Date of Award

2021

Degree Type

Open Access Thesis

Document Type

Master Thesis

Degree Name

Master of Arts (MA)

Department

Communication Sciences and Disorders

First Advisor

Christen Guffey Page

Department Affiliation

Clinical Therapeutic Programs

Second Advisor

Sue Mahanna-Boden

Department Affiliation

Clinical Therapeutic Programs

Third Advisor

Jade Hill Robinson

Department Affiliation

Clinical Therapeutic Programs

Abstract

Main Argument: Acquired brain injury impacts 2.8 million individuals each year in the United States (Taylor et al., 2017). Stroke, traumatic brain injury, tumor, infection, and other conditions cause life-altering changes to the way humans interact with each other. Social interaction and communication are important in many aspects of life, including but not limited to work, community, relationships, and mental health, etc. Damage to the brain often changes the ability to communicate drastically, which can impact all of the aforementioned aspects of life (Ardila & Rubilo, 2018). Speech-language pathologists (SLPs) address the acquired neurogenic communication disorders associated with brain injury in order to enhance life participation. However, previous research indicated a difference between goals identified by clients versus SLPs (Foster et al., 2013). Individuals with acquired neurogenic communication disorders prefer therapeutic goals related to activity and participation; however, goals addressed by SLPs are often impairment-based. This discrepancy impacts implementation of person-centered care (PCC). Person-centered care involves incorporating the client and his/her family/co-survivors into treatment using individualized techniques. Previous literature found that PCC enhances treatment outcomes, specifically life participation (DiLollo & Favreau, 2010; Hersh et al., 2012). Current research investigated SLPs’ perspectives of therapy as well as SLPs’ and clients’ perspectives on therapeutic goal-setting (Foster et al., 2013; DiLollo & Favreau, 2010; Brown et al., 2011; LPAA Project Group, 2001). However, limited literature is available investigating clients’ and co-survivors' perspectives of the therapeutic process. Since PCC involves all those involved in an individual's life, SLPs must understand perspectives of co-survivors and clients with acquired neurogenic communication disorders. This information will enhance current practices of SLPs by meeting the needs of clients and co-survivors through PCC.

Procedures: The purpose of this study was to describe the perspectives of co-survivors and clients on PCC within speech-language therapy (SLT). The researcher aimed to answer one grand tour question with this study. How do adults with acquired neurogenic communication disorders and their co-survivors perceive the implementation of person-centered care in speech-language therapy? To answer this question, three focus group interviews, two with PWA and one with co-survivors, were conducted. Data was analyzed using open, axial, and selective coding processes, which resulted in categories that create a storyline.

Findings: The purpose of this study was to utilize qualitative measures to determine the perspectives of clients and co-survivors on PCC during SLT. Findings revealed that client and co-survivor participants perceived components of PCC as being provided by SLPs during SLT services. The following components of PCC that these participants provided included treating the person as a whole, client and co-survivor involvement in therapy, life participation, and positive relationships between clients and SLPs.

The application of these findings can further support individuals with acquired neurogenic communication disorders by demonstrating the impact of incorporating PCC into SLT. Consequently, positive relationships are built between all parties, the individual is treated as a whole person instead of a diagnosis, SLPs provide support to clients and co-survivors, and life participation is priority.

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