Overprotection in conversation in couples with aphasia

Overprotection can manifest itself in conversation when a spouse ‘speaks for’ a person with aphasia. This tendency can have an effect on a person with aphasia’s participation in conversation. To study this phenomenon and establish if there are relationships between overprotection, ‘speaking for’ behaviors and participation in conversation, eighteen couples completed questionnaires on overprotection and were video-recorded in an interview situation. Main results demonstrated significant and moderate relationships between (1) overprotection as reported by spouses and their 'speaking for' behaviors in conversation and (2) spouses’ ‘speaking for’ behaviors and minor participation in conversation by person with aphasia

Evaluation of AID-COM, a communication-focused program for family carers of people with early-stage Alzheimer’s disease: a pilot study (innovative practice)

Families providing care to relatives with Alzheimer’s disease are quickly destabilized by changes that disrupt communication. This pilot mixed-design study aimed to provide a quantitative and qualitative evaluation of a communication-based training program for carers of people with early-stage Alzheimer’s disease. Five participants received three training sessions. The use of communication strategies by participants and their effectiveness were evaluated before and after the training, and a focus group was conducted to gather participants’ impressions about the impacts of the training on communication with the person they cared for. The AID-COM (AID for COMmunication) program appears to have met expectations. © The Author(s) 2019

Development of a procedure for the evaluation of spouses' and persons with aphasia's contributions an interview situation

Person with aphasia’s participation in group conversations in presence of her/his spouse have not been extensively studied. The development of a procedure that addresses the spouses’contributions (i.e., ‘repair’, ‘speaking for’ and ‘support’) as well as the reaction and participation of the person with aphasia in an interview situation is presented. Results from eight couples indicate that spouses are quite active when the aphasic person has the floor. Aphasic persons most often approve what the spouse has contributed and continue to participate fully. However, unsolicited ‘speaking for’ behaviors are sometimes followed by a decrease participation in conversation of people with aphasia

Increasing the intensity and comprehensiveness of aphasia services: identification of key factors influencing implementation across six countries

Background: Aphasia services are currently faced by increasing evidence for therapy of greater intensity and comprehensiveness. Intensive Comprehensive Aphasia Programs (ICAPs) combine these elements in an evidence-based, time-limited group program. The incorporation of new service delivery models in routine clinical practice is, however, likely to pose challenges for both the service provider and administering clinicians. This program of research aims to identify these challenges from the perspective of aphasia clinicians from six countries and will seek to trial potential solutions. Continual advancements in global communication technologies suggest that solutions will be easily shared and accessed across multiple countries. Aims: To identify the perceived and experienced barriers and facilitators to the implementation of 1) intensive aphasia services, 2) comprehensive aphasia services, and 3) ICAPs, from aphasia clinicians across six countries. Methods and procedures: A qualitative enquiry approach included data from six focus groups (n = 34 participants) in Australia, New Zealand, Canada, United States of America (USA), United Kingdom (UK), and Ireland. A thematic analysis of focus group data was informed by the Theoretical Domains Framework (TDF). Outcomes and results: Five prominent theoretical domains from the TDF influenced the implementation of all three aphasia service types across participating countries: environmental context and resources, beliefs about consequences, social/professional role and identity, skills, and knowledge. Four overarching themes assisted the identification and explanation of the key barriers and facilitators: 1. Collaboration, joint initiatives and partnerships, 2. Advocacy, the promotion of aphasia services and evidence-based practice, 3. Innovation, the ability to problem solve challenges, and 4. Culture, the influence of underlying values. Conclusions: The results of this study will inform the development of a theoretically informed intervention to improve health services’ adherence to aphasia best practice recommendations

The use of studiocode for tracking change in conversational therapy

Spouses of people with aphasia have reported that developing an effective mode of communication with their partner is one of their most important needs ((McGurk, Kneebone, & Pit ten Café, 2011; Michallet, Le Dorze & Tétrault, 2001). There is a growing interest in a intervention focused on communication between the person with aphasia and his/her main conversation partner (e.g.,Turner & Witworth, 2006; Beeke, Maxim & Wilkinson, 2007). In studies that aim to verify the efficacy of conversational intervention, few measures have been taken during the intervention to measure the evolution. As a result, they are conducted with less experimental control than it is desirable. These studies provide valuable information on the evolution of conversations, but quantitative research is needed to study more couples and conversations. The present pilot project was developed to verify the efficacy of a conversational intervention with a dyad of a man with aphasia and his spouse, using the powerful Studiocode program for quantitative analysis

Stroke and Aphasia in Canada

As is the case in many areas of the world, aphasia treatment is far from being a priority within the Canadian healthcare system. This poster represents one part of a larger initiative planned to begin addressing the challenges of aphasia intervention and developing aphasia research capacity in Canada by aligning with the stroke community. While the presentation will focus on the Canadian experience in the area of stroke and aphasia, we hope to stimulate an international exchange of views

Creating a rehabilitation living lab to optimize participation and inclusion for persons with physical disabilities

