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- Johansson, Inga-Lena, 1967-
(author)
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Parkinson’s Disease and Communication : Intelligibility, Interaction and Participation
- 2024
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Doctoral thesis (other academic/artistic)abstract
- Parkinson’s disease is a neurodegenerative disorder affecting dopamine production in the basal ganglia. It is a common cause of disability among elderly people. The main symptoms are tremor, rigidity, and bradykinesia, but there is a substantial individual variation of how the disease manifests itself. Communicative changes occur frequently and motor speech impairment in the form of dysarthria is common. Other communicative abilities, such as language functions and the use of body gestures, may also be affected. Traditionally, the focus for research and clinical assessments and interventions in the context of communicative changes in Parkinson’s disease has mainly been on speech and voice impairment. However, the impact on communication is multi-faceted, and different factors may affect the ability to make oneself understood and participate in conversations. Conversation is also a collaborative activity, where all participants’ contributions would need to be considered. Although there is a growing body of research on communicative impact in Parkinson’s disease, these aspects have, so far, been less studied. In the present thesis, communicative changes in Parkinson’s disease were explored with a focus on speech intelligibility, interaction in conversations, and communicative participation.In study I, qualitative interviews with dyads consisting of a person with Parkinson’s disease and a close communication partner revealed individual variation in experiences of communicative changes. The results indicated multi-factorial disease-related impact on everyday communication and communicative participation. A change noted in almost all dyads was that the partner with Parkinson’s disease participated less in conversations. In study II, listener ratings of connected speech intelligibility showed both inter- and intra-speaker variability between different types of assessment tasks, indicating that di-verse factors may influence intelligibility for individual speakers. Listener knowledge of context significantly increased intelligibility scores. Acoustic analyses of consonant articulation in study III indicated that some measures may be more sensitive for detecting impact on speech and intelligibility for speakers with Parkinson’s disease, while other aspects of articulation may be demanding in terms of acoustic realisation also for healthy elderly speakers. Visual examination of spectrograms may provide qualitative information about speech production in relation to intelligibility. Paper IV reports a pilot trial of dyadic intervention from a self-management perspective. Qualitative exploratory interviews and video recordings of the dyads’ joint conversations formed the basis for the intervention. At follow-up, the participating dyads reported increased communicative awareness and changes in mind-set but minor changes of communicative behaviours. The results from the included studies contribute to the understanding of the complexity and individual variability of possible communicative impact in Parkinson’s disease and support a holistic perspective on communication. The thesis demonstrates that it is necessary to apply multiple methods in assessment for achieving in-depth knowledge of how Parkinson’s disease impacts on speech intelligibility and everyday communication, to optimally tailor communication interventions to the individuals’ needs. This should also include insights in the communicative habits and experiences of persons with Parkinson’s disease and their close communication partners.
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| 2. |
- Norén, Niklas, 1966-, et al.
(author)
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Dialogical Perspectives on Aided Communication
- 2013
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In: Aided Communication in Everyday Interaction. - Guildford : J&R Press Ltd. - 9781907826115 - 1907826114 ; , s. 1-22
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Book chapter (other academic/artistic)abstract
- This articile is an introduction to a research anthology on aided communication, and argues for a dialogical approach to challenged interaction i research and clinical practise.
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| 3. |
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Aided Communication in Everyday Interaction
- 2013
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Editorial collection (other academic/artistic)abstract
- This book argues for the importance of the participants' perspective within both theory and practice on the function of augmentative and alternative communication (AAC) aids in everyday talk-in-interaction. Interactional approaches such as Conversation Analysis (CA) and Topical episode analysis are used to analyze and demonstrate the way participants make sense and display their understanding of AAC-mediated action. The book documents various practices and methods of the everyday use of AAC which can be applied clinically when establishing evidence-based assessment and intervention procedures. The book aims to bridge the gap between research and clinical practice, analyzes and explains the use of AAC aids, uses video recordings and transcriptions of naturally occurring, everyday talk-in-interacton, and demonstrates how the communicative context of the user's home is a powerful environment for learning and developing AAC use.
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| 4. |
- Astell, A. J., et al.
(author)
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Developing a pragmatic evaluation of ICTs for older adults with cognitive impairment at scale : the IN LIFE experience
- 2022
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In: Universal Access in the Information Society. - Heidelberg, Germany : Springer. - 1615-5289 .- 1615-5297. ; 21:1, s. 1-19
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Journal article (peer-reviewed)abstract
- Implementing information and communications technology (ICT) at scale requires evaluation processes to capture the impacton users as well as the infrastructure into which it is being introduced. For older adults living with cognitive impairment, thisrequires evaluation that can accommodate diferent levels of cognitive impairment, alongside input from family and formalcaregivers, plus stakeholder organisations. The European Horizon 2020 project INdependent LIving support Functions forthe Elderly (IN LIFE) set out to integrate 17 technologies into a single digital platform for older people living with cognitive impairment plus their families, care providers and stakeholders. The IN LIFE evaluation took place across six nationalpilot sites to examine a number of variables including impact on the users, user acceptance of the individual services andthe overall platform, plus the economic case for the IN LIFE platform. The results confrmed the interest and need amongolder adults, family caregivers, formal caregivers and stakeholders, for information and communications technology (ICT).Relative to the baseline, quality of life improved and cognition stabilised; however, there was an overall reluctance to payfor the platform. The fndings provide insights into existing barriers and challenges for adoption of ICT for older peopleliving with cognitive impairment.
