Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 3, Clinical Research Centre, Singapore, Singapore.
Biological Science Department, Mzuzu University, Mzuzu, Malawi.
Worldviews Evid Based Nurs. 2022 Aug;19(4):282-296. doi: 10.1111/wvn.12580. Epub 2022 May 19.
Previous studies have predominantly focused on the needs of persons with aphasia (PWA), after a stroke diagnosis. However, aphasia is found to cause communication challenges in persons with stroke and their family caregivers as a unit. Evidence is inconclusive about the communication patterns of both persons with aphasia and their family caregivers after a stroke. Studies have not been synthesized on facilitators and barriers of communication patterns between PWA and family caregivers after a stroke.
A meta-synthesis of qualitative evidence was conducted to explore family communication patterns after post-stroke vascular aphasia.
An electronic literature search of PubMed, CINAHL, Cochrane Library, PsyINFO, and Scopus was performed from January to March 2021. The methods of qualitative meta-synthesis were underpinned by Sandelowski and Barosso's guidelines. Data analysis was facilitated by Braun and Clarke thematic analysis, using NVivo 11 software.
A total of twenty studies were included for meta-synthesis. Three themes with corresponding subthemes were identified: (1) changes in family communication patterns (subthemes: adapting to the changes in PWA after a stroke, striving toward communication recovery); (2) facilitators of family communication patterns (subthemes: supportive communication techniques, hope of recovery, time to re-adjust, and community engagement [recreational activities]); and (3) barriers of communication (subthemes: emotional turmoil and daunting tasks of rehabilitation).
Although persons with aphasia and family caregivers are striving to achieve normalcy in communication, they are often challenged by communication deficits and protective family behaviors. Therefore, to establish effective communication, it is of paramount importance for nursing professionals to educate PWAs and their caregivers on facilitators and barriers of family communication patterns. Technology-based family communication facilitation and support groups for PWA and their family caregivers are recommended to promote family communication. The review was registered with PROSPERO (CRD42021235519).
先前的研究主要集中在中风后失语症患者（PWA）的需求上。然而，失语症会导致中风患者及其家庭照顾者之间的沟通障碍。中风后 PWA 及其家庭照顾者的沟通模式证据尚无定论。尚未对中风后 PWA 和家庭照顾者之间沟通模式的促进因素和障碍进行综合研究。
对定性证据进行元综合分析，以探索中风后血管性失语症患者的家庭沟通模式。
2021 年 1 月至 3 月，对 PubMed、CINAHL、Cochrane 图书馆、PsyINFO 和 Scopus 进行了电子文献检索。定性元综合方法的基础是桑德洛斯基和巴罗索的指南。使用 NVivo 11 软件，通过 Braun 和 Clarke 主题分析促进数据分析。
共有 20 项研究纳入元综合分析。确定了三个主题和相应的子主题：（1）家庭沟通模式的变化（子主题：适应中风后 PWA 的变化，努力恢复沟通）；（2）家庭沟通模式的促进因素（子主题：支持性沟通技巧、康复希望、重新调整时间和社区参与[娱乐活动]）；（3）沟通障碍（子主题：情绪动荡和康复任务艰巨）。
尽管失语症患者和家庭照顾者正在努力实现沟通的正常化，但他们经常受到沟通障碍和保护性行为的挑战。因此，为了建立有效的沟通，护理专业人员向 PWA 及其照顾者传授家庭沟通模式的促进因素和障碍至关重要。建议为 PWA 及其家庭照顾者提供基于技术的家庭沟通促进和支持小组，以促进家庭沟通。该综述已在 PROSPERO（CRD42021235519）上注册。
