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  • Rehabilitation programs strive to help patients become more independent in all aspects of daily living. Therefore, management of a patient's healthcare requirements should be an integral part of the rehabilitation program, including management of medications. Some rehabilitation programs implement self-medication programs (SMP); however, patients with cognitive deficits are often excluded. This study explored whether patients with cognitive deficits due to stroke could successfully complete an SMP using an interdisciplinary cognitive rehabilitation approach. Twenty-seven stroke patients and 36 debilitated patients with cognitive deficits participated in an SMP. A nurse and a pharmacist educated patients on their medications, and a speech-language pathologist provided cognitive rehabilitation to the stroke patients, which incorporated information from the SMP. Eighty-one percent of the stroke patients successfully completed the SMP, compared to 36% of the debilitated patients. Thus, an interdisciplinary approach to medication management for cognitively impaired stroke patients holds promise.

  • Background: Management of aphasia often focuses on training augmentative communication strategies such as communication books, computerised systems, gestures, writing, or drawing. Although many individuals are able to acquire a targeted skill in a structured format, many do not successfully use the trained skill in more functional situations. Training alternative communication strategies can be a time-consuming project; thus, it would be beneficial if speech-language pathologists could predict, a priori, how a patient may respond to this type of treatment approach. It has been hypothesised that use of augmentative communication strategies requires executive functioning, specifically cognitive flexibility, which may be impaired following brain damage. Therefore, assessment of cognitive flexibility may help clinicians determine which persons with aphasia would most likely benefit from training of augmentative communication strategies. Aims: The purpose of this study was to develop a measure of cognitive flexibility and to determine whether this measure predicted strategy usage during a functional communication task. Methods and Procedures: A novel scoring system for the Communicative Abilities in Daily Living (CADL) was developed to capture the degree of participants' cognitive flexibility. This score was correlated with the Wisconsin Card Sorting Test (WCST), to determine the validity of the scoring system. The CADL cognitive flexibility score was then correlated with performance on a referential communication task. A multiple regression analysis was conducted with severity of aphasia as an additional predictor variable. Outcomes and Results: There was a significant correlation between the cognitive flexibility score from the CADL and the WCST, confirming the validity of the scoring system as a measure of cognitive flexibility. Results of the regression analysis demonstrated a significant relationship between the cognitive flexibility score and strategy usage on a functional communication task. This relationship remained significant when the overall severity of aphasia was added to the regression analysis, suggesting that cognitive flexibility is a stronger predictor of strategy usage than severity of aphasia. These results may provide clinicians insight into which individuals would benefit most from the training of compensatory strategies, leading to the development of more appropriate goals and treatment methods.

  • Background: Because communication deficits caused by aphasia affect both persons with aphasia and their communication partners, most speech-language pathologists are aware of the importance of client and caregiver education. To maximise the effectiveness of their communicative interactions, training should be conducted for both the aphasic clients and their caregivers. Training conducted in group environments offers peer support through shared learning experiences and joint problem solving. Aims: The purpose of this study was to explore the benefits of a caregiver education and training programme in improving communication between caregivers and their aphasic partners using didactic and experiential approaches in a group setting. Methods & procedures: Ten caregivers and their aphasic partners, ranging from 4 to 130 months post-stroke, participated in a 12-week group training and education programme. Information about stroke and aphasia was provided in a didactic format, and facilitative communication strategies were discussed and practised using Kolb's (1984) experiential learning cycle model. The experiential learning cycle involved drawing on concrete experiences, engaging in reflective observation and abstract conceptualisation, and practising what was learned through active experimentation. Outcomes & results: Analysis of communicative performance on transactional and interactional tasks demonstrated increased communicative success. Responses on a questionnaire indicated that participants had a better understanding of aphasia and were more confident using facilitating strategies. Conclusions: Group education and training for caregivers and their aphasic partners can be beneficial, even after the couple has been living with aphasia for a number of years. Having an opportunity to practise, observe, and reflect on their performances facilitated participants' learning, and there were observed and reported positive alterations in interactions. © 2005 Psychology Press Ltd.

Last update from database: 3/13/26, 4:15 PM (UTC)

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