Psychosocial care of people with aphasia : practices of speech-language therapists in South Africa

Abstract

Rationale: The study aimed to explore the practices of South African speech-language therapists in providing psychosocial care to people with aphasia. People with aphasia are at risk of adverse psychosocial disruptions and access to appropriate support may be particularly challenging for individuals with compromised communication abilities. The study was the first of its kind in the unique multilingual and multicultural context. By understanding current practices, direction for improved psychosocial care to people with aphasia, as well as support to speech-language therapists delivering this care may be provided. Method: A 20-item previously published online survey was completed by 56 South African speech-language therapists. Purposive sampling and snowball sampling were used to recruit participants for the study. A mixed-methods design was adopted. Descriptive and inferential statistics, as well as qualitative content analysis, were used. Results: Respondents recognised addressing psychosocial wellbeing to be very important. A variety of psychosocial approaches were used in practice. However, 67.9% of the sample felt ill-equipped to provide psychosocial care to people with aphasia. Further barriers included: time/caseload pressures (60.7%) and feeling out of their depth (48.2%). Enablers were access to more training opportunities (89.3%), adequate time (62.5%), and ongoing support from skilled professionals (55.4%). The majority of respondents also perceived mental health professionals to have limited expertise in working with people with aphasia, making onward referral challenging. Conclusions: Respondents aimed to support people with aphasia’s psychosocial wellbeing by working collaboratively, including family and setting person centred goals. However, many challenges to the provision of psychosocial care to people with aphasia were identified. In order to improve services, more training, role definition and interprofessional collaboration is required.