Description of research
It’s estimated that about a third of stroke survivors will have some degree of aphasia, of language disability. Chronic aphasia can have substantial psychological and social consequences for a person, lowering their mood and quality of life.
Although speech and language therapists (SLTs) may help aphasia patients with their rehabilitation, there remains a clear lack of evidence-based treatments available for them to help their patients with problems of everyday talking, known as discourse. In addition, SLTs generally lack the expertise and confidence to effectively use the tools that do exist to help patients with discourse problems. These barriers prevent patients receiving the therapy that could maximise their everyday communication skills and lead to a better recovery.
Recent research suggests that one method of improving the outcomes of patients with discourse problems is through a re-imagining and integration of existing evidence-based treatments for aphasia in new ways. There is also international agreement amongst SLTs on the desperate need for better professional education and new clinical tools to help them treat clients with discourse problems more effectively.
This study aims to address both the need for evidence-based treatments and improvement of clinical expertise to approach discourse problems after stroke.
A new person-centred discourse treatment called ‘LUNA’ will be developed, based on rigorous review of aphasia theories and intervention research. All the treatment materials will be subsequently co-designed by the researchers with a small group of NHS SLTs and people with chronic aphasia, so that they are easily understood by service providers and recipients.
The study will include a UK-wide online survey of practising SLTs to obtain information about their discourse knowledge and skills, and what helps and hinders them in delivering discourse assessments and treatment to their patients in practice. This information will be used to develop a training programme to enhance the knowledge and skills of SLTs, and be trialled with 30 SLT volunteers. The training programme should ensure that any newly developed tools from LUNA can be accurately and efficiently used in regular clinical practice.
In the final stage of the study, treatment with LUNA plus usual care will be compared to treatment with usual care only in 24 people with chronic aphasia. This will explore whether LUNA is a feasible and acceptable treatment for its users; whether it can lead to an improvement in patient discourse ability, their psychological state and social interaction; and whether it can be delivered as intended in the manual.
The project is due to start 1 May 2018 and end 1 February 2021, lasting 33 months.