Perspectives on ICT-delivered aphasia rehabilitation: exploring feasibility, usability and acceptance of this mode of rehabilitation

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Date
2019-10-03
Authors
Kearns, Áine
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University College Cork
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Abstract
Background: Speech and language therapy can provide positive outcomes for people with aphasia after stroke. The intensity of therapy is a key component for successful rehabilitation outcomes but, due to resource constraints, it can be a challenge for services to provide intensive face-to-face rehabilitation. The availability of information and communication technologies (ICT) and software rehabilitation programmes offer the opportunity for intensive self-managed aphasia rehabilitation. However, it is important to establish the feasibility and acceptance of this mode of rehabilitation among those who are involved in aphasia rehabilitation; the person with aphasia (PwA) and the speech and language therapists (SLTs) who work with them. Research Aims: This thesis provides a unique perspective on the acceptance and usage of ICT-delivered aphasia rehabilitation for post-stroke aphasia. It aims to 1) investigate the feasibility of self-administered intensive ICT-delivered aphasia rehabilitation targeting auditory sentence comprehension deficits 2) explore the experiences and perspectives of people with aphasia engaging in this form of rehabilitation and 3) explore the perspectives of SLTs on the use of ICT in aphasia rehabilitation. Methods: The research in this thesis employs a mixed methods research design including: 1) participatory health research techniques in order to develop a user-designed aphasia-accessible feedback questionnaire on ICT usability and functionality 2) a mixed methods feasibility study to examine the outcomes, acceptance and usability of ICT-delivered aphasia rehabilitation targeting auditory comprehension at sentence level and 3) a descriptive qualitative study to explore speech and language therapists’ views of ICT-delivered aphasia rehabilitation. Results: The co-design process highlighted that people with aphasia can, and should, be included in all stages of the research process and especially in the development and design of evaluation measures for use by people with aphasia. The findings of the feasibility study suggest that an ICT-delivered therapeutic programme underpinned by a general approach to auditory comprehension does not result in significant treatment effects outside of assessments that reproduce the therapy task approach. ICT-delivered aphasia rehabilitation may be acceptable to some people with aphasia and has a role within rehabilitation. However, face-to-face contact remains a valued aspect of aphasia rehabilitation for both people with aphasia and SLTs. Attention must be given to the facilitating conditions required to support the PwA and the SLTs to enable this mode of intervention. Conclusion: This research is timely, with the rapid growth in available technologies and increasing demands for services among an ageing population. The users’ perspectives, both the PwA and the SLTs working with them, must not be overlooked when considering the impact of this mode of rehabilitation. This research identifies the factors that influence acceptance and usage of ICT-delivered aphasia rehabilitation within an Irish context.
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Aphasia , Rehabilitation , Information and communication technologies (ICT)
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Kearns, Á. 2019. Perspectives on ICT-delivered aphasia rehabilitation: exploring feasibility, usability and acceptance of this mode of rehabilitation. PhD Thesis, University College Cork.
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