A description of social participation in working‐age persons with aphasia: A review of the literature

Abstract

Background: Communication impairments following stroke impact on social interactions and life experience. To look beyond body functions and activities into actual performance in life, knowledge about participation of working‐age persons with aphasia is necessary. Aims: To describe what is known in the literature about participation in working‐age persons with aphasia after stroke and to assess the quality of these studies, a systematic literature search was performed for the period 1960–2005 in Pubmed, CINAHL, Psychinfo, and Cochrane. The journal Stroke (1970–2005) was searched by hand, as well as the online content of the journal Aphasiology (1999–2005). Search terms were derived from the International Classification of Functioning, Disability and Health (ICF). Aspects of domestic life, interpersonal interactions and relationships, education and employment, and community, civic, and social life were included. Three investigators assessed the relevance of the identified studies using selection criteria. Main Contribution: From 1592 hits, 18 articles were analysed. Comparison between studies was very difficult, due to a lack of consistency in the conceptual framework used in the studies, small sample sizes, and a large variety in instruments. However, this review reveals a decrease in domestic life. Interpersonal interactions and relationships changed after aphasia onset, with shifts in contacts from friends to professionals, shifts in roles as partner, family member, parent, friend, citizen. A decrease in employment activities is reported and return to work is often to a less demanding level. No studies were found describing community, civic, and social life. Conclusions: Participation in different aspects of life is diminished in persons with aphasia. However, knowledge about this is scattered and fragmented. Many researchers have not clearly defined the concept of participation. Data should be interpreted with extreme caution and no firm conclusions can be made. There is a need for further research in this area, specifically clarifying the concepts used.