Harmon Tyson G, Hegewald Riley, Dromey Christopher
Department of Communication Disorders, Brigham Young University, Provo, UT.
Am J Speech Lang Pathol. 2024 Dec 12;33(6S):3393-3409. doi: 10.1044/2024_AJSLP-23-00354. Epub 2024 Dec 2.
The aim of this study was to explore the subjective experiences of people with aphasia when communicating in the presence of various types of background noise. We hypothesized that (a) people with aphasia would report greater perceived effort and stress than controls when talking in noise, (b) perceived effort and stress would be greater in noise than silence, and (c) people with aphasia would describe more negative reactions to communicating in noise than controls.
Eleven people with aphasia and 11 age- and gender-matched controls retold stories in a baseline silent condition and five background noise conditions (pink noise, cocktail party, monologue, one-sided phone call, and conversation) and rated their perceived effort and stress after each story. Participants then described their experience in a semistructured interview. Perceived effort and stress ratings were analyzed statistically using quantitative methods. Interview data were analyzed qualitatively.
Quantitative findings showed that people with aphasia reported significantly greater perceived effort and stress than controls. Across groups, phone call, conversation, and monologue conditions were perceived as either more effortful or stressful than the silent baseline condition. Although both participant groups discussed cognitive and emotional challenges and strategies related to talking in noise, qualitative findings showed distinct difficulties for people with aphasia. Specifically, unlike controls, participants with aphasia mentioned difficulty ignoring background noise, decreased processing speed, fatigue, negative emotional reactions, deliberately focusing, slowing down/taking breaks, and consciously regulating their emotions.
Although aphasia therapy often occurs in quiet clinic environments, everyday communication does not. The increased perceived difficulty that people with aphasia have for coping with background noise should be acknowledged, and training should be designed to prepare people with aphasia to communicate in noisy environments.
本研究旨在探索失语症患者在存在各种背景噪音的情况下进行交流时的主观体验。我们假设：（a）失语症患者在噪声环境中交谈时，会比对照组报告更高的感知努力和压力；（b）噪声环境中的感知努力和压力会比安静环境中更大；（c）失语症患者对在噪声环境中交流的负面反应会比对照组更多。
11名失语症患者以及11名年龄和性别匹配的对照组人员在基线安静条件下以及五种背景噪音条件（粉红噪音、鸡尾酒会噪音、独白、单边电话通话和对话）下复述故事，并在每个故事复述后对他们的感知努力和压力进行评分。参与者随后在半结构化访谈中描述他们的经历。使用定量方法对感知努力和压力评分进行统计分析。对访谈数据进行定性分析。
定量研究结果表明，失语症患者报告的感知努力和压力明显高于对照组。在所有组中，电话通话、对话和独白条件被认为比安静的基线条件更费力或压力更大。尽管两个参与者组都讨论了与在噪声环境中交谈相关的认知和情感挑战及策略，但定性研究结果显示失语症患者存在明显的困难。具体而言，与对照组不同，失语症患者参与者提到难以忽略背景噪音、处理速度下降、疲劳、负面情绪反应、刻意集中注意力、放慢速度/休息以及有意识地调节情绪。
尽管失语症治疗通常在安静的临床环境中进行，但日常交流并非如此。应认识到失语症患者应对背景噪音的感知困难增加，并且应设计培训，使失语症患者为在嘈杂环境中交流做好准备。
