title: Communication difficulties and the use of communication strategies: from the perspective of individuals with aphasia.
abstract: BACKGROUND
  To enhance communicative ability and thereby the possibility of increased participation of persons with aphasia, the use of communication strategies has been proposed. However, little is known about how persons with aphasia experience having conversations and how they perceive their own and their conversation partner's use of communication strategies.
  
  
  OBJECTIVE
  To explore how people with aphasia experience having conversations, how they handle communication difficulties, and how they perceive their own and their communication partners' use of communication strategies.
  
  
  METHODS
  Semi-structured interviews were conducted with four women and seven men with chronic aphasia (n = 11). Interviews were video-recorded, transcribed verbatim and analysed by qualitative content analysis.
  
  
  RESULTS
  Informants appreciated having conversations despite the fact that they perceived their aphasia as a serious hindrance. Different factors related to the informants, the conversation partners, the conversation itself and the physical environment were perceived to impact on conversations. The importance of the communication partners' knowledge and understanding of aphasia and their use of supporting conversation strategies were acknowledged by the informants. The informants' views on using communication aid devices or strategies varied considerably. Four themes that characterized the informants' narratives were: loss and frustration, fear and uncertainty, shared responsibility based on knowledge, and longing for the past or moving forward.
  
  
  CONCLUSIONS
  The informants longed to regain their former language ability and role as an active participant in society. To enhance participation of persons with aphasia, it is suggested that communication partner training should be an important and integral part of aphasia rehabilitation. Important elements of such training are reflecting on communication behaviours, training in real-life situations, and acknowledging each individual's special needs and preferences. To deal with the consequences of aphasia, counselling and psychological support may be needed.
authors.affiliation: Public Health and Caring Sciences, Caring Sciences, Uppsala University, Uppsala, Sweden. monica.blom.johansson@pubcare.uu.se
authors.forename: Monica Blom
authors.initials: MB
authors.lastname: Johansson
authors.forename: Marianne
authors.initials: M
authors.lastname: Carlsson
authors.forename: Karin
authors.initials: K
authors.lastname: Sonnander
mesh_terms: D000368:Aged; D001037:Aphasia / Q000523:psychology / Q000534:rehabilitation*; D003142:Communication; D003144:Communication Barriers; D004644:Emotions; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011340:Problem Solving; D011788:Quality of Life; D012944:Social Support; D018454:Spouses / Q000523:psychology; D013548:Sweden