Preliminary outcomes from a pilot study of personalised online supported conversation for participation intervention for people with Aphasia

ABSTRACT

Background

Aphasia negatively impacts face-to-face social participation and the difficulties that people experience using the phone exacerbate these challenges in staying in touch with family and friends. Videoconferencing enables multimodal communication, and teamed with supported conversation, could facilitate access to conversation and thereby increase social participation for people with chronic aphasia.

Aims

This pilot study examined whether supported conversation provided over Skype could improve people’s social participation. It reports on preliminary outcomes of this intervention on people’s social network, communication confidence, aphasia-related quality of life, and mood.

Methods & Procedures

29 participants with chronic aphasia received an initial 2-hour technology training session followed by 16hours of online supported conversation for participation intervention provided by qualified or student speech and language therapists. The intervention was personalised by individualising goals in technology, communication, and participation. An observational prospective cohort study design was used with baseline, immediately post-intervention, and 8-week follow-up assessments. Measures of social network and communication confidence (primary outcome measures), and aphasia-related quality of life, life participation, and mood (secondary outcome measures) were undertaken. Shapiro-Wilk tests were conducted to examine normality of distribution of each variable. Where data were normally distributed, one-way repeated-measures ANOVAs were used to examine the effect of time. Where data were not normally distributed, Wilcoxon Signed Ranks test was used.

Outcomes & Results: 27 participants completed the intervention. As a group, participants reported significantly more social contacts, more life participation, and higher aphasia-related quality of life post-intervention, which were maintained. There was a group gain on the measure of communication confidence post-intervention, although this was not maintained. As a group, the participants’ mood did not significantly change through intervention and follow-up. Individual variability was noted across all outcome measures.

Conclusions: These preliminary findings suggest that relatively low dose and non-intensive online supported conversation for participation intervention delivered by qualified or student speech and language therapists improved social participation in some people with aphasia and improved their quality of life. Communication confidence also improved for some, although benefits were short term. Findings make novel contributions to the existing supported conversation evidence base with positive social participation and quality of life outcomes, likely achieved by the explicit participation focus. Whilst preliminary findings are positive, study limitations need addressing. Further investigations are merited to refine the intervention and outcome measure choice and capture feasibility data. Finally, a definitive controlled trial is needed to explore the clinical efficacy and cost-effectiveness.

KEYWORDS:

• Aphasia
• supported conversation
• telerehabilitation
• social isolation
• quality of life
• participation

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary material

Supplemental data for this article can be accessed here.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Notes

1. See https://support.skype.com/en/faq/FA31/does-skype-use-encryption

2. [email protected]

3. Participants were able to attend the university clinic during the therapy block if they experienced particular difficulty learning to use a feature of Skype.

4. Both clinician and participant manuals are available by contacting [email protected].

5. This would later become drilled down to component parts such as to independently initiate a video call, to turn back on the camera if it was accidentally turned off, and so on.

6. This gain scaled up (i.e. 0.25 × 37 items) = 9.25 and was calculated for drawing comparisons in the Discussion

7. This gain scaled up (i.e. 0.25 × 16 items) = 4 and was calculated for drawing comparisons in the Discussion

Additional information

Funding

This work was supported by the The Barts Charity [MGU0243].