Exploring Experiences of Expressive Aphasia in Brain Injury Patients: A Qualitative Study

Abstract

Background: Aphasia affects 0.37% of South Africans. Expressive aphasic patients’ ability to react appropriately to the environment contributes to their hospital experience, and ultimately their mental health and recovery. The challenge of communication for these patients makes it important to anticipate their experiences. Objectives: The purpose of the present study was to explore the patterns of patient experiences in relation to expressive aphasia following brain injuries in order to identify helpful recommendations for alternative communication and for promoting mental health and well-being.Methods: A qualitative case series study was completed with the participation of seven adults who had recovered from expressive aphasia. Participants had received their acute care at Worcester Provincial Hospital, South Africa and at the time of the study were able to communicate effectively concerning their experiences and perspectives. Interviews were transcribed and transcripts analysed by two independent researchers. A thematic analysis method, within a constructionist framework, and at a latent level, was applied.Results: Participants were generally satisfied with the services of health professionals. All participants described their families as being supportive. However, even though most participants had attempted to initiate alternative forms of communication, their families had not reciprocated this. Participants experienced sadness, frustration and anger following the onset of expressive aphasia. They reported gaining insight into the way their lives might change in the near future, such as their roles within the community, as well as into their experiences of introspection and self-reflection. Conclusions: Persons with new onset expressive aphasia during acute care at a large South African hospital experience negative emotions (such as feelings of frustration, entrapment and sadness) as well as inadequate responses to their desire to use alternative forms of communication. Anticipation of such negative experiences may substantially help communication. Formal training in this regard is recommended for health care professionals. Also, visitors to patients with expressive aphasia require basic instruction on the use of alternative communication.