O Acidente Vascular Encefálico (AVE) pode ser definido como um rápido desenvolvimento de sinais clínicos de distúrbios focais ou globais da função cerebral e traz como consequência sintomas com duração superior a 24 horas. Afasia é um comprometimento de linguagem, que ocorre quando alguém sofre um prejuízo no cérebro relacionado a esta área. Os prejuízos de comunicação apresentados pela pessoa afásica irão refletir nas atividades sociais e de vida diária. Os familiares envolvidos também se sentem afetados, alterando sua qualidade de vida. Este estudo teve por objetivo investigar os principais fatores que interferem na qualidade de vida dos afásicos pós-AVE e de seus familiares. A coleta de dados considerou três parâmetros: o primeiro foi constituído pelo levantamento de dados socioeconômicos do contexto familiar dos sujeitos afásicos; o segundo, pela aplicação dos questionários de qualidade de vida nos sujeitos afásicos (SSQOL) e nos familiares (WHOQOL); e o terceiro, pela aplicação de um Roteiro de Avaliação da Linguagem Expressiva no sujeito afásico para definição das semiologias. Como resultados, o nível socioeconômico do contexto familiar de 50% dos indivíduos afásicos pertence à classe social média. Os domínios menos afetados referentes ao questionário aplicado com os indivíduos afásicos (SSQOL) foram mobilidade (96,67%) e cuidados pessoais (90%) e os domínios mais afetados foram linguagem (49%) e comportamento (55%). Os domínios menos afetados referentes ao questionário aplicado com os familiares (WHOQOL-Bref) foram relações pessoais (80%) e psicológico (76,06%) e os domínios mais afetados foram físico (72,38%) e meio ambiente (69,58%). Houve relação estatisticamente significante entre a qualidade de vida do indivíduo afásico e do seu familiar. Diante do exposto, observou-se o prejuízo na qualidade de vida tanto do familiar como também do indivíduo afásico após o episódio de AVE. / Stroke can be defined as a quick development of clinical focal or global disturbances signs of brain function bringing consequence symptoms lasting more than 24 hours. Aphasia is a language impairment, which occurs when someone suffers a brain injury related to this area. The communication losses shown by the aphasic person will reflect on social and daily life activities. Family members that were involved also feel affected by changing their quality of life. This study aimed to investigate the main factors that affect the quality of life of aphasic person post-stroke and their families. Data collection considered three parameters: the first was established by the socioeconomic data survey in the aphasic individuals familiar context, the second was the quality of life questionnaires application in the aphasic individuals (SSQOL) and relatives (WHOQOL), and third, the implementation of a roadmap for the Assessment of Expressive Language in aphasic person for semiologies definitions. As a result, the family socioeconomic status context 50% of aphasic individuals belong to the middle class. The domains least affected regarding the questionnaire administered to the aphasic individuals were: mobility (96.67%) and personal care (90%). Already the most affect domains were: language (49%) and behavior (55%). The domains least affected regarding the questionnaire given to relatives (WHOQOL-Bref) were: personal relationships (80%) and psychological (76.06%). Already the most affected domains were: physical (72.38%) and environment (69.58%). There was a statistically significant relationship between aphasic person and his family quality of life. Given the above, it was observed the impairment in quality of life both of the family as well as the aphasic individual after the stroke episode.

Thesis (M.S.)--Duquesne University, 2007. / Title from document title page. Abstract included in electronic submission form. Includes bibliographical references (p. 92-99) and index.

