Factors Associated With Adherence to Self-Managed Aphasia Therapy Practice on a Computer-A Mixed Methods Study...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Health Informatics

Background:

• Aphasia, a communication disorder post-stroke, can be managed through asynchronous tele-rehabilitation using specialist computer software.
• Self-managed aphasia computer therapy offers increased opportunities for practicing rehabilitation exercises at home.

Purpose of the Study:

• To explore factors associated with adherence to self-managed aphasia computer therapy practice.
• To investigate demographic, clinical, and intervention variables linked to therapy adherence.
• To understand patient and carer perceptions of engagement in tele-rehabilitation.

Main Methods:

• Mixed-methods approach combining quantitative analysis of adherence data and qualitative thematic analysis of interviews.
• Secondary analysis of data from 85 participants in the Big CACTUS randomized controlled trial (computer therapy group).
• Qualitative interviews with 11 patients and 12 informal carers.

Main Results:

• Longer time post-stroke was associated with higher adherence to computer therapy.
• Greater access to computer therapy and more therapist support correlated with increased adherence.
• Key engagement factors included capability, opportunity (external/technological), and motivation (beliefs, emotions, habit).

Conclusions:

• Adherence to self-managed aphasia computer therapy is influenced by clinical, intervention, and personal factors.
• Speech and language therapist support is crucial for optimizing practice engagement.
• Clinicians should consider patient suitability and support needs for tele-rehabilitation.