Better pathways to living successfully with aphasia: Translating a national aphasia rehabilitation research program into clinical practice

Improved translation of health research knowledge into clinical practice is required to provide people with aphasia with effective and equitable health treatments. However, implementation of research outcomes can be slow leading to poorer health outcomes. Knowledge Transfer and Exchange (KTE) approaches trialed in individual aphasia rehabilitation studies have demonstrated that research knowledge can be translated into clinical practice to improve communication access for people with aphasia. This paper describes a multilayered KTE strategy developed by mapping a national aphasia research program onto The Knowledge-to-Action-Process Framework (Graham et al., 2006) to maximize the effective translation of research evidence into clinical practice

The provision of health information to stroke patients within an acute hospital setting: What actually happens and how do patients feel about it?

This preliminary study describes how health information is provided to stroke patients in an acute hospital and describes their perceptions of health information provision. A further aim was to determine if patients with aphasia were disadvantaged in their receipt of information. Seven stroke patients were observed in hospital for an average of 102 minutes each and then interviewed using a semi-structured interview. When communication occurred, only 17.5% of communication time was spent providing information. Patients with aphasia received information for less time and on fewer topics. Implications regarding approaches to information provision for patients with and without aphasia are discussed

Conversation Therapy for Aphasia: A Survey

There has been a growing interest in the engagement in and management of conversation in aphasia. The literature describes aspects of conversation in aphasia such as nonverbal communication and management of repair (e.g. Ferguson, 1994; Madden, Oelschlaeger & Damico, 2003). Research delineates strategies and resources employed to achieve conversation by people with aphasia and partners (e.g. Beeke, 2003; Beeke, Wilkinson & Maxim, 2001, 2009; Oelschlaeger & Damico, 1998; Wilkinson, Lock, Bryan & Sage, 2011). There is also growing interest in conversation as a target of aphasia treatment. Various approaches related to conversation have been reported such as multimodality training (Purdy & Van Dyke, 2011), discourse treatment for word retrieval (Boyle, 2011), group conversation therapy (Elman & Bernstein-Ellis, 1999; Simmons-Mackie, Elman, Holland & Damico, 2007), interaction-focused intervention (Wilkinson, Lock, Bryan & Sage, 2011), couples therapy (Boles, 2011) and partner training (Kagan et al, 2001). There has also been discussion of the impact of impairment-focused therapy on conversation (Carragher et al. 2012). Despite this growing knowledge base, there are no data regarding the translation of knowledge into clinical practice. Has conversation therapy become a routine aspect of clinical practice in aphasia? If so, what do clinicians do in conversation therapy for aphasia? In order to explore these questions, a web-based survey was initiated

Predictors of rehabilitation intervention decisions in adults with acquired hearing impairment

Purpose: This study investigated the predictors of rehabilitation intervention decisions in middle-age and older adults with acquired hearing impairment seeking help for the first time

Characteristics of age-friendly bus information

Bus information is an important element to consider when developing and implementing age-friendly bus systems. Little is known regarding the bus information needs and preferences of older people. This study aims to illuminate characteristics of age-friendly bus information. Participant observations with stimulated recall interviews (n=40) were used to identify older peoples' (age 60 and over) perspectives on bus information. The data were analyzed using qualitative content analysis. A printed information location checklist also was conducted. Categorical analysis identified that older people used a variety of information sources including printed information, telephone, Internet, bus drivers, word of mouth, and experience. Positive and negative characteristics of each source were identified. Older people also required a range of levels of information complexity. Popular locations for sourcing printed information included post offices, news agents, tourist information centers, and libraries. Transport providers and policy makers should consider the needs and preferences of older people when providing bus information. Effective information provision requires a range of media, covering a broad spectrum of information complexity and through a variety of locations

Perspectives on quality of life by people with aphasia and their family: Suggestions for successful living

Understanding the client's perspective is essential for good practitioner care in rehabilitation after stroke, and nothing is more relevant than enquiring directly about our clients' quality of life to inform our management. Relatively little is known about how older people with aphasia consider the quality of their current lives, and this article seeks to explore this issue. Four women's accounts of their life quality are presented, as well as their husbands' or daughter's accounts of their lives. Their stories share some common elements. Who you love or share your life with; where you live; feeling independent and/or in control; and engaging in satisfying activities mattered to these women's life quality. The impact of aphasia varies across the cases, and the need to accept change for successful living is illustrated in all accounts

