Aphasiology, 2013

Vol. 27, No. 11, 12811301, http://dx.doi.org/10.1080/02687038.2013.818098

REVIEW
Qualitative research in aphasia: A review of the literature
Nina Simmons-Mackie and Karen E. Lynch
Southeastern Louisiana University, Communication Sciences and Disorders,
Hammond, LA 70402 USA
Background: In the past decade, there has been a growing interest in qualitative research
in the field of aphasia. Knowledge of patterns and trends in this body of research would
inform future research. However, there is little information about the characteristics or
patterns of qualitative research in aphasia.
Aims: In order to describe qualitative research in aphasia, a review of the aphasia literature from 1993 to 2013 was undertaken. Studies were identified using a variety of search
terms for the following electronic databases: PubMed, CINAHL, PsychINFO, Web of
Science and ComDisDome. A total of 78 articles that met the review criteria were identified and data were extracted in the following areas: topic of study, participants, data
collection, research design and data analysis.
Main Contribution: Publication of qualitative research in aphasia has increased since
1993 and contributed to an important database regarding phenomena associated with life
with aphasia. The most prevalent research topics relate to the experience of aphasia, activities or participation of people with aphasia, perceptions of intervention or outcomes,
perceived goals or needs and environmental factors. People with aphasia were the most
frequent participants. A majority of studies employed generic qualitative methods independent of a traditional qualitative philosophy. Interview was the most prevalent data
collection method, and few studies reported methods of determining if the amount of
data were sufficient to meet the study aims. The depth of interpretation (level of analysis)
varied across studies from concrete category listings to higher-level explanatory themes.
Conclusions: Despite the variation across studies, identified trends provided valuable
information and raised interesting questions for debate. Questions are posed for future
consideration such as should aphasia researchers more frequently apply methods from
established qualitative traditions? and should aphasia research include a wider variety
of data collection methods? Questions were raised regarding terminology (e.g., themes
versus categories) and depth of interpretation in qualitative studies. The findings also provide concrete direction; for example, qualitative researchers might improve the reporting
of methods for determining data sufficiency.
Keywords: Aphasia; Qualitative research; Research design; Qualitative.

Address correspondence to: Nina Simmons-Mackie, Southeastern Louisiana University,

Communication Sciences and Disorders, 580 Northwoods Dr., Abita Springs, LA 70420, USA. E-mail:
nmackie@selu.edu
2013 Taylor & Francis

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Qualitative research includes a variety of research traditions designed to provide a rich

description of a person, group, event or phenomenon and/or gain a deeper understanding regarding an aspect of social life, experience or culture (e.g., Creswell, 2006;
Lincoln & Guba, 1985; Wolcott, 1994). As such, qualitative research is particularly
well suited to exploring complex social phenomena such as communication and communication disorders. The umbrella term, qualitative research, encompasses a number
of philosophical and methodological approaches. For example, phenomenology,
ethnography and grounded theory are well-known, established qualitative traditions
(Creswell, 2006).
With the shift towards client-centred medicine and social model philosophies in
health care, researchers and practitioners have been increasingly interested in the
experiences and insider perspectives of key stakeholders such as patients and health
care providers (Hammell, 2001). This expansion of philosophy has been paralleled
by a marked growth in qualitative research in health care fields (Bradely, Curry,
& Devers, 2007; Sandelowski, 2004). The increase in qualitative research has been
apparent in aphasiology as well. Beginning almost 20 years ago, a series of articles described potential applications of qualitative research in aphasia (Damico,
Oelschlaeger, & Simmons-Mackie, 1999; Damico & Simmons-Mackie, 2003; Damico,
Simmons-Mackie, Oelschlaeger, Elman, & Armstrong, 1999; Damico, SimmonsMackie, & Schweitzer, 1995; Simmons-Mackie, 1994; Simmons-Mackie & Damico,
1999, 2003). These articles discussed the key features of qualitative research and the
requirements for systematic and rigorous qualitative study in aphasia. Since that time,
aphasia researchers have increasingly employed qualitative methods to gather authentic data and access insider perspectives on various topics relevant to aphasia and
aphasia intervention. However, little is known regarding the patterns of qualitative
investigation in the aphasia literature. In what topics of study has qualitative research
contributed to the knowledge base in aphasia? What types of qualitative research have
prevailed? What types of data collection and analysis strategies have been used? Insight
into the patterns of qualitative research in aphasia can identify potential strengths
and weaknesses in current research practices and help researchers reflect on possible changes in future research. Therefore, a project was initiated to review qualitative
research in the published aphasia literature in an effort to discover and describe trends
and issues that will inform future research. This review was not designed as a critical review of the quality of each study. Rather, the goal of this review process was to
identify general patterns of qualitative research in aphasia.

