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Evidensbaserad logopedisk intervention vid strokeorsakad afasi hos vuxna: En verksamhetsknuten litteraturstudie
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi. (Logopedi)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi. (Logopedi)
2014 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
Abstract [en]

Background: The speech- and language deficit aphasia affects 12 000 persons annually in Sweden. Aphasia is caused by injury in the brain and the most common etiology is stroke. According to the tool for describing and assessing aphasia, A-FROM (Kagan et al., 2008), the four following aspects of aphasia need to be considered: severity of aphasia, participation in life situations, communication and language environment and personal factors. Several different interventions and treatments can be performed in every domain. There is scientific evidence for interventions performed by speech and language pathologists; however, the question is yet being discussed since results are unambiguous.

Purpose: The main purpose of this study is to investigate which aphasia interventions performed by speech and language pathologists that are supported by evidence. A further purpose is to visit clinical practices to obtain data concerning how speech and language pathologists work with persons with aphasia. Method: Systematic search for literature was executed in seven medical databases. Articles that met certain criteria were graded regarding evidence. The authors additionally made visits to speech and language pathologists at a hospital Svealand, Sweden, for observation and interviewing of speech and language pathologists.

Results and conclusions: The level of evidence for interventions varies. No intervention is investigated in more than three included studies and the number of participants is often small. Recommendations for clinical work can be given based on evidence from the included studies. The one intervention that was being studied by the most studies is CIAT/CILT. Interventions targeting expressive language, in particular word retrieval, have the strongest support in evidence.  

Abstract [sv]

Bakgrund: Språkstörningen afasi drabbar 12 000 personer årligen i Sverige. Afasi är en förvärvad språkstörning och orsakas av en skada i hjärnan, vanligaste orsaken är stroke.  Enligt ett verktyg för att beskriva och bedöma afasi, A-FROM (Kagan et al. 2008), kan man se till fyra aspekter av afasin: afasisvårigheter, delaktighet i vardagliga situationer, språklig och kommunikativ omgivning samt personliga faktorer. Inom varje domän kan flera olika typer av logopedisk intervention och behandling genomföras. Vetenskaplig evidens stödjer effekt av logopedisk intervention men diskussion pågår då resultaten inte är entydiga. Forskning på området är inte heller entydig kring vilken typ av intervention som har mest evidens att ge effekt.

Syfte: Studiens huvudsyfte är att genom granskning av de senaste årens forskning besvara vilka logopediska afasiinterventioner som stöds av evidens. Ett ytterligare syfte är att göra besök i klinisk verksamhet för att inhämta data kring hur logopeder arbetar med personer med afasi. Metod: Systematiska litteratursökningar genomfördes i sju medicinska databaser. Artiklar som uppfyllde uppsatta inklusionskriterier evidensgraderades. Vidare besöktes ett sjukhus i Svealand för auskultation på och intervjuer med legitimerade logopeder.

Resultat och slutsats: Studien visade på att afasiinterventioner har varierande grad av evidens. Varje typ av intervention behandlades av endast en eller ett fåtal inkluderade artiklar som ofta hade få försöksdeltagare. Förslag på rekommendationer för kliniskt arbete kan utfärdas utifrån inkluderade studier och deras evidensgrad. Den enskilda interventionen som studerats av flest inkluderade studier (tre studier) är CIAT/CILT. Starkast stöd i evidens har träning av expressiva förmågor, främst ordmobilisering.

Place, publisher, year, edition, pages
2014. , 53 p.
Series
Examensarbete i logopedi, 088
Keyword [en]
aphasia, stroke, speech and language pathology, aphasia intervention, aphasia treatment, evidence-based medicine, A-FROM
Keyword [sv]
afasi, stroke, logopedi, afasiintervention, afasibehandling, evidensbaserad vård, A-FROM
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-217394OAI: oai:DiVA.org:uu-217394DiVA: diva2:693063
Subject / course
Speech and Language Pathology
Educational program
Degree of Master of Science in Speech and Language Pathology
Supervisors
Examiners
Available from: 2014-02-04 Created: 2014-02-03 Last updated: 2014-02-20Bibliographically approved

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