Social participation in working-age adults with aphasia : an updated systematic review

Abstract

Background: A previous systematic review found limited data regarding social participation in working-age people with aphasia (PWA). This population has many roles to fulfill, that are negatively affected by aphasia. A review of recent studies may reveal more information on the challenges in re-establishing social roles and thus may inform treatment thereof. Method: The aim was to provide an updated systematic review on social participation in PWA under 65 years of age. Studies from 2005-2017 were searched from Scopus, Pubmed and Psychinfo. Search terms were derived from the International Classification of Functioning, Disability and Health (ICF) and the Aphasia- Framework for Outcomes Measures (A-FROM). Aspects of domestic life, interpersonal relations and interactions, education and employment and community, civic and social life were investigated. Results: From 2,864 initial hits, 11 studies were identified, all of which were on the American Speech-Language-Hearing Association (ASHA) Level III of evidence. The studies indicated that participation in domestic life is reduced and PWA showed reduced social networks, loss of friendships and changes in the quality of marital relations. Few PWA returned to work or spent time on education. Limitations in community, civic and social life were noted and there were contradictory findings on the impact of contextual factors on social participation. There was an increase in research into contextual factors impacting on social participation in PWA and in the use of conceptual frameworks in the last decade. Conclusions: Social participation in working-age adults is limited across the social domains. While the ICF conceptual framework is increasingly used, no studies used the A-FROM. There is greater use of standardised assessments and larger sample sizes.