The coproduction of a multilevel personal narrative intervention for people with aphasia in a community communication support group - A pilot study
Journal
Frontiers in Stroke, Stroke Recovery and Rehabilitation
Date Issued
July 17, 2024
Editor(s)
DOI
10.3389/fstro.2024.1393676
Abstract
Introduction: People with aphasia (PWA) face challenges in sharing personal
stories due to communication difficulties. Discourse treatment in aphasia
focusing on personal narrative macrostructure has yet to receive the
attention this warrants of researchers and clinicians. Emerging person-centered
approaches involve coproduction and codesign with PWA for meaningful
discourse treatments. Few studies explore discourse treatment’s impact on
functional communication. This pilot study aims to explore whether the use of
the coproduction approach in the development of a multilevel personal narrative
intervention at the group level increased the production of macrostructure
elements in trained and untrained narrative discourse contexts, improved aphasia
severity and functional communication skills, and advanced quality of life of the
participants with aphasia.
Methods: An ABA design was followed featuring a pre-treatment baseline
assessment phase, a treatment phase, and a post-treatment assessment
phase immediately after treatment was completed. Three people with chronic
stroke-induced aphasia, three communication partners, and a moderator
took part in the study. All participants were members of a university-led
community aphasia communication group. The research protocol consisted
of eleven, two-hour, weekly sessions over an 11-week block. Nine treatment
sessions were carried out following codesign and coproduction methods that
focused on participants with aphasia producing words, sentences, and total
communication strategies to express macrostructure elements in their personal
stories. Assessment measures were collected at baseline and post-treatment
to evaluate improvements in trained and untrained narrative abilities, aphasia
severity, functional communication, and the impact of aphasia on quality of life.
Results: Multilevel personal narrative therapy improved the narrative skills of
the participants with aphasia at the macrostructural level of narrative discourse.
Improvements were also observed in functional communication and quality of
life post-treatment.
Discussion: The involvement of participants with aphasia in the codesign and
coproduction of the treatment content for the group intervention facilitated
improvement in narrative skills, functional communication, and overall quality
of life with aphasia. It is recommended that researchers and clinicians
consider using content from the personal narratives of clients with aphasia to build discourse treatment and adopt codesign and coproduction approaches, when designing interventions for people with chronic aphasia, to improve communication outcomes in everyday life.
stories due to communication difficulties. Discourse treatment in aphasia
focusing on personal narrative macrostructure has yet to receive the
attention this warrants of researchers and clinicians. Emerging person-centered
approaches involve coproduction and codesign with PWA for meaningful
discourse treatments. Few studies explore discourse treatment’s impact on
functional communication. This pilot study aims to explore whether the use of
the coproduction approach in the development of a multilevel personal narrative
intervention at the group level increased the production of macrostructure
elements in trained and untrained narrative discourse contexts, improved aphasia
severity and functional communication skills, and advanced quality of life of the
participants with aphasia.
Methods: An ABA design was followed featuring a pre-treatment baseline
assessment phase, a treatment phase, and a post-treatment assessment
phase immediately after treatment was completed. Three people with chronic
stroke-induced aphasia, three communication partners, and a moderator
took part in the study. All participants were members of a university-led
community aphasia communication group. The research protocol consisted
of eleven, two-hour, weekly sessions over an 11-week block. Nine treatment
sessions were carried out following codesign and coproduction methods that
focused on participants with aphasia producing words, sentences, and total
communication strategies to express macrostructure elements in their personal
stories. Assessment measures were collected at baseline and post-treatment
to evaluate improvements in trained and untrained narrative abilities, aphasia
severity, functional communication, and the impact of aphasia on quality of life.
Results: Multilevel personal narrative therapy improved the narrative skills of
the participants with aphasia at the macrostructural level of narrative discourse.
Improvements were also observed in functional communication and quality of
life post-treatment.
Discussion: The involvement of participants with aphasia in the codesign and
coproduction of the treatment content for the group intervention facilitated
improvement in narrative skills, functional communication, and overall quality
of life with aphasia. It is recommended that researchers and clinicians
consider using content from the personal narratives of clients with aphasia to build discourse treatment and adopt codesign and coproduction approaches, when designing interventions for people with chronic aphasia, to improve communication outcomes in everyday life.
Subjects
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