Experiences of participation in goal setting for people with stroke-induced aphasia in Norway. A qualitative study

Abstract

Purpose: The body of research into client participation in aphasia rehabilitation is increasing, but the evidence on how it is implemented into clinical practice is still scarce. Particularly, the importance of including the "insider's perspective" has been demanded. The aim of this study was to explore how people with aphasia experienced client participation during the process of goal setting and clinical decision making in language rehabilitation.

Methods: Fifteen people with stroke-induced aphasia participated in semi-structured in-depth interviews. A qualitative analysis using Systematic Text Condensation was undertaken.

Results: Analysis revealed four main themes: (1) pleased with services, (2) vagueness in language rehabilitation, (3) personal goals exist, and (4) desired level of participation.

Conclusion: Even though people with stroke-induced aphasia overall are pleased with the language rehabilitation, there is a need for greater emphasis on making the framework of language rehabilitation less vague. Therapists should also spend more time on collaboration with people with stroke-induced aphasia and use available methods to support communication and collaboration. The findings underscore the need for further exploration of the potential outcomes of implementing client participation in goal setting and clinical decision making for persons with stroke-induced aphasia. Implications for rehabilitation All persons with stroke induced aphasia should be asked about their goals for rehabilitation not only once, but during the whole continuum of their rehabilitation journey. Rehabilitation professionals should place greater emphasis on client participation by asking people with stroke induced aphasia how they prefer to participate at different stages of rehabilitation. To ensure active participation for those who wants it, existing tools and techniques which promoted collaborative goal setting should be better incorporated.

Keywords: Clinical decision-making; client participation; person-centered rehabilitation; semi-structured interviews; shared decision-making; systematic text condensation.