Patient Perspectives of a University-Based Intensive Comprehensive Aphasia Program for Stroke Survivors with Aphasia

ABSTRACT

Background

Stroke survivors with aphasia who participate in intensive post-acute aphasia rehabilitation programs make a variety of significant investments. As the number of Intensive Comprehensive Aphasia Programs (ICAPs) increase across healthcare settings worldwide, patient perspectives of this innovative service delivery become increasingly important. Stakeholder perspectives can provide meaningful contributions to intervention implementation, growth, and sustainability.

Aims

The purpose of this pilot study was to qualitatively explore patient perspectives about the experience of participating in a university-based ICAP implemented by graduate student clinicians.

Methods & Procedures

Researchers used an interpretive phenomenological approach to analyze nine structured interviews from five stroke survivors with aphasia who described their lived experiences during an ICAP. Thematic analysis involved an iterative and collaborative coding process. Transcripts were coded and themes were developed from the patients’ shared perspectives. Trustworthiness was maximized through acknowledgement of the researchers’ positionality and bias, variation in the sample, member checks, and sustained relationships between stakeholders.

Outcomes & Results

Three primary themes emerged from patient interviews: (1) the ICAP is hard work; (2) the impact of the ICAP on communication is noticeable, and (3) relationships “make” the ICAP.

Conclusions

Themes support emerging evidence that ICAPs implemented by graduate student clinicians may be a worthwhile investment for many stroke survivors with aphasia, thereby contributing to the cost-benefit utility and implementation feasibility of this service delivery model. Stroke survivors with aphasia reported mixed levels of acceptability pertaining to the perceptible impact on communication improvement, and the challenging, rewarding, frequent, and varied opportunities to interact with others.

KEYWORDS:

• patient and public involvement (PPI)
• patient perspectives
• Intensive Comprehensive Aphasia Program (ICAP)
• cohort model
• aphasia rehabilitation

Acknowledgements

This study was supported by the 2018-2019 University of Montana Small Grants Program (Index M25483 UGP2018). Contributors: Harley Kincheloe and Alyssa Kozlowski (Undergraduate Research Assistants), thank you for your insight and commitment to the transcription process. Thank you to the stroke survivors with aphasia who participated in the interviews and to their family care partners who supported them during the ICAP.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplemental Material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/02687038.2022.2153327.

Additional information

Funding

This work was supported by the University of Montana Grant Program, Small Grants, 2018-2019 Index# M25483

Notes on contributors

Catherine A. Off

Catherine A. Off, Ph.D., CCC-SLP, Professor and Chair, School of Speech, Language, Hearing, & Occupational Sciences, College of Health, University of Montana. Nonfinancial disclosure: Founder and Co-Director of the Big Sky Aphasia Program and clinical supervisor for the 2018 UMT ICAP. Financial disclosure: Salary provided by University of Montana; PI for the awarded 2018-2019 University of Montana Small Grants Program, Grant Index # M25483 UGP2018.

Anya A. Leyhe

Anya A. Leyhe, Speech-Language Pathologist for Missoula County Public Schools and Adjunct Instructor in the School of Speech, Language, Hearing, & Occupational Sciences, College of Health, at the University of Montana. Nonfinancial disclosure: None to report. Financial disclosure: Funded by the 2018-2019 University of Montana Small Grants Program, Grant Index #M25483 UGP2018.

Carolyn R. Baylor

Carolyn R. Baylor, Ph.D., CCC-SLP, Associate Professor, Department of Rehabilitation Medicine, University of Washington and Adjunct Associate Professor, Speech & Hearing Sciences, University of Washington. Nonfinancial disclosure: None to report. Financial disclosure: Funded in part by the 2018-2019 University of Montana Small Grants Program, Grant Index #M25483 UGP2018; salary provided by the University of Washington.

Jenna Griffin-Musick

Jenna Griffin-Musick, M.S., CCC-SLP, Clinical Assistant Professor, School of Speech, Language, Hearing, & Occupational Sciences, College of Health, University of Montana. Nonfinancial disclosure: Director of the Big Sky Aphasia Program and clinical supervisor for the 2018 UMT ICAP. Financial disclosure: Salary provided by University of Montana.

Kirsten Murray

Kirsten Murray, Ph.D., LPC, Professor, Department of Counseling, College of Education, University of Montana. Nonfinancial disclosure: Family counselor for the Big Sky Aphasia Program. Financial disclosure: Salary provided by University of Montana.