The participants' perspective: how biographic-narrative intervention influences identity negotiation and quality of life in aphasia

• Published in: International journal of language & communication disorders 2015-11, Vol.50 (6), p.788-800
• Main Authors: Corsten, Sabine, Schimpf, Erika J., Konradi, Jürgen, Keilmann, Annerose, Hardering, Friedericke
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aphasia; Aphasia - diagnosis; Aphasia - psychology; Aphasia - rehabilitation; biographic-narrative work; Cooperative Behavior; Female; Germany; Group Processes; Health; Humans; Identification (Psychology); identity; Interdisciplinary Approach; Interdisciplinary Communication; Intervention; Interview, Psychological; Language Impairments; Language Therapy; Life Satisfaction; Male; Middle Aged; Mixed Methods Research; Narration; Narratives; Negotiating; Negotiation; outcome measures; Patient Satisfaction; Pretests Posttests; Psychological Patterns; Quality of Life; Quality of Life - psychology; Self concept; Semi Structured Interviews; Social Identification; Story Telling; Storytelling; Stroke; Stroke - diagnosis; Stroke - psychology; Stroke Rehabilitation
• ISSN: 1368-2822; 1460-6984
• DOI: 10.1111/1460-6984.12173

Background People with aphasia experience a pronounced decrease in quality of life (QoL). Beyond that identity negotiation is hindered, which is crucial for QoL. Biographic–narrative approaches use life story telling to support identity (re)development after disruptive events like stroke. Because of the language deficits inherent in aphasia such ‘talk‐based’ approaches have to be modified for an optimal use. Aims To evaluate an adapted interdisciplinary biographic–narrative intervention using quantitative measures of health‐related quality of life (HRQL) and mood. Additionally, semi‐structured interviews were conducted to gain a deeper understanding of identity development processes in people with aphasia. Methods & Procedures Twenty‐seven participants with various types of chronic aphasia were enrolled. The biographic narrative intervention consisted of five face‐to‐face in‐depth interviews and seven group sessions conducted over 10 weeks in a mixed‐method design with pre‐ and post‐tests and a follow‐up assessment 3 months post‐intervention. For quantitative evaluation the Aachen Life Quality Inventory (ALQI), the Satisfaction with Life Scale (SWLS) and the Visual Analog Mood Scales (VAMS) were used. Semi‐structured interviews were conducted post‐treatment, including questions concerning the participants’ experiences with the intervention and identity change. Results were analysed using interpretative principles from Grounded Theory. Outcomes & Results For all 27 participants, we found significant and stable growth in HRQL. Self‐reported states of mood also improved. As expected, overall cognitively based life satisfaction did not change. The interviews revealed two main categories: ‘evaluation of the face‐to‐face interviews’ and ‘evaluation of the group sessions’. Further analysis found four overlapping main themes which were identified as identity issues: agency, control, disease concept and doing things. Conclusions & Implications Our quantitative and qualitative results demonstrated the benefits associated with the biographic–narrative intervention. The participants’ sense of self changed through the approach. The findings provide foundations for future work using biographic narrative interventions to influence QoL and identity renegotiation in people with aphasia.