Shared Decision Making for Persons with Aphasia: A Scoping Review

EasyChair Preprint no. 6394

Abstract

Introduction: Persons with aphasia (PWA) often retain decision making capacity, but language impairments pose barriers to participation. Shared Decision Making (SDM) promotes patient involvement in decision making. SDM approaches could aid in overcoming healthcare barriers faced by PWA; however little is known about SDM for PWA. This scoping review synthesizes the evidence on SDM approaches/interventions for PWA.

Methods: We searched the following databases: MEDLINE, EMBASE, PsycINFO, AMED, CINAHL, ComDisDome, LLBA, Scopus (1982 to June 2020), including peer reviewed and grey literature.

Two reviewers independently extracted data using a standardized and pre-piloted data extraction form. Inconsistencies in extracted data were resolved through consensus with a third rater. We extracted citation and study information, SDM definitions, conceptual/theoretical underpinnings, aphasia subtypes, settings of care, SDM interventions and associated communication interventions, SDM-relevant outcomes and measures, and important findings and gaps in the research.

Results: After deduplication, the search yielded 5492 citations. Of these, the full text was screened for 86 articles. Two studies met the inclusion criteria.

In these articles, decisions discussed were: whether to continue or terminate speech therapy; plans related to discharge. Neither study provided a clear definition of SDM or SDM interventions. No specific outcomes related to SDM for PWA were measured, nor was the effectiveness of SDM for PWA explored.

Conclusions: There is a dearth of evidence informing the use of SDM with PWA. This population is at risk of being inappropriately excluded from decisions about their health due to their communication impairment. There is an ethical imperative to design and empirically evaluate SDM interventions tailored to PWA.

Keyphrases: aphasia, scoping review, shared decision making

@Booklet{EasyChair:6394,
  author = {Konstantina Charamis and Caitlin Parsons and Marie-Cécile Domecq and Carol Leonard and Laura Boland},
  title = {Shared Decision Making for Persons with Aphasia: A Scoping Review},
  howpublished = {EasyChair Preprint no. 6394},

  year = {EasyChair, 2021}}