School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK.
Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, UK.
Int J Speech Lang Pathol. 2020 Feb;22(1):59-69. doi: 10.1080/17549507.2019.1585949. Epub 2019 Apr 15.
To identify which elements of the therapeutic alliance are important to people with aphasia (PWA) attending speech-language pathology post-stroke. A Q methodology design was adopted to explore which elements of the therapeutic alliance were valued by PWA. Statements ( = 453) relevant to the research question were extrapolated from the literature and qualitative interviews. A representative sample of statements ( = 38) was identified from the expansive data set. PWA ( = 23) sorted statements hierarchically according to whether they thought the statement was important or unimportant. Completed Q sorts were analysed using a by-person factor analysis. Analysis yielded a five-factor solution, representing five distinct viewpoints: (1) acknowledge me, help me to understand; (2) respect me, listen to me; (3) challenge me, direct me; (4) understand me, laugh with me; and (5) hear me, encourage me. The findings highlight the need for clinicians to adopt a flexible and idiosyncratic approach to therapeutic alliance construction in order to meet the relational needs of a heterogeneous population. This is the first study to use Q methodology with PWA, demonstrating that Q methodology is an effective and viable method for investigating subjectivity in this population.
为了确定对接受脑卒中后言语病理学治疗的失语症患者（PWA）而言，治疗联盟中的哪些元素是重要的。采用 Q 方法设计来探索 PWA 重视治疗联盟的哪些元素。从文献和定性访谈中推断出与研究问题相关的陈述（ = 453）。从广泛的数据集中确定了具有代表性的陈述样本（ = 38）。PWA（ = 23）根据他们认为陈述是否重要或不重要，对陈述进行层次排序。通过个人因素分析对完成的 Q 排序进行分析。分析产生了五个因素的解决方案，代表五个不同的观点：（1）承认我，帮助我理解；（2）尊重我，倾听我；（3）挑战我，指导我；（4）理解我，与我一起笑；（5）倾听我，鼓励我。研究结果强调了临床医生需要采取灵活和个性化的方法来构建治疗联盟，以满足异质人群的关系需求。这是第一项使用 Q 方法研究 PWA 的研究，证明 Q 方法是一种有效且可行的方法，可以调查该人群的主观性。
