Perspectives of working-age adults with aphasia regarding social participation

Abstract

Background: Working-age adults with aphasia experience difficulties in social participation, specifically the ability to fulfil social roles and reintegrate into communities. Literature regarding social participation of people with aphasia (PWA) is predominantly based on high income countries limiting generalizability of findings. Investigation of PWA’s perspectives on social participation in lower-middle-income countries such as South Africa is warranted. Objective: To describe the perspectives of working-age adults with aphasia regarding social participation within the first two years post-incident. Method: Semi-structured interviews were used to obtain the perspectives of 10 working-age adults (mild to moderate aphasia), using pictorial and written supports, and supported conversation techniques. Data were coded and thematically analysed to identify common themes amongst participants’ perspectives of social participation. Results: Five main themes and two sub-themes were identified. Participants’ perspectives of social participation align with previous qualitative studies regarding perspectives of working-age adults with aphasia, specifically their preference for re-engagement in meaningful activities. Participants described preference for specific 2 communication partners, specifically close friends and family. Reduced social participation was apparent due to difficulties in returning to work. The rehabilitation process was identified as an area of social engagement, specifically participants’ relationships with their speech-language therapist. Faith-related activities were the primary contexts that involved other community members. Conclusion: Successful social participation was dependent on the perceived value and the supportive nature of social activities rather than the quantity of activities. Rehabilitation should facilitate and optimise PWA’s communicative functioning within valued areas of social participation, enhancing person-centred care. Keywords: Social participation; aphasia; mild-moderate aphasia; stroke; lower-middle-income countries; working-age adults; A-FROM; ICF; speech-language therapy; person-centred care.