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| 5. |
- Blomgren, Charlotte, et al.
(author)
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Long-term performance of instrumental activities of daily living in young and middle-aged stroke survivors-Impact of cognitive dysfunction, emotional problems and fatigue.
- 2019
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In: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 14:5
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Journal article (peer-reviewed)abstract
- With an upward trend in the number of people who return home to independent living after stroke, the ability to perform more complex activities is becoming an increasingly important long-term outcome after stroke. Although associations between Instrumental Activities of Daily Living (IADL) and cognitive dysfunction, emotional problems, and fatigue have been reported, less is known about the long-term impact of these stroke consequences on the performance of everyday activities in young and middle-aged stroke survivors.To explore the impact of cognitive dysfunction, emotional problems, and fatigue on long-term performance of instrumental activities of daily living in young and middle-aged stroke survivors.Data on stroke survivors, aged 18-69 at index stroke, were collected from the Sahlgrenska Academy Study on Ischaemic Stroke. IADL outcome was assessed using the Frenchay Activities Index (FAI), and the impact of chosen variables was assessed using Spearman´s rank-order correlation and logistic regression.Seven years after index stroke, 296 stroke survivors (median age of 64) were included in this study. Cognitive dysfunction showed the strongest correlations with FAI outcome and independently explained worse outcome on FAI summary score and the domain of work/leisure activities. Fatigue was independently explanatory of worse outcome on FAI summary score and domestic chores, while depressive symptoms independently explained worse outcome on work/leisure activities. In a subgroup with only those participants who had no or minimal residual neurological deficits at follow-up (NIHSS score 0), cognitive dysfunction independently explained worse outcome on FAI summary score and work/leisure activities. Depressive symptoms independently explained worse outcome on FAI summary score and domestic chores.Our results show that in young and middle-aged stroke survivors, cognitive dysfunction, depressive symptoms, and fatigue negatively impact performance of IADL even at seven years post stroke onset. Further, we have shown that an impact of both cognitive dysfunction and depressive symptoms can be found also among stroke survivors with mild or no remaining neurological deficits.
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| 6. |
- Brännmark, Cecilia, et al.
(author)
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FIND Stroke Recovery Study (FIND): rationale and protocol for a longitudinal observational cohort study of trajectories of recovery and biomarkers poststroke
- 2023
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In: Bmj Open. - 2044-6055. ; 13:5
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Journal article (peer-reviewed)abstract
- ntroduction Comprehensive studies mapping domain-specific trajectories of recovery after stroke and biomarkers reflecting these processes are scarce. We, therefore, initiated an exploratory prospective observational study of stroke cases with repeated evaluation, the FIND Stroke Recovery Study. We aim to capture trajectories of recovery from different impairments, including cognition, in combination with broad profiling of blood and imaging biomarkers of the recovery. Methods and analysis We recruit individuals with first-ever stroke at the stroke unit at the Sahlgrenska University Hospital, Sweden, to FIND. The inclusion started early 2018 and we aim to enrol minimum 500 patients. Neurological and cognitive impairments across multiple domains are assessed using validated clinical assessment methods, advanced neuroimaging is performed and blood samples for biomarker measuring (protein, RNA and DNA) at inclusion and follow-up visits at 3 months, 6 months, 1 year, 2 years and 5 years poststroke. At baseline and at each follow-up visit, we also register clinical variables known to influence outcomes such as prestroke functioning, stroke severity, acute interventions, rehabilitation, other treatments, socioeconomic status, infections (including COVID-19) and other comorbidities. Recurrent stroke and other major vascular events are identified continuously in national registers. Ethics and dissemination FIND composes a unique stroke cohort with detailed phenotyping, repetitive assessments of outcomes across multiple neurological and cognitive domains and patient-reported outcomes as well as blood and imaging biomarker profiling. Ethical approval for the FIND study has been obtained from the Regional Ethics Review Board in Gothenburg and the Swedish Ethics Review Board. The results of this exploratory study will provide novel data on the time course of recovery and biomarkers after stroke. The description of this protocol will inform the stroke research community of our ongoing study and facilitate comparisons with other data sets.
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| 7. |
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| 8. |
- Ekström, Anna, et al.
(author)
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Digital communication support and Alzheimer’s disease
- 2017
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In: Dementia. - : Sage Publications. - 1471-3012 .- 1741-2684. ; 16:6, s. 711-731
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Journal article (peer-reviewed)abstract
- Communication is one of the areas where people with dementia and their caregivers experience most challenges. The purpose of this study is to contribute to the understanding of possibilities and pitfalls of using personalized communication applications installed on tablet computers to support communication for people with dementia and their conversational partners. The study is based on video recordings of a woman, 52 years old, with Alzheimer’s disease interacting with her husband in their home. The couple was recorded interacting with and without a tablet computer including a personalized communication application. The results from the present study reveal both significant possibilities and potential difficulties in introducing a digital communication device to people with dementia and their conversational partners. For the woman in the present study, the amount of interactive actions and the number of communicative actions seem to increase with the use of the communication application. The results also indicate that problems associated with dementia are foregrounded in interaction where the tablet computer is used.
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