Brunel University School of Health Sciences and Social Care PhD Theses
Abstract
This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.Aphasia impairs using and understanding language, and thus impacts on communication, identity and relationships. However, little research has investigated how people with aphasia understand friends and friendship.
This Participatory Action Research (PAR) study explored how younger adults
with aphasia experience friendship. Participants were 28 people with aphasia,
some of whom were members of the Research Group. Data from 12 initial interviews in Phase 1 of the study led to a model of friendship and aphasia. This underpinned development of peer-led Friendship Events in Phase 2 of the study, after which 16 additional participants with aphasia were interviewed, contributing to elaboration of the model. Within the context of living with aphasia, which was central for all participants, eight inter-connected themes emerged. Friends could be anchors in a time of change and trusted stabilising influences while reconfiguring identity. Participants described the hard work of friendship, the place of communication in supporting friendship, and the challenge of equality within post-aphasia friendships. Time, humour and two-way flexibility were crucial in developing new kinds of friendship. Participants categorised a wide variety of
relationships as friendship. These findings elucidate understandings of friendship loss and change as well as strategies to maintain friendship post-onset of aphasia. The study sheds new light on social connectedness and social support provided by friends, family and peers with aphasia. It emphasises the role of friendship in reconfiguring
identity, and offers practical recommendations for harnessing the
benefits of friends and friendship in life with aphasia. PAR methodology facilitated creation of accessible tools to support
conversations and awareness-raising about friendship. The study highlights
the strengths of relational methods for researching friendship and the
transformative potential of doing PAR with marginalised groups such as people with aphasia