The psychosocial experiences of partners of people with aphasia : the evolution of an idiographic, qualitative methodology
This thesis is concerned with understanding the psychosocial effects of aphasia for partners, and with the outcomes and processes of group programmes of support and conversation training. It comprises three studies, each of which builds upon the other in method and depth. Study One utilised the quantitative, idiographic Personal Questionnaire Rapid Scaling Technique (Mulhall, 1978) to examine the psychosocial issues of 12 partners of people with aphasia (PWA) before and throughout the programmes. Individual statistical analysis suggested that the scores of four partners showed significant positive change as a result of the support programme, and two changed as a result of the conversation training programme. Results were achieved by considerable data reduction, so changes in individual issues could not be determined. Study Two therefore shifted from the quantitative, researcher's perspective to a method able to capture more fully insider perspectives. The Framework Method (Ritchie and Spencer, 1994) was used to analyse semi-structured interview data from the programme participants. This highlighted, within broad themes, varied and interacting factors that influenced participation and psychosocial change: programme content and organisation, individual circumstances, group and personal processes. The predominant focus of Study Two's findings was the process of intervention, leaving the essential question of how partners really experience psychosocial life with PWA unanswered. By taking a further qualitative shift, Study Three answers that question for one woman. An interpretative phenomenological analysis (Smith, 1996) of her in-depth interview suggests her experience was a complicated process of accommodation linked to life pre-stroke and post-stroke. This process featured complex phases labelled as 'rescue mission and hope', 'endurance, loss and hopelessness' and, finally, 'regeneration'. These phases were linked to her changing perception of her relationship with her husband, her role and her self-image. The thesis concludes with a discussion of methodology, theoretical findings and avenues for further research.