Living successfully with aphasia: Family members share their views

Language and lifestyle changes experienced following the onset of aphasia extend beyond the individual to impact family members of persons with aphasia. Research exploring the meaning of living successfully with aphasia has explored the perspectives of individuals with aphasia and speech-language pathologists. Family members' views of living successfully with aphasia may also contribute valuable insights into positive adaptive processes and factors that may influence clinical interventions and community-based services for individuals with aphasia and their families. Purpose: To explore, from the perspectives of family members of individuals with aphasia, the meaning of living successfully with aphasia. Method: Twenty-four family members (nominated by individuals with aphasia) participated in semistructured in-depth interviews about living successfully with aphasia. Interviews were transcribed verbatim and analyzed using interpretative phenomenological analysis to identify themes relating to the meaning of living successfully with aphasia. Results: Seven themes were identified from analysis of family member participant transcripts: getting involved in life, support for the person with aphasia, communication, family members' own needs, putting life in perspective, focusing on and celebrating strengths and improvements, and experiences with services. Conclusion: Findings provide evidence to support previous research indicating that aphasia affects the whole family and not just an individual. The inclusion of family members as part of the rehabilitation team is indicated. Family members' needs and priorities must be considered in conceptualizing living successfully with aphasia to ensure family members are included in intervention programs

Stroke patients' awareness of risk and readiness to change behaviors

Purpose: Behavior change is an important component of secondary stroke prevention. The transtheoretical model, which describes behavior change as occurring through a series of stages, may be a useful way of assessing patients' readiness to change behavior. The model has been successfully applied to other chronic conditions and argues that people progressing "forward" through the stages are more likely to successfully change their behavior. The aim of this study was to describe stroke patients' readiness to change behaviors for stroke-related risk factors using this model, in the absence of a behavior modification intervention. Method: Patients (n = 27) from an acute stroke ward of a major metropolitan hospital in Brisbane, Australia, were interviewed prior to and at 3 months following hospital discharge regarding their awareness of stroke risk factors and their readiness to change stroke risk related behaviors. Results: At both points in time, 30% of patients could not spontaneously nominate one or more stroke risk factors. Despite a trend of "forward" progression in stages of change between the 2 interviews for behaviors relating to hypertension, heart disease, and high cholesterol, there were no statistically significant changes over time for any of the behaviors. Patients' readiness to change stroke risk related behaviors differed for each risk factor. Conclusion: Acknowledging that patients' readiness to change may differ for each risk factor may promote more effective facilitation of stroke secondary prevention behaviors

Outcomes from an intensive comprehensive aphasia program (ICAP): A retrospective look

Intensive comprehensive aphasia programs (ICAPs) are increasingly sought-after by consumers. It is important to examine outcomes from this unique clinical service model to determine feasibility, effectiveness, and potentially, to determine profiles of patient recovery. This poster presents retrospective data from first time participants in one ICAP over a 5 year period. Findings demonstrate significant improvements on language and activity/participation measures from pre-treatment to post-treatment

Do people with aphasia want written stroke and aphasia information? A verbal survey exploring preferences for when and how to provide stroke and aphasia information

Purpose: Written health information can be better comprehended by people with aphasia if it is provided in an aphasia-friendly format. However, before pursuing research in the area of text-formatting for people with aphasia, it must be determined whether people with aphasia consider it helpful to receive health information in the written media. This study, therefore, aimed to determine the following: whether people with aphasia consider it important to receive written stroke and aphasia information; when people with aphasia prefer to receive this information; and what their preferences are for health information media. Method: Surveys were administered in a face-to-face interview with 40 adults with aphasia. Participants were purposefully selected using maximum variation sampling for a variety of variables including aphasia severity, reading ability, and time post stroke. Results: Participants thought it important to receive written information about both stroke and aphasia. They considered it helpful to receive written information at several stages post stroke, particularly from 1 month onwards. The largest proportion (97%) of participants identified 6 months post stroke as the most helpful time to receive this information. Written information was the most preferred media at participants' present time post stroke (M=39 months; range, 2-178 months). Videos/DVDs were the most preferred media during the 6 months immediately following the stroke. Conclusion: Despite reading and language difficulties, participants considered written information to be important, hence people with aphasia should receive written information about both stroke and aphasia. This information should be easily accessible throughout the continuum of care