The impact of stroke aphasia on health and well-being and appropriate nursing interventions: an exploration using the Theory of Human Scale Development.

AIMS AND OBJECTIVES: This paper considers the impact of aphasia on health and well-being and provides suggestions for appropriate nursing interventions. Background.  Effective communication is essential to holistic care and positive outcomes for individuals affected by aphasia. When verbal communication is absent, nurses fail to adequately use alternative strategies so that the standard of nurse/patient communication is frequently poor.

DESIGN: This is a discursive paper which reviews relevant literature and uses the Theory of Human Scale Development as a framework for discussion.

METHOD: The Theory of Human Scale Development is introduced. This theory emphasises that quality of life depends as much upon self-actualisation and relation building as on physical health. The theory is used within the discussion to highlight the significance of communication to quality of life and how its loss has profound psychological and social consequences.

RESULTS: Aphasia results in 'loss of self'. The situation is exacerbated by inadequate healthcare communication strategies. Suggestions are offered regarding more appropriate strategies. Efficacy of family input is considered; nursing competence regarding language practice therapies is discussed, and the 'quest approach' is explored. Aphasia has a negative impact on relationships by denying access to support networks, which results in isolation. The individual's predicament is worsened by negative nursing responses. Positive nursing strategies, which alleviate effects of aphasia on individuals' social health, are investigated. Concept analysis and self-awareness exercises as methods of enhancing compassion skills are explored. The social model of disability is discussed to highlight the benefits to individuals of environmental adaptations. The social benefits of aphasia-group affiliation are discussed.

CONCLUSION: The paper concludes by emphasising that fundamental human needs involve social and psychological as well as physical aspects.

RELEVANCE TO CLINICAL PRACTICE: Nursing interventions must address all needs to provide holistic care in its fullest sense.