Eriksson Karin, Hartelius Lena, Saldert Charlotta
University of Gothenburg Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
Institute of Neuroscience and Physiology, Division of Speech and Language Pathology, University of Gothenburg, Gothenburg, Sweden.
Int J Lang Commun Disord. 2016 Jul;51(4):402-14. doi: 10.1111/1460-6984.12216. Epub 2016 Mar 6.
Communication partner training (CPT) has been shown to improve the communicative environment of people with aphasia. Interaction-focused training is one type of training that provides an individualized intervention to participants. Although shown to be effective, outcomes have mostly been evaluated in non-experimental case studies.
The aim of the controlled experimental intervention study was to evaluate an individualized approach in a CPT programme directed to significant others of people with aphasia. Specifically the effects on conversation partners' ability to support the person with aphasia in conversation and on the individuals with aphasias' perception of their functional communication were explored.
METHODS & PROCEDURES: Six dyads consisting of a person with aphasia and a significant other were included in a replicated single-subject design with multiple baselines across individuals. The intervention followed the interaction-focused communication training programme included in Supporting Partners of People with Aphasia in Relationships and Conversation (SPARRC). The main elements of the training consisted of supervised viewing of the couples' own video-recorded natural interaction and the formulation of individual goals for the adaptation of particular communicative strategies. Outcome was measured via blinded ratings of filmed conversational interaction obtained once a week throughout the different phases of baseline, intervention and follow-up. A rating scale to assess overall quality of conversation was used, taking into account both transfer of information and social aspects of conversation. Measures of perceived functional communication in the persons with aphasia were also collected from the individuals with aphasia and their conversation partners.
OUTCOMES & RESULTS: The results were mixed, with two of the six participants showing small improvements in ability to support their partner with aphasia in conversation. Half the participants with aphasia and half the significant others reported improvements on perceived functional communication in the person with aphasia after intervention, but no changes were statistically significant.
CONCLUSIONS & IMPLICATIONS: This study adds to the growing body of research concerning CPT by pinpointing the importance of careful consideration regarding set-up of training, suitability of participants and evaluation of outcome.
沟通伙伴训练(CPT)已被证明可改善失语症患者的沟通环境。以互动为重点的训练是一种为参与者提供个性化干预的训练类型。尽管已证明其有效,但结果大多在非实验性案例研究中进行评估。
这项对照实验性干预研究的目的是评估针对失语症患者重要他人的CPT计划中的个性化方法。具体而言,探讨了对对话伙伴在对话中支持失语症患者能力的影响,以及对失语症患者功能性沟通认知的影响。
六个由失语症患者及其重要他人组成的二元组被纳入重复单受试者设计,个体间采用多基线。干预遵循《在关系和对话中支持失语症患者的伙伴》(SPARRC)中包含的以互动为重点的沟通训练计划。训练的主要内容包括对夫妻自己录制的自然互动视频进行监督观看,以及制定适应特定沟通策略的个人目标。在基线、干预和随访的不同阶段,每周通过对拍摄的对话互动进行盲评来测量结果。使用了一个评估对话整体质量的量表,同时考虑了信息传递和对话的社会方面。还从失语症患者及其对话伙伴那里收集了失语症患者功能性沟通认知的测量数据。
结果喜忧参半,六名参与者中有两名在对话中支持失语症伙伴的能力有小幅提高。一半的失语症参与者和一半的重要他人报告说,干预后失语症患者在功能性沟通认知方面有所改善,但没有变化具有统计学意义。
本研究通过指出在训练设置、参与者适用性和结果评估方面仔细考虑的重要性,为有关CPT的不断增加的研究做出了贡献。