Communication confidence in different settings: perceptions of nineteen people with aphasia

Communication confidence in different settings: perceptions of nineteen people with aphasia

Background This small scale study was undertaken as part of an undergraduate degree. Aphasia is a clinical entity that can be defined in a literal way. It can also be described as a catalyst that results in a change in identity, and therefore also has emotional meaning for the people it affects. This latter description can be aligned with the social model that suggests that individuals are not intrinsically disabled, rather they are disabled by the society in which they live. Understanding and measuring the emotional effects of communication disability is challenging. In a recent single case study investigation Babbit & Cherney (2010) introduced a measure that examined the relationship between aphasia, communicative confidence and identity after a stroke, the Communication Confidence Rating Scale for Aphasia (CCRSA). Our study widened the scope of the original Babbit & Cherney (2010) study and used the CCRSA to investigate whether the communicative confidence of nineteen people with aphasia (PWA) was affected by their environment.

Method Participants were recruited from two aphasia support groups operating in two different parts of Britain. The 12 men and 7 women who participated in this study were aged between 41 and 77 and had lived with their aphasia for an average of seven years. The PWA were asked to complete the CCRSA. Adaptations were introduced to enable a comparison between communicative confidence in three different settings: home, community and support group. Aphasia friendly adaptations (Dalemans et al, 2009 and Bixley et al, 2011) also ensured that the PWA, irrespective of the severity of their aphasia, were able to respond to the questionnaire independently.

Results Questionnaires were collated and analysed statistically. Results suggested that participants were confident communicating at home and within support groups. PWA were not confident communicating in public. Findings were statistically significant. Participants reported that they were most confident (80%) talking to family and friends and were least confident when they used the telephone (26%).

Discussion The results of this study suggest that PWA do not feel confident communicating in public or using the telephone. These findings confirm the perception that the societal barriers described by Pound et al (2000) prevent PWA accessing the society in which they live. The very similar positive confidence ratings for home and support groups provide a rationale for the benefits of long term group intervention and support for PWA. Our findings also suggest that the CCRSA may be a useful outcome measure that could be used to evaluate the positive effect that Speech and Language Therapy intervention can have on the communicative confidence of PWA.

References BABBIT, E.M. & CHERNEY, L.R. (2010) Communication confidence in persons with aphasia. Topics in Stroke Rehabilitation, 17, 3, 214-223. BIXLEY, M., DMU4 & HAMILTON, C. (2011) Aphasia – an information leaflet designed by people with aphasia. British Aphasiology Society Biennial International Conference Book of Abstracts, 12. DALEMANS, R. (2009) Facilitating the participation of people with aphasia in research: A description of strategies. Clinical Rehabilitation, 23, 2, 948-959. POUND, C., PARR, S., LINDSAY, J. & WOOLF, C. (2000) Beyond Aphasia: Therapies for Living with Communication Disability. Bicester: Winslow.