Department of Communicative Disorders and Sciences, University at Buffalo, NY.
Think + Speak Lab, Shirley Ryan AbilityLab, Chicago, IL.
Am J Speech Lang Pathol. 2024 Nov 4;33(6):3012-3025. doi: 10.1044/2024_AJSLP-24-00174. Epub 2024 Oct 7.
Determining the prognosis of aphasia recovery is an important task for clinicians in the rehabilitation of persons with aphasia. Although there are many variables identified as impactful to aphasia recovery, it is less clear (a) how clinicians perceive causality in aphasia rehabilitation and (b) how prognostic variables interact with each other. This study aimed to understand causal relations between prognostic variables from the clinician perspective.
Ratings of perceived causality were obtained from 11 clinicians serving people with aphasia. Participants were presented with 255 directed causal relations (e.g., depression → aphasia severity), representing a total of 18 demographic, diagnostic, and psychosocial variables. Participants rated the perceived causality on a Likert scale from 0 () to 10 (). We also obtained ratings about frequency of access to information about each of the 18 variables.
A perceived causal network showed differences among variables in their perceived causality. There were many causal relations identified, particularly between diagnostic and psychosocial variables. The variables with the strongest perceived causality were predominantly psychosocial variables, including depression, social support, and participation. However, these psychosocial variables were also the variables that clinicians had the least frequent access to information about. There were also notable differences between participants in their perceived causal networks.
Clinicians hold valuable information about aphasia rehabilitation, including what variables are important to aphasia recovery. Understanding the complexity of interaction among prognostic variables and obtaining data from clinicians about prognostic variables and causality will advance the rehabilitation of aphasia.
确定失语症康复的预后是失语症患者康复临床医生的一项重要任务。尽管有许多变量被确定为对失语症康复有影响，但（a）临床医生如何感知失语症康复中的因果关系，以及（b）预后变量如何相互作用，这两个问题仍不明确。本研究旨在从临床医生的角度了解预后变量之间的因果关系。
11 名为失语症患者提供服务的临床医生对因果关系的感知进行了评估。参与者共收到 255 条定向因果关系（例如，抑郁→失语症严重程度），共涉及 18 个人口统计学、诊断和心理社会变量。参与者在 0（无因果关系）到 10（因果关系非常强）的李克特量表上对感知因果关系进行评分。我们还获得了关于每个 18 个变量的信息可获得性的评分。
感知因果网络显示，变量之间在感知因果关系方面存在差异。确定了许多因果关系，特别是在诊断和心理社会变量之间。感知因果关系最强的变量主要是心理社会变量，包括抑郁、社会支持和参与。然而，这些心理社会变量也是临床医生获得信息最少的变量。参与者之间的感知因果网络也存在显著差异。
临床医生掌握着关于失语症康复的有价值的信息，包括哪些变量对失语症康复很重要。了解预后变量之间相互作用的复杂性，并从临床医生那里获得预后变量和因果关系的数据，将推进失语症的康复。
