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Previous issue date: 2013-01-21 / This thesis had the general aim at characterizing the communicative profiles of adults with acquired brain damage after a unilateral stroke, as well as to develop tasks for a communication rehabilitation program focusing on dicourse. This thesis was comprised of three studies, one theoretical and the two empirical. The first one was conducted by means of a systematic review in order to verify which approaches have been used in rehabilitation of communicative discursive processing in acquired neurological disorders. A search was performed in the PubMed database, between 2002 and 2012, with keywords for the constructs rehabilitation, neurological disorder, communication, and discursive abilities. Only four empirical studies were found. The second study was designed to identify changes in communicative processing due to unilateral stroke, describing how many and which the communicative clinical subgroups are, and to explore whether sociocultural, individual and clinical variables differ among communicative clusters. A hierarchical clusters was made based on the performance of verbal oral tasks of the Montreal Communication Assessment Battery brief version (Bateria Montreal da Comunica??o vers?o breve) with a sample of 71 patients with ischemic stroke, 35 adults with right brain damage and 36 with left brain damage not followed by aphasia.Comparisons among clusters were made by Chi-square and One-Way ANOVA (post-hoc Bonferroni). Three communicative clusters were found: (1) discursive impairment (conversational speech), (2) deficit in pragmatic processing (interpreting speaking actions) and in lexical semantics (overt verbal fluency), and (3) spared performance, , without any differences regarding sociocultural, individual and clinical factors. The last empirical study aimed at presenting tasks development process for a discourse rehabilitation program. The sample was comprised of 39 participants distributed into 8 phases. The proposal of methodological flow for developing intervention tasks with the same methodological rigor used to develop evaluation paradigms may contribute to the field of rehabilitating complex communicative units. Findings of the three studies altogether suggest that although communication assessment had been growing, there still is a great demand for investigations regarding rehabilitation of conversational and general communicative impairments / Esta tese teve como objetivo geral caracterizar os perfis comunicativos de adultos com acometimentos neurol?gicos ap?s acidente vascular cerebral (AVC) unilateral, de hemisf?rio direito ou de hemisf?rio esquerdo, assim como visou a desenvolver tarefas para um programa de reabilita??o da comunica??o com ?nfase no discurso, te?rica e empiricamente embasado. Assim, foram desenvolvidos tr?s estudos, um te?rico e dois, emp?ricos. No estudo te?rico, fez-se uma revis?o sistem?tica para verificar quais as abordagens empregadas na reabilita??o do processamento comunicativo discursivo de quadros neurol?gicos adquiridos. Realizou-se uma busca na base PubMed, entre 2002 e 2012, com palavras-chave para os construtos reabilita??o, les?o neurol?gica, comunica??o e habilidades discursivas. Foram encontrados apenas quatro estudos emp?ricos, todos com pacientes af?sicos que melhoraram p?s-interven??o. O segundo estudo procurou identificar quais s?o as altera??es nos processamentos comunicativos p?s-AVC unilateral, descrever quantos e quais s?o os subgrupos cl?nicos comunicativos, e explorar se as vari?veis sociodemogr?ficas e cl?nicas diferem entre os clusters comunicativos. Realizou-se uma an?lise de clusters hier?rquicos pelo desempenho em tarefas verbais orais da Bateria Montreal da Comunica??o vers?o breve, com uma amostra de 71 pacientes com AVC isqu?mico, sendo 35 adultos com les?o de hemisf?rio direito e 36 com les?o de hemisf?rio esquerdo n?o af?sicos.Compara??es entre clusters foram feitas por Qui-quadrado e One-Way ANOVA (post-hoc Bonferroni). Encontraram-se tr?s clusters comunicativos: (1) com preju?zos no processamento discursivo (conversacional), (2) desempenho deficit?rio nos processamentos pragm?tico (interpreta??o de atos de fala) e l?xico-sem?ntico (flu?ncia verbal livre), e (3) desempenho m?dio adequado, sem diferen?as quantos a vari?veis sociodemogr?ficas e cl?nicas. O ?ltimo estudo visou a apresentar o processo de desenvolvimento de tarefas para um programa de reabilita??o do processamento discursivo, com 39 participantes distribu?dos em oito etapas. Essa proposta de fluxo metodol?gico para desenvolvimento de tarefas com mesmo rigor metodol?gico utilizado para o desenvolvimento de paradigma de avalia??o pode contribuir para a ?rea da reabilita??o de unidades comunicativas complexas. Os achados dos tr?s estudos sugerem que apesar dos avan?os na ?rea de avalia??o da comunica??o em quadros neurol?gicos adquiridos, ainda h? uma grande demanda por identifica??o de perfis cognitivo-comunicativos p?s-AVC unilaterais e por investiga??es sobre reabilita??o comunicativa e discursiva.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/827 |
| Date | 21 January 2013 |
| Creators | Gindri, Gigiane |
| Contributors | Fonseca, Rochele Paz |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Psicologia, PUCRS, BR, Faculdade de Psicologia |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 2588426296948062698, 500, 600, 2599381623216554467 |
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