented intervention programmes typically consist of support, information, and skill training, such as communication partner training (CPT). However, because of time constraints and perceived lack of skills and routines, such programmes, especially CPT, are not common practice among speech-language pathologists (SLPs).Aims:To design and evaluate an early family-oriented intervention of persons with stroke-induced moderate to severe aphasia and their significant others in dyads. The intervention was designed to be flexible to meet the needs of each participant, to emotionally support the significant others and supply them with information needed, to include CPT that is easy to learn and conduct for SLPs, and to be able to provide CPT when the persons with aphasia still have access to SLP services.Methods & Procedures:An evaluative multiple-case study, involving three dyads, was conducted no more than 2 months after the onset of aphasia. The intervention consisted of six sessions: three sessions directed to the significant other (primarily support and information) and three to the dyad (primarily CPT). The intervention was evaluated both qualitatively and quantitatively based on video recordings of conversations and self-assessment questionnaires.Outcomes & Results:The importance of emotional support as well as information about stroke/aphasia was clearly acknowledged, especially by the significant others. All significant others perceived increased knowledge and understanding of aphasia and related issues.Communicative skills (as manifested in the video recordings) showed improvements from pre- to post-intervention.Conclusions:The results corroborate the need for individualised and flexible family-oriented SLP services that are broad in content. Furthermore, the results support the early initiation of such services with recurrent contact. The usefulness of CPT this early in the rehabilitation process was indicated but is yet to be proved.
|
|
| 6. |
- Blom Johansson, Monica, 1965-, et al.
(författare)
-
Communication changes and SLP-services according to significant others of persons with aphasia
- 2012
-
Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 26:8, s. 1005-1028
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Significant others are important to persons with aphasia. For several reasons they should be involved in speech-language pathology (SLP) services, including acquiring facilitating communicative strategies and receiving support. In order to further adapt SLP services there is a need to know the perceptions and views of the significant others. Little is known about how they perceive changes in communication as well as received SLP services and in what way they want to be involved in these services.Aims: The study aimed to investigate which communicative changes significant others of persons with aphasia had experienced after a stroke event and to what extent these changes were experienced. A further aim was to describe the significant others’ experiences of SLP services and their motivation to participate in these services. Finally, the significant others’ experiences were compared in terms of sex, age, type of relationship, time since stroke onset, and type and severity of aphasia.Methods & Procedures: An 80-item study-specific questionnaire was answered by 173 significant others of persons with aphasia living throughout Sweden (response rate 69%). Of these, 33% were male and 67% female. Mean age was 64.2 years (range 33–87 years) and 85.5% of the participants were a cohabiting partner to a person with aphasia.Outcomes & Results: A total of 64% of participants perceived their conversations as being less stimulating and enjoyable compared with conversations before stroke onset. Aphasia was considered a substantial or very substantial problem by 64%. The participants took on an increased communicative responsibility, and 70% had changed their communicative behaviour in order to facilitate conversations. A total of 75% (n = 130) had met with the SLP of the person with aphasia. Of those, 63% perceived their own support from SLP services to be adequate; 87% considered language ability training as the most important SLP service. Type and severity of aphasia were especially related to the communicative experiences of the participants and their motivation to be involved in SLP services.Conclusions: The substantial decrease from pre- to post-stroke regarding enjoyment and meaningfulness of conversations suggests the need to further improve SLP services in order to help the people in question communicate at an optimal level. We suggest that clinicians should put more emphasis on explaining the benefits and availability of different kinds of aphasia rehabilitation services, such as functional communication training and communication partner training in addition to language ability training.
|
|
| 7. |
- Cruice, Madeline, et al.
(författare)
-
Reporting Interventions in Communication Partner Training : A Critical Review and Narrative Synthesis of the Literature
- 2018
-
Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 32:10, s. 1135-1166
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Communication partner training (CPT) is an umbrella term for a complex behavioural intervention for communications partners (CPs) of people with aphasia (PWA) and possibly PWA themselves, with many interacting components, deployed in flexible ways. Recent systematic reviews (Simmons-Mackie, Raymer, Armstrong, Holland, & Cherney, 2010; Simmons-Mackie, Raymer, & Cherney, 2016) have highlighted the effectiveness of CPT in addressing the skills of conversation partners and the communicative participation of people with aphasia but have suggested that CPT has been variably delivered, with no clear picture of what the essential elements of CPT are and how CPT is expected to achieve its results through hypothesised mechanisms of change (Coster, 2013).Aim: This paper aims broadly to consider specification of CPT and describes how CPT has been conducted overall and in relation to treatment recipients. Recommendations for CPT and areas for future research are considered.Methods & Procedures: A critical review and narrative synthesis was carried out through: (i) the systematic application of the 12-item TIDieR checklist (Hoffmann et al., 2014) to the 56 studies appraised in the Simmons-Mackie et al. (2010, 2016)) reviews, providing a quantitative overview of the completeness of CPT intervention reporting; and (ii) a qualitative synthesis of the reviewed CPT literature according to TIDieR items.Outcomes & Results: Half of the TIDieR checklist items were reported by 71% or more of the studies, and the rest of the items were reported by 0–63% of studies. TIDieR items relating to the treatment (goal, rationale or theory of essential elements, materials and procedures) and provision (provider, mode, timing, dose) were more frequently reported; however, the level of detail provided was often inadequate or incomplete. The interventions were insufficiently specified to enable replication for most of the studies considered. The most infrequently reported items were: name, location, intervention tailoring and modification, and planned and actual intervention adherence/fidelity.Conclusion: For a better understanding of an intervention, it is necessary to identify and describe potentially central elements and perhaps especially in complex interventions as CPT, where it is likely also more difficult. Whilst the reviewed CPT studies are on average reporting on slightly more than half of the TIDieR items, they are overall insufficiently detailed. Some items appear easier to report on, whereas other items have not been attended to, are too complex in nature to give a full report on, or simply have not been relevant for the individual study to include.
|
|
| 8. |
|
|
| 9. |
- 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.
|
|
