Social participation following right hemisphere stroke: Influence of a cognitive-communication disorder.

Background The ability to communicate is essential for engaging in social roles and maintaining relationships. Communication effectiveness or style may change suddenly following a stroke, and create negative consequences related to role engagement and relationship maintenance, which in turn may affect quality of life (QoL). A social isolation risk emerges, which has been explored for people with the communication impairment of aphasia. In response, the speech pathology community has been generating research about the impact of aphasia and establishing clinical service provision guidelines to ensure access to communication focussed rehabilitation. At present, however, the variable influence of a cognitive-communication disorder (CCD) arising following right hemisphere (RH) stroke on social role and relationship maintenance has not received equitable speech pathology research nor clinical interest. The dearth of evidence is surprising as CCD occurs with similar frequency to aphasia, and the impairments that arise may alter both communication effectiveness and style. This thesis supports the statement by Margaret Blake that “work is needed to right this ship that is listing to the left” (Blake, 2016, p. 64) by exploring long-term outcomes following a RH stroke. Research aims The primary objective of the research was to explore social participation in the presence of a RH stroke, with a focus on risk factors for social participation restriction and the significance of participation change related to relationship maintenance and quality of life. Three aims were addressed, namely to 1) determine perceived change in social participation as reported by people with RH stroke (self-report) and significant others (proxy-report), to 2) explore risk factors for, and the ability of routinely administered acute-stage screens to predict, social participation restriction in people with a RH stroke, and lastly to establish the significance of the change by 3) exploring the relationship between social participation, social network ...