Hallé Marie-Christine, Le Dorze Guylaine, Mingant Anne
School of Speech-Language Therapy and Audiology, Université de Montréal, Montreal, QC, Canada.
Int J Lang Commun Disord. 2014 Nov;49(6):748-60. doi: 10.1111/1460-6984.12108. Epub 2014 Jun 12.
Although aphasia rehabilitation should include significant others, it is currently unknown how this recommendation is adopted in speech-language therapy practice. Speech-language therapists' (SLTs) experience of including significant others in aphasia rehabilitation is also understudied, yet a better understanding of clinical reality would be necessary to facilitate implementation of best evidence pertaining to family interventions.
To explore the process through which SLTs work with significant others of people with aphasia in rehabilitation settings.
METHODS & PROCEDURES: Individual semi-structured interviews were conducted with eight SLTs who had been working with persons with aphasia in rehabilitation centres for at least 1 year. Grounded theory principles were applied in analysing interview transcripts.
OUTCOMES & RESULTS: A theoretical model was developed representing SLTs' process of working with significant others of persons with aphasia in rehabilitation. Including significant others was perceived as challenging, yet a bonus to their fundamental patient-centred approach. Basic interventions with significant others when they were available included information sharing. If necessary, significant others were referred to social workers or psychologists or the participants collaborated with those professionals. Participants rarely and only under specific conditions provided significant others with language exercises or trained them to communicate better with the aphasic person. As a result, even if participants felt satisfied with their efforts to offer family and friends interventions, they also had unachieved ideals, such as having more frequent contacts with significant others.
CONCLUSIONS & IMPLICATIONS: If SLTs perceived work with significant others as a feasible necessity, rather than as a challenging bonus, they could be more inclined to include family and friends within therapy with the aim to improve their communication with the person with aphasia. SLTs could also be more satisfied with their practice. In order to operate these changes in perceptions, we suggest that SLT curriculums include in-depth training about family intervention, a redefinition of the concept of patient, and exploration of SLTs' beliefs and emotions related to significant others.
尽管失语症康复应纳入重要他人，但目前尚不清楚这一建议在言语治疗实践中是如何被采纳的。言语治疗师（SLT）在失语症康复中纳入重要他人的经验也未得到充分研究，然而，要促进与家庭干预相关的最佳证据的实施，就有必要更好地了解临床实际情况。
探讨言语治疗师在康复环境中与失语症患者的重要他人合作的过程。
对8名在康复中心与失语症患者合作至少1年的言语治疗师进行了个体半结构式访谈。运用扎根理论原则分析访谈记录。
构建了一个理论模型，描述言语治疗师在康复中与失语症患者的重要他人合作的过程。纳入重要他人被认为具有挑战性，但这对他们以患者为中心的基本治疗方法来说是一个额外收获。在重要他人在场时，对他们的基本干预措施包括信息共享。如有必要，会将重要他人转介给社会工作者或心理学家，或者让参与者与这些专业人员合作。参与者很少且仅在特定条件下才会为重要他人提供语言练习或训练他们更好地与失语症患者交流。结果，即使参与者对他们为家人和朋友提供干预的努力感到满意，但他们也有未实现的理想，比如与重要他人有更频繁的接触。
如果言语治疗师将与重要他人的合作视为一项可行的必要工作，而不是一项具有挑战性的额外任务，他们可能会更倾向于在治疗中纳入家人和朋友，以改善他们与失语症患者的沟通。言语治疗师对自己的工作也可能会更满意。为了实现这些观念上的转变，我们建议言语治疗师课程应包括关于家庭干预的深入培训、对患者概念的重新定义，以及探索言语治疗师与重要他人相关的信念和情感。
