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      Aphasia and literacy—the insider's perspective

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          Abstract

          Background

          Few studies have investigated how people with aphasia (PWA) experience literacy skills. Taking the insider's perspective is a way to increase understanding of the individual experiences of literacy among PWA, which may have clinical implications.

          Aims

          To describe how literacy, i.e., reading and writing, is experienced in everyday life by PWA and to gain insight into the part played by literacy skills in their lives.

          Methods & Procedures

          A qualitative descriptive research approach was taken. In‐depth interviews were conducted with 12 PWA (six women and six men) who had all lived with aphasia for at least 6 months post‐stroke. The interviews were analysed using qualitative content analysis.

          Outcomes & Results

          One overarching theme emerged from the data: literacy as an ongoing recovery process. Based on this overarching theme, two subthemes were identified: changes in conditions for literacy (experiences of reading and writing initially post‐onset compared with experiences at the time of the interview); and facing expectations about literacy (participants’ own and other people's expectations of them in terms of literacy).

          Conclusions & Implications

          The findings are important at a general level in that they indicate that PWA are able to articulate their individual experiences and thoughts about literacy, i.e., reading and writing. Specifically, PWA in this study experience literacy as playing an essential part in their lives and the findings imply that personal experiences are important in the design of reading and writing interventions in speech and language therapy.

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          Most cited references30

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          Qualitative research and evaluation methods.

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            Literacy in theory and pratice

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              The impact of stroke: are people with aphasia different to those without?

              Stroke rehabilitation programmes aim to improve functional outcomes and quality of life. This study explored long-term outcomes in a cohort of people admitted to two acute stroke units with stroke. Comparisons were drawn between people with aphasia (PWA) and people without aphasia. People admitted to hospital with a first stroke were assessed at 2-weeks, 3-months and 6-months post-stroke. Measures included: the Barthel Index for Activities of Daily Living (ADL), the Frenchay Aphasia Screening Test, the General Health Questionnaire-12 for emotional well-being and the Stroke and Aphasia Quality of Life Scale-39g. Extended ADL and social support were also measured at 3 and 6 months, with the Frenchay Activities Index and the Social Support Survey, respectively. Of 126 eligible participants, 96(76%) took part and 87(69%) were able to self-report. Self-report data are reported here. Although outcomes improved significantly across time, at 6 months people continued to experience substantial functional limitations (16% aphasic; 32% dependent on basic ADL); participation limitations (79% ≤30 on the FAI); high psychological distress (45%) and compromised quality of life (54% ≤4 on the SAQOL-39g). Levels of social support remained relatively stable. Though at 3-months post-stroke PWA were significantly more likely to experience high psychological distress (93% versus 50% for those without), across time, there were no significant differences between PWA and those without on psychological distress and also ADL and social support. There were, however, significant differences on extended ADL (F(1,68) = 7.80, p < 0.01) and quality of life (F(1,69) = 6.30, p < 0.05). PWA participated in fewer activities and reported worse quality of life after stroke than people without aphasia, even when their physical abilities, well-being and social support were comparable. Implications for clinical practice and future research are discussed.
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                Author and article information

                Contributors
                ingrid.henriksson@neuro.gu.se
                Journal
                Int J Lang Commun Disord
                Int J Lang Commun Disord
                10.1111/(ISSN)1460-6984
                JLCD
                International Journal of Language & Communication Disorders
                John Wiley and Sons Inc. (Hoboken )
                1368-2822
                1460-6984
                31 December 2016
                Sep-Oct 2017
                : 52
                : 5 ( doiID: 10.1111/1460-6984.2017.52.issue-5 )
                : 573-584
                Affiliations
                [ 1 ] Institute of Neuroscience and Physiology, Unit of Speech and Language Pathology, The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
                Author notes
                [*] [* ]Address correspondence to: Ingrid Henriksson, Institute of Neuroscience and Physiology, Unit of Speech and Language Pathology, The Sahlgrenska Academy, University of Gothenburg, Box 452, Gothenburg SE‐405 30, Sweden; e‐mail: ingrid.henriksson@ 123456neuro.gu.se
                Article
                JLCD12302
                10.1111/1460-6984.12302
                5599967
                28039933
                004eca36-ba4d-4d63-8791-aa82750de9bf
                © 2016 The Authors International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists

                This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 16 March 2016
                : 29 September 2016
                : 10 October 2016
                Page count
                Figures: 0, Tables: 2, Pages: 12, Words: 9586
                Funding
                Funded by: Swedish National Stroke Association
                Funded by: Swedish Research Council
                Categories
                Research Report
                Research Reports
                Custom metadata
                2.0
                jlcd12302
                September–October 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.1.9 mode:remove_FC converted:15.09.2017

                Neurosciences
                aphasia,literacy,insider's perspective,qualitative content analysis,interviews
                Neurosciences
                aphasia, literacy, insider's perspective, qualitative content analysis, interviews

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