Self-management of aphasia: a scoping review

Background: Self-management approaches are routinely used in chronic conditions to enable patients to take responsibility for their own care. A self-management approach may be appropriate for individuals with aphasia, but this has not been systematically investigated. The purpose of this review was to explore self-management in relation to aphasia. Aims: The study aimed to explore existing research and intervention approaches for aphasia that incorporate self-management principles. A secondary aim was to examine the presence of the term self-management in the research literature and online resources relating to aphasia. Methods & Procedures: A scoping review methodology was selected to explore literature relating to self-management of aphasia. Five databases were systematically searched in May 2017: PubMed, Embase, CINAHL, PsycINFO, and Linguistics & Language Behaviour Abstracts. Search terms used were aphasia OR dysphasia AND self-management OR self-directed OR self-care OR self-efficacy OR independence OR independent AND intervention OR treatment OR rehabilitation. A structured website search of aphasia, speech pathology and stroke associations from four English-speaking countries was performed in September 2017. Outcomes & Results: A total of 43 studies met inclusion criteria for the literature review. Analysis of eligible studies showed three areas of aphasia intervention which incorporated principles self-management: 1) technology-based interventions, 2) group/community-based interventions, and 3) communication partner training. The structured website search revealed no information relating specifically to aphasia self-management. Conclusions: Principles of self-management are being used in some aphasia interventions, but there is little evidence of a self-management approach being applied in aphasia. The term self-management is not widely present in aphasia literature and when it has been used tends to refer to self-administered treatment rather than a structured self-management approach.