Specialists in rehabilitation and speech-communication disorders from hospitals, universities, and the National Health Service Foundation in the United Kingdom have conducted a study to identify conversation topics of greatest meaningfulness to persons with aphasia. Their key motivation was to provide a basis, empirically, for choosing vocabulary to target in therapies for word-finding in conversation, observing that such interventions produce good outcomes on treated items, but show limited or no generalization to untreated items.
Their research question was “What conversation topics do people with aphasia find most meaningful to talk about?”, and they used focus groups to probe for answers. Twelve persons with chronic aphasia were recruited from three community aphasia groups. They were divided into two groups of six, which were given the research question for group consideration and discussion. These activities were videotaped, transcribed, and analyzed employing a stepped process called framework analysis, that uses content analysis to identify main themes and subthemes, then indexes and sorts the transcripts thematically, permitting a charting process that places themes into columns, participants into rows, and verbatim discussion excerpts into matrix cells for overall interpretation and prioritization by the researchers. Absolute numbers of participants concurring on the meaningfulness of a topic were tallied from the matrix and used to prioritize meaningfulness. Where more than half of participants in at least one focus group agreed, consensus on meaningfulness was considered established.
Twenty topics were thereby identified and characterized. Three topic areas — ‘family & friends’, ‘food & drink’, and ‘living with aphasia’ – were deemed meaningful via consensus in both groups; another four topics — including ‘the arts’, ‘jokes & humor’, ‘holidays & travel’, and ‘the news’ — achieved consensus in at least one of the groups. Two topics — ‘religion’ and ‘money’ — were considered off-limits in at least one group on grounds of personal privacy. The remaining topics — including ‘stroke recovery journey’, ‘medical’, ‘nutrition’, ‘sex’, ‘work’, ‘entertainment’, and ‘sports’ – failed to reach meaningfulness consensus in either of the focus groups.
In their discussion, the authors point out that the vocabulary suggested by this study complements and extends lexical therapy targets advanced by prior studies that draw on word-level indicators such as as conversational frequency, familiarity, and concreteness. Their insights may thus help expand and focus topic-based vocabulary to target in conversational word-finding therapies.
For further reading: N. Devane, S. Buxton, C. Fox, et al. 2024. What conversation topics are meaningful to people with aphasia? A qualitative study. Aphasiology, 1–18, https://doi.org/10.1080/02687038.2024.2319364