METHODS
A search of the literature identified studies that employed qualitative research methods to investigate issues relevant to aphasia. The following electronic databases
were searched: PubMed, CINAHL, PsychINFO, Web of Science and ComDisDome.
The search focused on aphasia and qualitative research published between January
1993 and January 2013 using a variety of search terms (e.g., aphasia, qualitative research, qualitative, grounded theory, ethnography, narrative, phenomenology).
A total of 925 articles were identified. Articles were eliminated from the review if they
were: (1) duplicates, (2) not published in a peer-reviewed journal, (3) not a report of
original research, (4) not a study of aphasia in adults, (5) not written in English, or
(6) not qualitative research. Qualitative research studies were defined as those that

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were self-described as qualitative research, and/or the authors identified an established qualitative or interpretive tradition such as phenomenology or grounded theory.
Descriptive case studies that were not described as qualitative research were not
included. Articles reporting research using conversation analysis or discourse analysis
were excluded from this review since these constitute a distinct approach to qualitative
investigation using different methods and criteria.
A total of 78 studies met the criteria for inclusion in this review of qualitative
research in aphasia (see Appendix A). Each of the articles was reviewed, and relevant information was extracted. Data were extracted in the following areas: topic
of study, reported research design or tradition, type of participants, data collection
(including participant selection and method of determining data sufficiency) and data
analysis (Appendix B). For topic, participants, design, type of data collection, sampling and data analysis method, the extracted data were initially analysed by grouping
and labelling similar data into semantic categories (Spradley, 1980). This resulted in
categories that were used to code the data across studies (see Appendix C). For example, data extracted to describe the topics of study were grouped into categories such as
experience of aphasia or intervention or program. Once these coding categories
were identified, the first author recycled through the extracted data and coded each
article. In order to ensure that data were coded reliably, a random sample of 15% of
the identified articles were reviewed and coded independently by a second investigator.
The resulting inter-rater agreement of 91% across studies and codes within categories
(i.e., categories of topic, research design/tradition, type of participants, data collection
methods, sampling, data sufficiency and data analysis) was deemed acceptable. Finally,
frequency counts were computed to determine the number of articles represented for
each of the coded categories.

RESULTS
The number of qualitative research articles in aphasia that met the criteria for this
review increased over the past 20 years (see Figure 1). Over four times as many qualitative articles were published in the second half of the review period as in the first half,
and a marked increase is apparent in the past 5 years.
70

Number of articles

60
45

50
40
30
19
20
10

0
19931997

19982002
20032007
Year of publication

20082012

Figure 1. Number of qualitative research articles in aphasia from 1993 through 2012 that met review
criteria.

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Research topics
Topics of the research articles were grouped into broad categories reflecting the primary focus of the article (see Table 1). The most prevalent topic related to perceptions
of the experience of aphasia (n = 20). These studies included experiences reported
from the perspective of people with aphasia (n = 13), family members or caregivers
(n = 7) and speech-language pathologists (SLPs) (n = 2). A variety of subtopics fit
within experience of aphasia such as the perspectives of people with aphasia and family members on living successfully with aphasia (e.g., Brown, Worrall, Davidson, &
Howe, 2010), the meaning of quality of life with aphasia (Cruice, Worrall, & Hickson,
2006) and perspectives on well-being, psychosocial adjustment and identity in aphasia
(e.g., Bronken, Kirkevold, Martensen, & Kvigne, 2012). Seventeen studies addressed
the aspects of activities or participation for people with aphasia. Examples of this
topic included studies of communication activities of people with aphasia (e.g., having
conversations, reading, making phone calls) (Davidson, Worrall, & Hickson, 2003),
participation in relationships (e.g., Davidson, Worrall, & Hickson, 2006; Northcott
& Hilari, 2011) and participation in informed consent (Penn, Frankel, Watermeyer,
& Muller, 2009). There were 16 articles reporting on specific interventions or services
including services for people with aphasia (e.g., script training, computer-based services) and services for others (e.g., residential family program, training for health care
providers). Ten articles investigated perceived needs or goals of people with aphasia,
family members or SLPs. There were seven studies on environmental factors affecting people with aphasia. These studies typically defined environmental barriers and
facilitators to participation for people with aphasia, including broad studies identifying environmental factors such as features in the community at large that impact
people with aphasia (e.g., Howe, Worrall, & Hickson, 2008) and more focused studies
such as environmental factors associated with public transport (Ashton et al., 2008)
or acute health care (OHalloran, Worrall, & Hickson, 2011). Four studies investigated the experience of discharge from speech-language therapy from the perspective
of people with aphasia or others such as SLPs. Finally, two articles did not fit into the
previous topics and were designated as other.

