Changes of lived experience in persons with aphasia subsequent to the COVID-19 outbreak: A qualitative study to reflect perspectives of aphasia service receivers and providers

Abstract

Introduction: The COVID-19 pandemic has negatively influenced the communication, community engagement, and social activities of Persons With Aphasia (PWA) worldwide (Kong, 2021). One of the most apparent impacts was the significant changes in their receiving of speech therapy (ST) services due to the rapid emergence of telepractice. PWA in Hong Kong, a city with confirmed COVID-19 cases relatively early on in the pandemic, have been equally affected (Fong et al., 2021). Given the scarce reports focusing on PWA, this study aimed to examine changes of lived experience and access to aphasia-specific ST services among PWA (and caregivers) during different outbreak phases of COVID-19 in Hong Kong. The perception on the quality and effectiveness of these services amid COVID-19 were also compared between service receivers (i.e. PWA and caregivers) and providers (i.e. speech therapists). Methods: Semi-structured interviews are being conducted involving fifteen PWA (and their caregivers), as well as ten speech therapists from five different clinical settings. In particular, service receivers were guided to individually report their health-care related, psychosocial, and financial impacts, experiences with changes/constraints in receiving ST services, and perceptions towards the use and efficacy of teletherapy across different phases of the outbreak. As for the speech therapists, they were guided to summarize their practice amid the pandemic (with a specific focus on implementation of telepractice to PWA and clients’ responses to this transition of training mode), and to reflect their perceptions on the effectiveness and limitations (i.e., pros and cons) of service delivery. Analysis of collected data was performed using a content analysis to determine the reported changes towards lived experience and to compare different perspectives towards the implementation of telepractice of aphasia training. Moreover, net promoter scores (NPS) and Likert scales were used, respectively, to measure changes in satisfaction on telepractice as well as perceived difficulties in telepractice delivery and psychological impacts. Preliminary results: Preliminary results revealed that the pandemic had reduced PWA’s chances of social gatherings; there was also increased stress level induced by mask wearing and the frequent need to practise good personal hygiene. Moreover, responses from the speech therapist group seemed to indicate a lower perceived efficacy of telepractice to deliver aphasia services. For example, replacement of face-to-face by online sessions during COVID was reported to create particular difficulties in evaluating PWA and sustaining their attention. Compared to in-person sessions, the online platform seemed to be less capable to ensure PWA’s acquisition of new language skills and maintenance of communication. Conclusion: Unlike the western clinical world, teletherapy has not been getting its popularity in Hong Kong until very recently because access to aphasia services has typically not been affected by distance. It is anticipated that the final findings of this study would allow us to better understand any mismatch between the actual aphasia services provided by speech therapists and the lived experience (and expectations) of service receivers in Hong Kong as they were navigating the COVID-19 pandemic. Subsequently, useful insights can be made for further implementation and enhancement of ST services.