Developing an evidence‐base for accessibility for people with aphasia

Background: Discrimination on the basis of disability is prohibited in many countries and therefore research on communication accessibility for people with aphasia has become a priority. Aims: The aim of this paper is to summarise and discuss the results of a series of research studies, carried out in one Centre, into accessibility issues for people with aphasia, focusing on the accessibility of community environments and the accessibility of information. Main Contribution: When asked about the accessibility of the community generally, people with aphasia reported both physical and societal barriers and facilitators, as well as barriers and facilitators related to other people. Many people with aphasia still do not receive written health information about aphasia and, when they do, the information is often written at a level too high for them to read. In terms of the accessibility of written information on websites about aphasia, high‐quality websites may not be easily accessible to people with aphasia. For accessible websites to be delivered, the involvement of people with aphasia is paramount. Conclusions: There are three common themes emerging from this series of research studies. First, accessibility is an important and often emotive issue for people with aphasia. Second, people with aphasia are marginalised by a communicatively inaccessible society. Third, there is considerable diversity among people with aphasia about their perceptions of the barriers and facilitators to communication in the community.

[1]  K. McKenna,et al.  Access to written information for people with aphasia , 2005 .

[2]  K. McKenna,et al.  The Suitability of Written Education Materials for Stroke Survivors and Their Carers , 2003, Topics in stroke rehabilitation.

[3]  A. Olofsson,et al.  ‘If only I manage to get home I'll get better’-Interviews with stroke patients after emergency stay in hospital on their experiences and needs , 2005, Clinical rehabilitation.

[4]  A. Kertesz The Western Aphasia Battery , 1982 .

[5]  S. Satya‐Murti Evidence-based Medicine: How to Practice and Teach EBM , 1997 .

[6]  Patricia Layzell Ward,et al.  Oxford Reference Online , 2002 .

[7]  A. Estey,et al.  Comprehension levels of patients reading health information , 1991 .

[8]  A. Boonen,et al.  The international classification for functioning, disability and health , 2007, Clinical Rheumatology.

[9]  S Bond,et al.  Inadequacies in the provision of information to stroke patients and their families. , 2001, Age and ageing.

[10]  E. Roth,et al.  Stroke Education Materials on the World Wide Web : An Evaluation of Their Quality and Suitability , 2004 .

[11]  Kryss McKenna,et al.  Aphasia websites: An examination of their quality and communicative accessibility , 2005 .

[12]  R. Flesch A new readability yardstick. , 1948, The Journal of applied psychology.

[13]  T Albert,et al.  How readable are practice leaflets? , 1992, BMJ.

[14]  Karen Bryan,et al.  Work after stroke: focusing on barriers and enablers , 2005 .

[15]  Edward Steinfeld,et al.  Enabling environments : measuring the impact of environment on disability and rehabiltation , 1999 .

[16]  L. Worrall,et al.  Observing people with aphasia: Environmental factors that influence their community participation , 2008 .

[17]  K. Sullivan,et al.  A Readability Analysis of Australian Stroke Information , 2001, Topics in stroke rehabilitation.

[18]  Sally Byng,et al.  Talking about aphasia : living with loss of language after stroke , 1997 .

[19]  L. G. Doak,et al.  Teaching Patients With Low Literacy Skills , 1985 .

[20]  Tanya Rose,et al.  The Provision of Health Information to Stroke Patients Within an Acute Hospital Setting: What Actually Happens and How Do Patients Feel About It? , 2006, Topics in stroke rehabilitation.

[21]  Louise Hickson,et al.  What is an aphasia-friendly environment? , 2004 .

[22]  G. Mulley,et al.  Questions People Ask About Stroke , 1993, Stroke.

[23]  Kryss McKenna,et al.  Discrepancy between older clients' ability to read and comprehend and the reading level of written educational materials used by occupational therapists. , 2006, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[24]  H. Pain,et al.  Providing appropriate information to patients and carers following a stroke. , 1998, Journal of advanced nursing.

[25]  T. Hoffmann,et al.  Designing effective written health education materials: Considerations for health professionals , 2004, Disability and rehabilitation.

[26]  L. Worrall,et al.  Environmental factors that influence the community participation of adults with aphasia: The perspective of service industry workers , 2006 .

[27]  L. Worrall,et al.  The effectiveness of aphasia‐friendly principles for printed health education materials for people with aphasia following stroke , 2003 .

[28]  G. Chard International Classification of Functioning, Disability and Health , 2004 .

[29]  Kryss McKenna,et al.  The relationship between specific features of aphasia-friendly written material and comprehension of written material for people with aphasia: An exploratory study , 2005 .

[30]  W. Kaiser,et al.  Aphasia — A Social Approach , 1996, Springer US.

[31]  S. Ebrahim,et al.  Patients' satisfaction with stroke services , 1994 .

[32]  H Rodgers,et al.  Satisfaction with information and advice received by stroke patients , 1997, Clinical rehabilitation.

[33]  E. Steinfeld,et al.  Theory as a Basis for Research on Enabling Environments , 1999 .

[34]  C. Warlow,et al.  Perceptions and knowledge of stroke among surviving patients with stroke and their carers. , 1994, Age and ageing.

[35]  D. Mclellan,et al.  Informing hospital patients and their relatives about stroke , 1987 .

[36]  S. Byng,et al.  Values in practice and practising values. , 2002, Journal of communication disorders.