Article

OBJECTIVES: To explore trial participants' experiences of the process and
outcomes of early, enhanced speech and language therapy after stroke with support
from an employed visitor. DESIGN: Qualitative study nested within a randomized
controlled trial. PARTICIPANTS: Twney-two people who, after stroke, had a
diagnosis of aphasia (12), dysarthria (5) or both (5) and who participated in the
ACT NoW study. SETTING:
Eight English NHS usual care settings. METHOD: Individual
interviews. Thematic content analysis assisted by a bespoke data transformation
protocol for incorporating non-verbal and semantically ambiguous data. RESULTS:
Participants highly regarded regular and sustained contact with someone outside
of immediate family/friends who engaged them in deliberate
activities/communication in the early months after stroke. Participants
identified differences in the process of intervention between speech and language
therapists and employed visitors. But no major discriminations were made between
the impact or value of this contact according to whether provided by a speech and
language therapist or employed visitor. Participant-defined criteria for
effectiveness of contact included: impact on mood and confidence,
self-recognition of progress and the meeting of individual needs. CONCLUSIONS: As in the randomized controlled trial, participants reported no evidence of added
benefit of early communication therapy beyond that from attention control. The
findings do not imply that regular contact with any non-professional can have
beneficial effects for someone with aphasia or dysarthria in the early weeks
following a stroke. The study points to specific conditions that would have to be
met for contact to have a positive effect.

Langue : ANGLAIS