title: The participants' perspective: how biographic-narrative intervention influences identity negotiation and quality of life in aphasia.
abstract: BACKGROUND
  People with aphasia experience a pronounced decrease in quality of life (QoL). Beyond that identity negotiation is hindered, which is crucial for QoL. Biographic-narrative approaches use life story telling to support identity (re)development after disruptive events like stroke. Because of the language deficits inherent in aphasia such 'talk-based' approaches have to be modified for an optimal use.
  
  
  OBJECTIVE
  To evaluate an adapted interdisciplinary biographic-narrative intervention using quantitative measures of health-related quality of life (HRQL) and mood. Additionally, semi-structured interviews were conducted to gain a deeper understanding of identity development processes in people with aphasia.
  
  
  METHODS
  Twenty-seven participants with various types of chronic aphasia were enrolled. The biographic narrative intervention consisted of five face-to-face in-depth interviews and seven group sessions conducted over 10 weeks in a mixed-method design with pre- and post-tests and a follow-up assessment 3 months post-intervention. For quantitative evaluation the Aachen Life Quality Inventory (ALQI), the Satisfaction with Life Scale (SWLS) and the Visual Analog Mood Scales (VAMS) were used. Semi-structured interviews were conducted post-treatment, including questions concerning the participants' experiences with the intervention and identity change. Results were analysed using interpretative principles from Grounded Theory.
  
  
  RESULTS
  For all 27 participants, we found significant and stable growth in HRQL. Self-reported states of mood also improved. As expected, overall cognitively based life satisfaction did not change. The interviews revealed two main categories: 'evaluation of the face-to-face interviews' and 'evaluation of the group sessions'. Further analysis found four overlapping main themes which were identified as identity issues: agency, control, disease concept and doing things.
  
  
  CONCLUSIONS
  Our quantitative and qualitative results demonstrated the benefits associated with the biographic-narrative intervention. The participants' sense of self changed through the approach. The findings provide foundations for future work using biographic narrative interventions to influence QoL and identity renegotiation in people with aphasia.
authors.affiliation: Department for Health Care and Nursing, Catholic University of Applied Sciences, Mainz, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Corsten
authors.affiliation: Department for Health Care and Nursing, Catholic University of Applied Sciences, Mainz, Germany.
authors.forename: Erika J
authors.initials: EJ
authors.lastname: Schimpf
authors.affiliation: Department for Health Care and Nursing, Catholic University of Applied Sciences, Mainz, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Konradi
authors.affiliation: Department for Communication Disorders, University Medical Center, Mainz, Germany.
authors.forename: Annerose
authors.initials: A
authors.lastname: Keilmann
authors.affiliation: Institute for Social and Political Sciences, Goethe-University Frankfurt/Main, Germany.
authors.forename: Friedericke
authors.initials: F
authors.lastname: Hardering
mesh_terms: D000328:Adult; D000368:Aged; D001037:Aphasia / Q000175:diagnosis / Q000523:psychology* / Q000534:rehabilitation*; D003299:Cooperative Behavior; D005260:Female; D005858:Germany; D006126:Group Processes; D006801:Humans; D033183:Interdisciplinary Communication; D007406:Interview, Psychological; D007808:Language Therapy; D008297:Male; D008875:Middle Aged; D033262:Narration; D017008:Negotiating; D017060:Patient Satisfaction; D011788:Quality of Life / Q000523:psychology*; D012933:Social Identification; D020521:Stroke / Q000175:diagnosis / Q000523:psychology*; D000071939:Stroke Rehabilitation
keywords: aphasia; biographic-narrative work; identity; outcome measures; quality of life