The aims of this thesis were to describe the experiences of persons with aphasia and their significant others of their conversations and use of communication strategies, examine current practice of family-oriented speech-language pathology (SLP) services, and test a family-oriented intervention in the early phase of rehabilitation. The persons with aphasia valued having conversations despite perceiving their aphasia as a serious social disability. They acknowledged the importance of the communication partners’ knowledge and understanding of aphasia and their use of supporting conversation strategies. Their own use of communication strategies varied considerably. The persons with aphasia longed to regain language ability and to be active participants in society. A majority of the significant others perceived their conversations with the person with aphasia as being less stimulating and enjoyable than conversations before stroke onset. Aphasia was considered a serious problem. The significant others took on increased communicative responsibility, where two thirds had changed their communicative behaviour to facilitate conversations. Type and severity of aphasia were especially related to the communicative experiences of the significant others and their motivation to be involved in SLP services. Thirty percent of the speech-language pathologists worked with people with aphasia and typically met with their families. They considered the involvement of significant others in SLP services as very important, especially in providing information about aphasia and communication partner training (CPT). However, involvement of significant others was restricted because of a time shortage and perceived limited skills and knowledge. In addition, there were national differences regarding aphasia rehabilitation services. The intervention consisted of three sessions directed to significant others (primarily emotional support and information) and three directed to the dyads (a person with aphasia and a significant other) (primarily CPT). All six participants (three dyads) felt that their knowledge and understanding of aphasia had increased and that their conversations had improved. These improvements were also evident to some extent with formal assessments. These results suggest the following: CPT should be an integral part of SLP services, national clinical guidelines are needed, and further education of speech-language pathologists and implementation of new knowledge into clinical practice requires consideration.

Stroke is a widespread disease in Sweden. Nurses play a central part for those who suffer from a stroke irrespective of where in the care chain they meet. To be able to meet the patients’ need of care the nurse must understand his/her lifeworld. Each and every patient is unique and the experience of being struck by a stroke depends on personality and life situation. Those who suffer from aphasia are usually excluded in research and therefore there is lack of improtant knowledge. The aim of this study is to describe the experiences of suffering from and living with a stroke. By studying autobiographies the opportunity has opened to share the experiences of patients suffering from aphasia. To suffer from stroke is a big changeover in life and gives visible and invisible disabilities. These disabilities limit them in their every day life. Nursing staff becomes authorities and it’s important that the staff provides time for discussions. A fruitful discussion reduces suffering and creates feelings of being noticed and involvement. The result shows that those who suffer longs and endeavours for living life as normal as possible. / I Sverige är stroke en av våra stora folksjukdomar. De som drabbas är en stor patientgrupp och sjuksköterskor har en central roll i deras omvårdnad oavsett vart i vårdkedjan de befinner sig. För att kunna bemöta patientens behov av omvårdnad måste sjuksköterskan sätta sig in i patientens livsvärld. Varje patient är unik och upplevelsen av att drabbas är olika beroende på personlighet och livssituation. Personer med afasi har tidigare uteslutits i studier vilket gör att det saknas forskning inom ett stort och viktigt område. Syftet med studien är att beskriva människors upplevelser av att drabbas av och leva med stroke. Genom att studera självbiografier tillkom även möjligheten att ta del av patienter med afasis upplevelser. Att drabbas av stroke är en stor omställning i livet och ger synliga och osynliga handikapp som begränsar i vardagslivet. Vårdpersonal blir auktoriteter i deras liv, och det är viktigt att de har tid för samtal med de drabbade. Ett gott samtal upplevs minska lidande och skapar känslan av att vara sedd och delaktig i vården. Resultatet visar att de drabbade längtar och strävar efter att leva livet så normalt som möjligt.

