What matters to people after stroke? using an innovative communication framework to involve people with aphasia in interviews about stroke rehabilitation

Background: People with severe communication impairments are rarely recognized as participants in their own right in rehabilitation research or in quality assurance in service development. Including their views is critical to gain a comprehensive understanding of their support needs and the development of equitable services. Aim: to explore the viewpoints of people with aphasia after stroke to inform community rehabilitation practice.

Method: Participants with communicative impairment currently engaged in community stroke rehabilitation were recruited. This study used Talking Mats TM, an innovative communication framework and speech therapy support tool which represents topics for discussion pictorially, as symbols which can be placed along a visual scale on a mat. Talking Mats were used to adapt the format of interviews previously conducted with a larger group of stroke patients (n=30) to elicit information and ensure participation of those with communication impairments. Interviews were videotaped and content analysed to explore what was important to participants in their lives and ways in which therapists had measured how participants were getting on with rehabilitation.

Results: Six participants (4 males, mean age 62, range 32-75), engaged in interviews using Talking Mats TM. The method was successful in facilitating discussion about relevant life domains. Participation as defined by the WHO ICF was important to all participants. Particularly, participation in interpersonal relationships and domestic life were key domains of importance for participants. Talking Mats also facilitated discussion of outcome measurement with participants.

Conclusion: Talking Mats enabled people with communication impairments to engage with research underpinning stroke rehabilitation practice.