Tami Howe

Background: Confidence, particularly in the domain of communication, has recently emerged as a factor which may influence people with aphasia’s (PWA) psychosocial well-being. However, PWA’s psychosocial needs, including their confidence in communication, are often neglected. Moreover, increasing confidence post-stroke has been identified as a research priority by stroke survivors, including PWA. Therefore, investigating how to increase confidence in communication for PWA is of clinical importance to speech-language pathologists (S-LPs) and their clients with aphasia. Aim: The purpose of this study was to explore the perspectives of S-LPs on the meaning of confidence in communication for PWA, factors which help with it, factors which detract from it, and what SLPs’ role in this area might be. Methods and Procedures: Based on the constructivist paradigm, and using a qualitative descriptive approach, semi-structured in-depth interviews were conducted with 15 S-LPs who had worked with PWA for at least one year. Qualitative content analysis was used to derive codes and categories from the interview transcripts in relation to each of the four research aims. To increase rigour, member-checking and peer debriefing were used. Results: Analysis of the semi-structured interviews generated the following: 56 codes for the meaning of confidence in communication for PWA, grouped into 12 categories (e.g., PWA being willing to put themselves out there and participate/try to communicate); 93 codes for factors which help with it, grouped into 14 categories (e.g., PWA practicing communication and experiencing success/improvement in the clinic and beyond); 62 codes for what detracts from confidence in communication for PWA, grouped into 13 categories (e.g., lack of social/communication support for PWA); and 88 codes for the role of S-LPs in working on this with PWA, grouped into 14 categories (e.g., educating others about aphasia and training communication partners on how to support PWA’s communication). Conclusion: S-LPs perceive working on confidence in communication with PWA to be part of their clinical role. Factors such as communication and social support from others may be important for SLPs to consider in relation to PWA’s confidence in communication and could ultimately have an impact on PWA’s life participation and psychosocial well-being.

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Background: Yoga is a community-based activity with great potential psychosocial and physical benefit to stroke survivors, one in three of whom has chronic aphasia. People with aphasia post-stroke may be unable to experience the benefits of yoga due to unique environmental factors that impact their participation; therefore, yoga classes need to be made more accessible for these individuals. Aim: The aim of this study was to explore barriers and facilitators to participation in a group yoga class for people with aphasia post-stroke from the perspective of people with aphasia, allied health professionals, and yoga instructors.Methods and Procedures: This study, underpinned by the critical paradigm, was the first phase of a participatory action research (PAR) project. Semi-structured qualitative interviews were conducted with 4 people with aphasia, 4 allied health professionals, and 4 yoga instructors. All participants had knowledge or experience with both aphasia and yoga. Interviews were transcribed and analyzed using qualitative content analysis. Member checking and peer debriefing were used to enhance rigour. Results: Analysis of participant interviews revealed 44 barriers grouped into 11 categories and 56 facilitators grouped into 11 categories. Barrier categories included: lack of collaboration with key stakeholders; lack of aphasia awareness in the yoga facility; advertising strategies are not aphasia-friendly; lack of participatory support from yoga provider and social network; yoga instructor does not have the necessary knowledge, skills, and attitudes; class composition and structure is not aphasia-friendly; and complex communication requirements. Facilitator categories included: collaboration with key stakeholders; aphasia education in the yoga facility; aphasia-friendly advertising strategies; additional participatory support from yoga provider and social network; yoga instructor has the necessary knowledge, skills, and attitudes; aphasia-friendly class composition and structure; and supported communication in the yoga facility. Conclusion: Results may guide the development of a communicatively accessible group yoga class for people with aphasia-post stroke in the future. Collaboration between the yoga provider and the specific group of yoga students with aphasia may be integral to class success and longevity. Further research investigating the validity of study results in a real-life context is indicated.

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