Factors that influence social dignity in persons with aphasia in their contact with healthcare professionals: a systematic literature review of qualitative studies

Abstract

Background: Persons living with aphasia have unique needs and challenges that would benefit from greater understanding among all health professionals. Aim: To explore which factors influence social dignity in persons with aphasia in their contact with healthcare professionals. Methods: A literature search was conducted in CINAHL, MEDLINE, Embase, PSYCINFO, ProQuest, Web of Science, ERIC and Epistemonikos. A total of 317 studies were read and eight were finally included. Qualitative content analysis methods were applied for data extraction and interpretation. Results: One overarching theme emerged: enabling person-centred communication among healthcare professionals. This covered two main themes – the experiences of empathy and of empowerment. The first of these is based on the subthemes of openness and awareness of feelings, and being acknowledged as a unique person. The second covers three subthemes: involvement in care and rehabilitation; capacity building to gain control and confidence in communication; and enabling communication in community aphasia groups. Conclusions: Healthcare professionals’ ability to safeguard the social dignity of persons with aphasia is contingent on enabling them to communicate in a person-centred manner. Without such communication, persons with aphasia may perceive that their feelings, uniqueness, involvement and confidence are being disregarded. Implications for practice: • Outcomes for persons with aphasia are potentially better when healthcare professionals involve them empathetically and empower them in communication • To promote person-oriented communication with persons with moderate or severe aphasia, healthcare professionals need to learn tailored skills from competent speech therapists • Persons with aphasia and healthcare professionals require a supportive organisational environment for person-centred care. Without such support persons with aphasia are often not empowered to participate in communication