Intervenção fonoaudiológica grupal e seu impacto na qualidade de vida de pessoas com afasia

Abstract

BACKGROUND: Stroke is one of the major cardiovascular complications in the world. Consequently, aphasia can occur, configured as a communication difficulty, both in the form of expressive and comprehensive impediments. Aphasia is present in 30% of stroke cases and group speech therapy has shown benefits in the quality of life of people with aphasia. OBJECTIVES: To evaluate the prevalence of aphasia in patients after the first ischemic stroke and its associated factors. Conduct an integrative literature review to examine the evidence of the effectiveness of group therapy in improving the quality of life of people with aphasia. To investigate the impact of a multicomponent group therapy program on the quality of life of people with subacute stroke-related aphasia and to identify sociodemographic characteristics associated with this improvement. METHODS: To address these objectives, the paper is divided into three chapters, each organized in the form of a scientific paper. Chapter 1 is an observational and retrospective study based on the JOINVASC database held in Joinville / SC, Brazil. All cases of first ischemic stroke admitted to a public hospital in the same city of Joinville were selected. Chapter 2 is organized from an integrative review on improving quality of life of aphasic subjects who underwent group speech therapy in 3 databases: Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature on Life Sciences (LILACS) and Public Medicine Library (PubMed) in April 2019 answering the guiding question: Does group speech therapy improve the quality of life of the patient with aphasia? Chapter 3 presents a pre- and post-test proof of concept study conducted with patients with aphasia (PWA) diagnosed more than 3 months after their first ischemic stroke who participated in multi-component speech therapy group. RESULTS: In article 1, the prevalence of aphasia was 22.6%, PWA had a higher occurrence of deaths compared to patients without aphasia and longer hospitalization. In article 2, five studies answered the guiding question and indicated that group therapy improves the quality of life of people with aphasia, increasing their self-confidence and social participation, as well as enhancing their sense of independence, autonomy, and improving their mood. In article 3, the communication domain of SAQOL-39 showed a significant increase after group therapy. Younger PWAs with a caregiver who live in more female and female environments exhibited higher scores in the communication domain after group therapy. Younger PWAs with lower severity of aphasia had higher mean psychological domain score after group therapy. CONCLUSION: Aphasia is a common complication and has an impact on mortality and length of stay after ischemic stroke. There is evidence indicating that group therapy is promising in terms of benefits related to the quality of life and social participation PWA. Multicomponent group speech therapy aimed at PWAs older than 3 months after stroke can contribute to improve the quality of life of these patients, especially in the communication domain.