L10: Impact of ALD Flashcards
(27 cards)
what % experience depression post stroke
60-70
what % experience depression post stroke aphasia
19-22%
who is more likely to have depression post stroke?
african american > white
impaired reading comp
what does depression lead to in post stroke aphasia?
poor emotional well being
reduces effects of rehab
impacts neg on long-term functioning and QoL
leads to higher mortality rates
other than depression, what other sequelae may occur in post stroke aphasia?
adjustments to daily living
disenfranchisement and marginalization (poor social participation)
higher rates of co-morbidities
higher rates of institutionalization esp among older persons w aphasia
loss of paid job
QoL=
an indv’s perception of their position in life in the context of the culture and value systems in which they live and relations to their goals, expectations, standards, ad concerns
aka complex (dont memorize)
health-related QoL (HRQL) =
the impact of a health state on a person’s ability to lead a fulfilling life
incorporates an indvs subjective evaluation of his or her physical, mental/emotional, family, and social functioning
more narrow than QoL
indvs w post stroke aphasia (in relation to HRQL) report…
sig worse HRQL than non aphasic post-stroke controls
worse QOL than healthy controls - independence, social relationships, and access to aspects of their enviro
what are the 4 factors associated with poorer HRQL - qualitative evidence?
emotional distress/depression
extent of comm disability and aphasic imp (more severe worse than milder)
presence of other medical problems
functional status/activity levels
what are some factors (7) contributing to or detracting from HRQL (qualitative evidence)?
activities
verbal comm
body functioning
social support/social network
adaptation of personal identify and dev of a collective identity
looking to the future/having a pos outlook
taking charge of one’s own continued comm improvement
what are the 5 factors related to living successfully w aphasia?
social network
making a pos contribution
enabling enviros and opps
flexible and responsive services
accessible info and aphasia aware professionals
ICF vs AFROM
ICF = international classification of functional disability of health … a way of classifying health and health related conditions. includes body fxs/structures, activity, participation, enviro/personal factors. can be used as an outcome measure, but for aphasia it is so broad so it lacks specificity.
AFROM = was dev from the ICF, specific to aphasia. NOT an outcome measure - a framework you may go about ax indvs w aphasia. Considers QOL and life participation. Common language for stakeholders.
what are 3 issues with ax QOL for aphasia?
selection and presentation of materials (aphasia friendly)
interviewer skills (supported convos for adults w aphasia - SCA)
use of proxies (proxy evaluations cannot be used interchangeably w self-reports)
what are the two types of QoL scales?
generic = across popns, broad-based/comprehensive
cond specific = w/i popn, precise
are complimentary and not mutually exclusive!
assessment for living with aphasia (ALA) is an example of
an outcome measure
what are the 5 important needs of relative/friends of persons with aphasia?
to feel PWA was in a safe enviro/receiving professional services
to be informed
to learn how to help PWA
to have hope
to be recognized as a member of the rehab team
relatives/friends of persons w aphasia felt that the PWA was at
the center of the rehab journey
what are the 3 clinical implications from the study on relatives/friends of PWA?
sig other’s perception of vulnerability = SLP can teach SCA to help SOs re-evaluate their perceptions
self-denial focus = SLP can reinforce SO’s own place and role in rehab
Family-centered care = SOs might feel more comfortable expressing their needs
client-centered or relationship-centered or family-centered care contributes to…
improved outcomes and inc quality of care
client-centered care allows for ____ goal setting…
collaborative
input from the SLP and the PWA +/- the care partner
SLP input - imp type and severity
PWA +/- care partner input - needs and desires relative to tx targets
what are 3 goal development considerations in client-centered care?
values
hierarchy (LTGs and STGs)
Indv factors (ex. acceptance of imp, motivation, trust)
what are the 9 broad categories of goals of PWA?
which are consistent w stroke w/o aphasia? (w/o A)
Which are distinct from stroke w/o apahsia? (w/ A)
return to pre-stroke life
comm (w/ A)
physical fx and health (w/o A)
speech therapy and other services (w/o A)
control and independence
dignity and respect (w/o A)
social, leisure, and work (w/ A)
altruism and contribution to society
information (w/o A)
communication as a goal is often
often involves…
a higher priority than physical goals
expressing basic needs as well as opinions … and comm about real life
third party disability =
disability and fx of family members due to the health cond of sig others
