Primary Care Physicians Can Help Stroke Survivors
Important role in coaching and depression treatment for patients with aphasia struggling to adapt
Primary care physicians can play an important role in providing feedback, coaching, and depression treatment to stroke patients with aphasia who are struggling with changes to their occupational, family, and social identities, according to a study co-authored by Boston University School of Public Health (SPH) researchers.
“Recognizing patients’ struggles with their identities and in creating a new narrative may help in fostering recovery for these patients,” wrote the team behind the study, which was published in the International Journal of Family Medicine.
The research team noted that, while much has been written about the effect on families of stroke patients who experience aphasia, there has been little direct study of patients’ experiences. The team interviewed 12 patients over 18 months about perceived changes in their relationships and identities.
Stroke is the most common cause of aphasia, a communication disorder characterized by impairments in the ability to produce or comprehend language.
All of the participants in the study reported that language and communication were an important part of their identities, as professionals, parents, friends, and spouses. Impairments in these areas “forced them to recreate or shift their identities. This process was dependent on several factors. These included previous interests they may have held, the severity of their aphasia, the support of their spouse or partner, their relationships with friends, and their ability to frame their experiences in new and adaptive ways,” the authors wrote.
Study participants described the impact of their aphasia on the way they perceived themselves and the way others perceived them, in multiple settings.
“Not all of these changes were described as negative,” the authors wrote, “though many were framed as challenging initially until the participant found a way to create a new identity for themselves.”
Because neurologists and rehabilitation professionals are involved with stroke patients for a relatively short amount of time, the researchers said, it falls to primary care providers to “help the patient to move forward in the formation of their new identity.”
Researchers included Joanne Wilkinson, assistant professor of family medicine at BU School of Medicine (MED) and of community health sciences at SPH; Barbara G. Bokhour, associate professor of health policy and management at SPH; Thomas Gilbert of MED; and Benjamin Musser, formerly a MED student.
Funding was provided through the American Academy of Family Physicians Foundation and the Schwartz Center for Compassionate Healthcare.