AbstractWe present an on-going multidisciplinary and multisectorial strategic development project put forth by the Centre for Interdisciplinary Research in Rehabilitation of greater Montréal (CRIR) in Quebec, Canada and its members, in collaboration with a Montréal “renovation-ready” shopping mall, local community organizations, and local, national and international research and industrial partners. Beginning in 2011, within the context of the Mall as Living Lab (MALL), more than 45 projects were initiated to: (1) identify the environmental, physical and social obstacles and facilitators to participation; (2) develop technology and interventions to optimize physical and cognitive function participation and inclusion; (3) implement and evaluate the impact of technology and interventions in vivo. Two years later and working within a participatory action research (PAR) approach, and the overarching WHO framework of the International Classification of Functioning, Disability and Health (ICF), we discuss challenges and future endeavors. Challenges include creating and maintaining partnerships, ensuring a PAR approach to engage multiple stakeholders (e.g. people with disabilities, rehabilitation and design researchers, health professionals, community members and shopping mall stakeholders) and assessing the overall impact of the living lab. Future endeavors, including the linking between research results and recommendations for renovations to the mall, are also presented

Integrating aphasia into stroke best practices: A Canadian KTE strategy

This poster reports on the activities to date of the Stroke and Aphasia Canada team including results of a Canadian Institutes of Health Research (CIHR) Knowledge Translation (KT) planning grant (grant #290592, 2013)

Which outcomes are most important to people with aphasia and their families? an international nominal group technique study framed within the ICF

PURPOSE: To identify important treatment outcomes from the perspective of people with aphasia and their families using the ICF as a frame of reference. METHODS: The nominal group technique was used with people with aphasia and their family members in seven countries to identify and rank important treatment outcomes from aphasia rehabilitation. People with aphasia identified outcomes for themselves; and family members identified outcomes for themselves and for the person with aphasia. Outcomes were analysed using qualitative content analysis and ICF linking. RESULTS: A total of 39 people with aphasia and 29 family members participated in one of 16 nominal groups. Inductive qualitative content analysis revealed the following six themes: (1) Improved communication; (2) Increased life participation; (3) Changed attitudes through increased awareness and education about aphasia; (4) Recovered normality; (5) Improved physical and emotional well-being; and (6) Improved health (and support) services. Prioritized outcomes for both participant groups linked to all ICF components; primary activity/participation (39%) and body functions (36%) for people with aphasia, and activity/participation (49%) and environmental factors (28%) for family members. Outcomes prioritized by family members relating to the person with aphasia, primarily linked to body functions (60%). CONCLUSIONS: People with aphasia and their families identified treatment outcomes which span all components of the ICF. This has implications for research outcome measurement and clinical service provision which currently focuses on the measurement of body function outcomes. The wide range of desired outcomes generated by both people with aphasia and their family members, highlights the importance of collaborative goal setting within a family-centred approach to rehabilitation. These results will be combined with other stakeholder perspectives to establish a core outcome set for aphasia treatment research. Implications for Rehabilitation Important outcomes for people with aphasia and their families span all components of the ICF. The relevancy and translation of research findings may be increased by measuring and reporting research outcomes which are important to people living with aphasia. The results of this study indicate that important treatment outcomes for people living with aphasia most frequently link to the activity/participation and body function components of the ICF. The outcomes identified in this study suggest a broad role for clinicians working in aphasia rehabilitation. The categories of identified outcomes may be used clinically as a starting point in goal-setting discussions with clients and their families

A core outcome set for aphasia treatment research: the ROMA consensus statement

Background: A core outcome set (COS; an agreed, minimum set of outcomes) was needed to address the heterogeneous measurement of outcomes in aphasia treatment research and to facilitate the production of transparent, meaningful and efficient outcome data. Objective: The Research Outcome Measurement in Aphasia (ROMA) consensus statement provides evidence-based recommendations for the measurement of outcomes for adults with post-stroke aphasia within phase I-IV aphasia treatment studies. Methods: This statement was informed by a four-year program of research which comprised investigation of stakeholder-important outcomes using consensus processes, a scoping review of aphasia outcome measurement instruments, and an international consensus meeting. This paper provides an overview of this process and presents the results and recommendations arising from the international consensus meeting. Results: Five essential outcome constructs were identified: Language, communication, patient-reported satisfaction with treatment and impact of treatment, emotional wellbeing, and quality of life. Consensus was reached for the following measurement instruments: Language: The Western Aphasia Battery Revised (WAB-R) (74% consensus); emotional well-being: General Health Questionnaire (GHQ)-12 (83% consensus); quality of life: Stroke and Aphasia Quality of Life Scale (SAQOL-39) (96% consensus). Consensus was unable to be reached for measures of communication (where multiple measures exist) or patient-reported satisfaction with treatment or impact of treatment (where no measures exist). Discussion: Harmonisation of the ROMA COS with other core outcome initiatives in stroke rehabilitation is discussed. Ongoing research and consensus processes are outlined. Conclusion: The WAB-R, GHQ, and SAQOL-39 are recommended to be routinely included within phase I-IV aphasia treatment studies. This consensus statement has been endorsed by the Collaboration of Aphasia Trialists, the British Aphasiology Society, the German Society for Aphasia Research and Therapy, and the Royal College of Speech Language Therapists