Communication Challenges for People with Chronic Aphasia: A Systematic Qualitative Review of Barriers and Facilitators in Local Services

Abstract

Aphasia is an acquired communication disorder caused by a cerebral lesion, such as a stroke. People with aphasia can experience various difficulties that may involve speaking, listening, reading, or writing. These difficulties have multiple impacts on their expression of their needs, interests, and opinions. Accordingly, people with aphasia often encounter barriers and facilitators when using local services, which reduces their participation. For instance, grocery shopping or going to a coffee house can be challenging for them. Hence, this systematic review was conducted to synthetize the barriers and facilitators for people with aphasia when using local services. Following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines, five databases and Google Scholar were searched for the literature published through April 2024. A total of nine studies were included in the present work. The results highlight that most of the barriers to communicational access to local services are environmental ones related to other people or society. A few environmental facilitators were mentioned, but these were mainly a reflection of the barriers. Personal facilitators were noted, but people with aphasia said that they were insufficient for counterbalancing environmental barriers. The results highlight the need to raise awareness of aphasia.

Keywords

• aphasia
• participation
• local services
• barriers and facilitators