Observing people with aphasia: Environmental factors that influence their community participation

Abstract

Background: Access to the community is increasingly being recognised as an important right of all people. To date, most of the research on community access for people with disabilities has been on individuals with physical disorders. Recently, Howe, Worrall, and Hickson (2007) conducted an in‐depth interview study to explore the environmental factors that influence the community participation of adults with aphasia. This report describes an investigation that used participant observation to triangulate and complement the findings of the interview study by Howe et al. (2007). The authors wish to acknowledge the contributions of the research participants. This research was also proudly supported by the Queensland Government’s Growing the Smart State PhD Funding Program and may be used to assist public policy development. The State of Queensland accepts no responsibility for decisions or actions resulting from any information supplied. The views and information contained in the research do not necessarily represent the views or opinions of the Queensland Government and carry no endorsement by the Queensland Government. Aim: The investigation aimed to explore the environmental factors that hinder or support the community participation of adults with aphasia. The specific research questions were: (a) What environmental factors are observed to hinder the community participation of adults with aphasia? (b) What environmental factors are observed to support the community participation of adults with aphasia? (c) What themes underlie the environmental factors that are observed to hinder or support the community participation of adults with aphasia? A companion report by Howe et al. (2007) describes the findings of an interview study that explored similar research questions. Methods and Procedures: In this qualitative description study, 10 participants with aphasia were observed participating in several community environments, using the method of participant observation. The participants, aged 35 to 72, were purposefully selected using maximum variation sampling for a variety of variables such as gender, aphasia severity, and living situation. Qualitative content analysis was used to analyse the field notes. Outcomes and Results: The study revealed 44 barriers, 59 facilitators, and six themes: Referents, Interaction, Familiarity, Communication Complexity, Time Available for Communication, and Availability of Extra Support for Communication. Conclusion: Results from this study complement and add to the credibility of the findings from an interview study that shares the same research aim. These results can contribute to the development of an audit tool for assessing environmental factors in order to improve access to the community for people with aphasia.