Brown Kyla, Worrall Linda E, Davidson Bronwyn, Howe Tami
Centre for Clinical Research Excellence in Aphasia Rehabilitation and Communication Disability Centre, The University of Queensland, Brisbane, Australia.
Int J Speech Lang Pathol. 2012 Apr;14(2):141-55. doi: 10.3109/17549507.2011.632026. Epub 2011 Dec 12.
The concept of living successfully with aphasia has recently emerged as an alternative to more traditional "deficit" models in aphasiology, encouraging a focus on positive rather than negative outcomes. This research aimed to integrate findings from studies exploring the perspectives of three participant groups (individuals with aphasia, speech-language pathologists, and family members) about living successfully with aphasia. Qualitative meta-analysis of three studies conducted by the authors was used to integrate perspectives across the participant groups. Steps in the qualitative meta-analysis were based on those described in the process of "meta-ethnography" by Noblit and Hare (1988) . Analysis was an inductive process, in which data from each study were re-analysed and translated into each other in order to identify higher-level overarching themes that accounted for similarities and discrepancies across the original studies. A total of seven overarching themes related to living successfully with aphasia were identified. These were: participation, meaningful relationships, support, communication, positivity, independence and autonomy, and living successfully with aphasia as a journey over time. Findings indicate the need for a holistic, client-centred approach that considers communication in the broader context of an individual's daily life. The overarching themes may act as guides for areas of importance to be addressed in clinical practice, as well as in future research. By working in partnership with individuals with aphasia and their families, speech-language pathologists are challenged to continue to improve services and assist clients on their journey of living successfully with aphasia.
失语症患者成功生活的概念最近作为失语症学中更传统“缺陷”模型的替代方案出现，鼓励关注积极而非消极结果。本研究旨在整合来自三项研究的结果，这些研究探讨了三个参与者群体（失语症患者、言语治疗师和家庭成员）对失语症患者成功生活的看法。作者对三项研究进行定性元分析，以整合各参与者群体的观点。定性元分析的步骤基于诺布利特和黑尔（1988年）在“元民族志”过程中描述的步骤。分析是一个归纳过程，其中对每项研究的数据进行重新分析并相互转化，以识别更高层次的总体主题，这些主题解释了原始研究中的异同。共确定了七个与失语症患者成功生活相关的总体主题。它们是：参与、有意义的关系、支持、沟通、积极性、独立性和自主性，以及失语症患者成功生活是一个随时间推移的过程。研究结果表明需要一种整体的、以患者为中心的方法，该方法在个人日常生活的更广泛背景下考虑沟通。这些总体主题可作为临床实践以及未来研究中需要解决的重要领域的指导。通过与失语症患者及其家人合作，言语治疗师面临着不断改进服务并协助患者踏上失语症患者成功生活之旅的挑战。