För att anhöriga och personer med afasi ska kunna etablera en fungerande vardag harkunskap om och förståelse för afasi visat sig viktig. I tidigare studier har anhöriga tillpersoner med afasi visat sig sakna relevant kunskap om och förståelse för afasi som debehöver för att etablera en fungerande vardag. Logopediska insatser som är riktadedirekt till anhöriga är relativt ovanliga i Sverige. Syftet med denna studie är att utifråndata från litteratur och intervjuer utforma frågor, så kallade item, som på ett tillförlitligtsätt kan mäta kunskap om och förståelse för afasi hos anhöriga till personer med afasi.Tre fokusgrupper bestående av anhöriga till personer med afasi, personer med afasi ochlogopeder användes för insamlande av intervjudata. Intervjudatan analyserades genomkvalitativ innehållsanalys. Från analysen framställdes sju kategorier med tillhörandeunderkategorier. Kategorierna låg till grund för utformningen av item. Sammanlagt har140 stycken item utformats. Dessa item var av två typer; item bestående av en 6-gradigLikert-skala och item av typen Multiple Choice. Vidare indelades item beroende påvilka svar som kan erhållas . Item med önskvärda svar( typ A) och situations- ochindividberoende item (typ B) som syftar till att ligga till grund för samtal mellananhörig till person med afasi och logoped.. De kategorier och item som studienresulterat i uppvisar samstämmighet med tidigare studier som fokuserat på anhöriga tillpersoner med afasi. Samstämmigheten tyder på att de item som inkluderas i ett framtidaformulär har möjlighet att kunna mäta av kunskap och förståelse hos anhöriga tillpersoner med afasi. För att framtagna item ska kunna resultera i det tilltänkta formuläretkrävs ytterligare validering, reliabilitetstestning och urval. / Previous studies have shown that significant others to persons with aphasia are in needof increased knowledge and understanding of aphasia. The knowledge andunderstanding for aphasia has shown to be crucial to significant others in terms ofpsychosocial well-being and to be able to establish a satisfying everyday life. PresentSpeech-language pathologist services in Sweden tend to have limited involvement ofsignificant others to persons with aphasia. This study aims to design a number ofquestions, items, which will be able to measure the knowledge and understanding ofaphasia for significant others of persons with aphasia. The items result from literaturestudies and semi-structured interviews with significant others to persons with aphasia,persons with aphasia and speech-language pathologists. Transcripts from interviews areanalyzed through content analysis. The study results in 140 items presented in sevencategories, each with a number of sub-categories. Two types of items are designed:items in the form of a 6-point Likert Scale and items in the form of Multiple Choice.The items are also divided depending on whether the answer is knowledgde-based (typeA) or to be used as material for discussion (type B). The categories and items from thisstudy are consistent with previous research. To transform the items into a completequestionnaire, further validation, testing of reliability and selection is needed.

Bakgrund: Varje år drabbas runt 30 000 svenskar av stroke och nästan en tredjedel av dem får afasi. Afasi innebär en förlust eller försämring av språksystemet som förekommer efter en hjärnskada. Patienter med afasi upplever detta tillstånd som en förlust av sin autonomi vilket påverkar livskvaliteten negativt. Att vårda någon som drabbats av afasi ställer särskilda krav på sjuksköterskan, både för att hitta nya vägar till kommunikation och för att kunna ge en så god vård som möjligt.   Syfte: Syftet med denna studie är att beskriva komponenter som kan påverka kommunikationen med patienter som drabbats av afasi efter stroke utifrån sjuksköterskans perspektiv.   Metod: Uppsatsen är en litteraturstudie där åtta kvalitativa artiklar, publicerade mellan åren 2000- 2012, ingår. Valda artiklar berör kommunikation mellan sjuksköterskan och patienter som drabbats av afasi efter stroke. Som teoretisk utgångspunkt används Joyce Travelbees teori med fokus på utveckling av relationen mellan sjuksköterska och patient.   Resultat: Utifrån valda artiklar framkom två huvudteman: Grunder för en effektiv kommunikation och Möjligheter och hinder i kommunikation. Att använda sig av den icke- verbala kommunikationen har visat sig vara mycket effektivt när talförmågan är nedsatt. Samtidigt kan en anpassad miljö och tillräckligt med tid göra det möjligt att uppnå en effektiv kommunikation med patienter som drabbats av afasi.   Diskussion: Genom att hjälpa patienter att vara delaktiga i sin vård samt att använda sig av den icke- verbala kommunikationen kan man nå patienter med afasi. Detta kan resultera i en rättvisare vård och det skulle troligtvis också kunna öka livskvaliteten för individen. / Background: Each year about 30,000 Swedes suffer a stroke and almost one third of them experience aphasia. Aphasia is a loss or impairment of the language system that occurs after a brain injury. Patients with aphasia experience this condition as a loss of their autonomy which worsens their quality of life. To care for someone affected by aphasia requires specific skills for nurse, both to find new ways to communicate, and also to be able to provide as good care as possible.   Aim:  The aim of this study is to describe components that affect communication with patients suffering from aphasia after a stroke from a nurse perspective.  Method: The study is a literature review including eight qualitative articles published between the years 2000 - 2012. Selected articles involve communication between the nurse and patients suffering from aphasia after a stroke. As a theoretical frame, Joyce Travelbee’s theory focusing on the development of the relationship between nurse and patient is used.   Results: Based on the selected articles, two main themes arose: Fundamentals for effective communication, and the Opportunities and barriers in communication. Making use of the non-verbal communication has proven to be very effective when speech is impaired. Meanwhile, adapted surroundings and enough time can make it possible to achieve effective communication with patients suffering from aphasia.     Discussion: By helping patients to be involved in their care, and to make use of non-verbal communication, it is possible to reach patients with aphasia. This can result in fairer healthcare and it would also probably increase the quality of life for the individual.

