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Asset-based approaches for stroke survivors with aphasia and their families: promoting and sustaining well-being in the long-term.

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Abstract

Introduction: The undeniable improvements in acute stroke care over recent years have not been matched by more effective post-hospital support for stroke survivors generally or for people with aphasia (PWA) and their families [1,2]. Researchers have begun to turn their attention to factors which promote more positive outcomes and which are associated with the concept of ‘living successfully with aphasia’ [3,4]. Asset-based or asset-focused approaches to supporting people to live well long-term in the community have become an area of increasing interest [5]. Asset-based approaches, founded on salutogenetic theory [6,7] – ‘what makes you feel well’ rather than ‘what makes you feel ill’ – have the potential to provide coherent strategies for people with aphasia and their families to live well and successfully with aphasia, and to be developed through a fundamental transformation of the patient-caregiver relationship into a collaborative partnership [8].

Methods: We used qualitative methods to explore the potential of asset-based approaches for PWA and family members in different contexts of culture, organisation and stage of aphasia. Interviews, group discussions and participatory action research (PAR) were undertaken by members of COST CATs WG5 in the UK, Norway, Israel, Ireland and Denmark, in a series of case studies. We asked: “What makes you to feel good / well / healthy?” ”Which strengths do you find in yourself?” ”Which are the social connections that make you feel good” ”What else can help you?”

Results: Drawing on data across all cases, we found that:
‘Reframing towards assets’ was in some cases hard conceptual work, although many participants connected readily to this approach. Getting the terminology and resources right was key in helping to shift and enhance the quality of asset-focused conversations. These provided a powerful tool for empowering PWA and family members, but facilitators needed to set the scene, be flexible and creative.
In response to the key questions, overarching themes were:
Social interaction and connections to people, places activities and things
Being with family
Being proactive: doing things for myself and by myself; making the most of opportunities
People with aphasia drew on personal strengths: courage, self-belief, determination, a positive outlook, and a sense of humour.
Family members made lifestyle changes and emphasised flexibility.
These things helped people overcome barriers, find meaning, regain confidence and make friendships or connections that made further things possible.

Conclusions : Our findings indicate the feasibility of taking an asset-focused approach to promoting and sustaining wellbeing for PWA and their families. Further research is needed to examine how service providers (health and social care, 3rd sector etc.) could deploy this approach in clinical or other settings.

Details

Original languageEnglish
StatePublished - 9 Feb 2017
Peer-reviewedYes
EventCOST Collaboration of Aphasia Trialists Conference - Rotterdam, Netherlands
Duration: 8 Feb 20179 Feb 2017

Conference

ConferenceCOST Collaboration of Aphasia Trialists Conference
CountryNetherlands
CityRotterdam
Period8/02/179/02/17

Keywords

    Research areas

  • Aphasia, Asset-based, Stroke

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