Joint Decision-Making Communication Between Spouses Affected by Aphasia

Abstract

Aphasia therapy should address communication in everyday contexts. One type of social interaction that occurs frequently in the daily lives of spouses is joint decision-making. Currently, no known study has investigated how spouses collaboratively make decisions when one of the spouses has aphasia and the other one does not. The purpose of this study was to analyze the communicative interactions of married couples affected by aphasia while they engaged in joint decision-making conversations. Fourteen married couples, in which one spouse had aphasia and the other one did not, completed two joint decision-making tasks. The tasks required the participants to formulate mutually approved lists of items deemed essential for their survival in two hypothetical “survival-type” scenarios. When completing the tasks, the participants’ communicative interactions were audio-video recorded. Next, the participants’ conversations were transcribed, and their “moves” were coded for speech functions, as described in the systemic functional linguistics literature. Participants with aphasia produced fewer overall moves than the spouses without aphasia in their joint decision-making conversations. The participants with aphasia also produced fewer continuing moves than their spouses without aphasia. A slight difference between the participants with and without aphasia was identified in the percentages of opening versus sustaining moves produced. All participants were generally supportive of the comments, ideas, and suggestions posed by their spouses during their collaborative interactions. This study identified similarities and discrepancies in the pattern of speech functions used by the participants with and without aphasia. Suggestions for tailoring interventions and guiding future research are included.