Some studies of stroke patients with semantic deficits have found no effect of word frequency on semantic tasks, as well as inconsistent performance across items and tasks. A deficit in semantic control has been suggested as the source of the deficit - i.e., an inability to focus on semantic features appropriate to the task. In the present study, two stroke patients performed significantly better in single-distractor versions (low semantic control) than multiple-distractor versions of semantic tasks (high semantic control) of comprehension tasks, which appears consistent with the semantic control hypothesis. On the other hand, two aphasic patients showed substantially better performance for auditory than visual presentation of words in comprehension tasks – a finding that is not expected on the basis of semantic control. Experiment 1 evaluated whether performance on a multiple-distractor comprehension task could be predicted solely on the basis of performance on a single-distractor version using Luce’s choice axiom. Single distractor performance significantly predicted performance and no convincing evidence was obtained for a role for semantic control. Experiment 2, which examined the modality effect, showed that for one of the patients, worse performance with auditory presentation was most likely due to rapid decay of phonological representations. For the other, worse performance was most likely due to a disruption to phonological representations of words or to their connection to semantic representations. In all, the results suggest that word comprehension deficits in aphasia can result from a variety of sources and not all are due to semantic control deficits.

Our aim in this work has been to redesign ModernFamilies and make a user-friendly interface for people with aphasia. The focus has been to identify general issues they might face while using different technology and applications, in order to find better alternative design for ModernFamilies, with a focus on usability. To approach this issue, we used a qualitative method. Our study includes several interviews and observations preformed in conjunction with the AGNES project (AGeing in a NEtworked Society) and speech therapists. Aphasia requires simple design that in the same time gives them support to understand and use technology and different applications. This paper can be used as a guide for designers who develop applications for people with aphasia and the results can also be applied to improve general user friendliness.

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A historical study of intervention for aphasia may provide information on how speech and language pathologists work with people with aphasia. Aphasia is seen as an umbrella term for symptoms of language disorders caused by aquired brain injury. The overall aim of the present study was to describe and analyze the development of intervention for aphasia during the periods 1990-1999 and 2000-2010. The study was conducted by analysis of 83 medical records from two hospitals in Sweden during a period of 20 years. These decades were compared to each other and yo current litteraturein search for differences and trends in aphasia intervention. The Results of the present study revealed that intervention mainly focused on recovering the linguistic ability in both the 1990s and 2000s. Intervention and literature focusing on communication seem to increase during the 2000s. In the 2000s, speech and language pathologists begin to report on working with cognitive abilities. The results of the present study cannot be generalized but may give an insight in aphasia intervention from a historical perspective in Sweden. / En studie om afasiinterventionens historia kan bidra med information om hur logopeder arbetar med personer med afasi. Afasi ses som ett paraplybegrepp för symtom på språkstörning som uppkommit efter en förvärvad hjärnskada. Syftet med föreliggande studie var att beskriva och analysera hur utvecklingen av den logopediska afasiinterventionen har sett ut under åren 1990-1999 och 2000-2010. Studien genomfördes genom analys av 83 journaler från två sjukhus i Sverige under en 20-års period. Dessa årtionden jämfördes med varandra och relaterades till aktuell litteratur för att utröna skillnader och trender i den logopediska interventionen. Resultatet i föreliggande studie visade att intervention med inriktning mot att återfå den språkliga förmågan är vanligast under både 1990-talet och 2000-talet. Intervention och litteratur inriktad mot kommunikation förefaller öka under 2000-talet. Under 2000-talet dokumenterar logopeder att de ger intervention med inriktning mot kognition. Resultaten i föreliggande studie kan inte generaliseras utan får ses som en inblick i afasiintervention ur ett historiskt perspektiv i Sverige.