JCPSLP Vol 17 No 2 2015_web

Table 1. Characteristics of participants with communication impairment and carers

Participants with communication impairment

Carers

Participant

1

2

3

4

1

2

3

4

Age

63

75

67

45

48

50

53

65

Gender

M

M

F

F

M

M

F

F

Diagnosis

Mild aphasia Mild aphasia Mod/sev aphasia Ataxic dysarthria

Years post onset

18

29

2 ½

27

Time (months) involved with group

10

4

1

5

3

12

1

5

Participants All group participants, carers and volunteers associated with the Fremantle Communication Group were invited to participate in the study. Four group participants and four family carers of participants from the Fremantle Communication Group (unrelated to each other) gave written consent to participate in the study using plain English and/or aphasia-friendly materials. Participants were aged between 45 and 75 years with a range of diagnoses following brain injury, mainly stroke (see Table 1). Three participants had mild to moderate aphasia while the fourth participant had a moderate ataxic dysarthria. They had attended the group for between 1 and 10 years. The carers interviewed were aged between 48 and 65 years and had been associated with the group for between 1 and 12 years. Carers did not attend the weekly group but were included in order to explore their experiences of the participants’ attendance at the group. Procedure All participants completed a semi-structured interview conducted in their own homes or at a suitable location selected by them. The interview involved a series of topics relating to their involvement in the group, such as (a) their motivation for attendance or their family member’s attendance; (b) how the group functions, in particular, in relation to the volunteers; and (c) the impact of the group on their own and their family members’ lives. The participants were not directly asked to provide their view on what they thought contributed to the success of the group or to assess the influence of the speech pathologist’s involvement. These topic areas provided a guide for the interviewer whereby the interviewer could stray from the protocol or delve further into particular issues when deemed appropriate. Each interview was between 30 and 45 minutes, using principles set out by Luck and Rose (2007) for interviewing people with aphasia, and framed by supported conversation techniques (Kagan, 1998). The interviews were conducted by a SLP student who was provided with training through practice interviews and feedback, and recorded digitally and transcribed verbatim and orthographically by the interviewer (Onwuegbuzie & Leech, 2007). Members of the research team checked 10% of the interview data for transcription accuracy against the audio-files to ensure the transcriptions were an accurate record of the discussion. Data analysis Thematic analysis is an approach used to recognize and report themes within a data set (Braun & Clarke, 2006). Using NVivo9, the process for this study followed the

a volunteer-led charity, the organisation oversaw, at the time of the study, two community conversation-based groups (identified here as group 1 and group 2) in metropolitan Perth, led either by volunteers or by members with communication impairment. Of these groups, only group one had been considered successful as evidenced by its continual recruitment, and attendance of regular members, over nearly a 13-year period; 82 people had attended the group during this time (attendance averaged two to three years, ranging from one session to 12 years) while group 2 faced dissolution at the time of the study. Both groups were volunteer led and had been set up with initial funding by the Rotary Health Foundation. One difference lay, however, in the regular, low-intensity speech-language pathology (SLP) involvement that had been maintained in group 1 and not the other. The SLP involvement was in a voluntary capacity, eventually coming under the umbrella of Communicate WA. With the charity exploring the viability of setting up further groups throughout the same geographical region, a model which suited local conditions was needed and an analysis of the critical success factors was undertaken to explore which specific factors underpinned the success of the group and, in particular, the extent to which SLP involvement was regarded as critical. The group, known as the Fremantle Communication Group, has met weekly since its inception with the SLP attending monthly throughout this period. The role of the SLP focused on volunteer training, along with active promotion of established communication frameworks, e.g., Supported conversation for adults with aphasia (SCA; Kagan, 1998) where volunteers are trained in communicative strategies and have appropriate materials available to support this, and “total communication” where all communication methods are facilitated. Additionally, the SLP provided information on the communicative skill level of each new member in liaison with local health services. Aims of the study This study aimed to examine the communication group experiences of group participants and their carers to identify which factors have contributed to the success and longevity of the Fremantle Communication Group. This process sought to facilitate reflection on how these factors might generalise to other contexts/groups with the view to informing a sustainable model for further communication groups. Integral to this aim was the need to isolate the contribution of the professional support, identifying to what extent this was critical and, if so, which components. Method Ethics approval was received from the Human Research Ethics Committee at Curtin University (SPSP 2011/49).

Melanie Breese (top), Louise Cato (centre) and Jade Cartwright

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JCPSLP Volume 17, Number 2 2015

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