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 Howe, T., Worrall, L. and Hickson, L. 2007. Interviews with people with aphasia: Environmental factors that influence their community participation. Manuscript submitted for publication [Google Scholar]) 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 Howe, T., Worrall, L. and Hickson, L. 2007. Interviews with people with aphasia: Environmental factors that influence their community participation. Manuscript submitted for publication [Google Scholar]). 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 Howe, T., Worrall, L. and Hickson, L. 2007. Interviews with people with aphasia: Environmental factors that influence their community participation. Manuscript submitted for publication [Google Scholar]) 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.