Participants
Various types of participants were included in the qualitative studies reviewed (see
Figure 2). Over two-thirds (54 out of 78) of the studies included people with aphasia as

TABLE 1
Categories of topics addressed in qualitative research articles reviewed
Broad topic area
The experience of aphasia
Activities and participation
Intervention or service
Goals or needs
Environmental factors
Discharge from services
Cultural or ethnic issues
Other

Number of articles
20
17
16
10
7
4
2
2

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70

Number of articles

60
50

54

40
30
20
17

10

13

0
People with Family/carers
SLPs
Others
aphasia
Types of participants

Service
providers

Figure 2. Number of articles involving specific types of participants in qualitative research articles reviewed.

research participants. Family members and significant others were included in 17 studies; SLPs were included in 13 studies. Service providers such as stroke team members
and other people such as employers were included in 11 studies.

Research design
Historically qualitative research has been classified or characterised according to the
research tradition or philosophical roots upon which the research is based. In fact,
many definitions refer to qualitative research as a variety of traditions designed to
explicate social or cultural phenomena (e.g., Creswell, 2006). Each tradition reflects
an underlying philosophy or orientation that helps guide the research methods. Thus,
the tradition helps determine the types of questions or topics that are suitable, the
types of data that are allowable and the types of claims that can be made from the
results (e.g., Creswell, 2006).
Of the 78 articles included in the current review, 52 articles described the research
either in very general terms such as qualitative methods (n = 47) or the authors
adopted a pragmatic or practical approach such as basic qualitative description
(Sandelowski, 2000) (n = 5). Nonspecific or pragmatic qualitative approaches typically employ qualitative methodology (e.g., open-ended interview, thematic analysis)
independent of one of the traditional philosophical orientations (e.g., phenomenology, ethnography) (Sandelowski, 2000; Smith, Bekker & Cheater, 2011; Thomas,
2006). The remaining 26 articles included reports of research conducted according
to or adapted from one of the following established research traditions: phenomenology, grounded theory, narrative analysis or ethnography. Figure 3 demonstrates the
distribution of research traditions in the literature reviewed.

Data collection
The review included an analysis of several aspects of data collection including the sampling methods, method of data collection and the measures taken to ensure that the
data were sufficient to answer the research question. Results will be reported relative
to each of these aspects of data collection.

SIMMONS-MACKIE AND LYNCH

Number of articles

1286

70
60
50
40
30
20
10
0

52

11

t
ali

at

gy

ive

ry

om

n
he

tiv

eo

lo

o
en

Qu

de

n
ou

th

e
pg

ra
ar

Gr
Qualitative research tradition

hy

a
gr

Et

hn

Figure 3. Qualitative research traditions or designs reported in qualitative articles reviewed.

It is standard practice for research articles to include information concerning sample selection; that is, how the participants or events were selected for inclusion in
a study. A majority of the articles reviewed (52 out of 78) reported using convenience samples to select participants or did not specifically label or describe sampling
methods. Two articles explicitly reported snowball sampling, where participants are
nominated by others (e.g., the person with aphasia (PWA) nominates friends to participate in interviews) (Atkinson & Flint, 2001); however, snowball sampling was implied
in several additional articles. Purposeful sampling was explicitly reported in 13 articles. Purposeful sampling requires that participants are deliberately selected with an
explicit purpose in mind that is consistent with the aims of the study (Marshall, 1996).
Maximum variation sampling, a type of purposeful sampling, was reported in 9 articles. Maximum variation sampling requires that participants are selected based on
diverse characteristics of particular interest (Patton, 2002). Two articles reported semirandom sampling. Two of the 13 articles employing observation reported that event or
time sampling was used to identify situations sampled for observation (Hammersley
& Atkinson, 1995).
In addition to sampling methods, researchers must choose from a wide variety of
data collection strategies applicable to qualitative research such as qualitative interviews, focus groups, participant observation, artefact review, diaries and collection of
video or audio data (Creswell, 2006). Data collection methods are typically designed
to suit the subject matter, the research question and/or the qualitative design of the
study. Figure 4 shows the distribution of types of data collection methods employed
across the studies reviewed. Clearly, the overwhelming approach to qualitative data
collection in aphasia has been interviews, either one-on-one or in focus groups, with
interviews represented in 96% of the articles (75 out of 78). Interviews with people
with aphasia were conducted in 52 of these studies. Studies employing more than one
data collection strategy are represented recurrently. Only 18 studies employed more
than one data collection method (e.g., interviews & observations; interviews & video).
Data collection involves not only determination of the approach to sampling and
the method of collecting data (e.g., interview), but also involves consideration of the
amount of data needed to address the research questions posed (e.g., Walker, 2012).
Thus, another aspect of data collection is the method of determining the sufficiency
of data collected for a particular study. Some researchers consider a useful criterion

QUALITATIVE RESEARCH IN APHASIA

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80

Number of articles

70
60
50
40

75

30
20
10
14
8

Recording

Diary

Artefacts

0
Interviews/
focus group

Observation

Data collection method

Figure 4. Data collection methods employed in qualitative research articles reviewed.

in qualitative research is collecting data to saturation. Saturation is the collection of

data in a study until redundancy occurs (Morse, 2005), and includes data saturation and theoretical saturation. Data saturation involves continual sampling within a
study until repetition of the data set has occurred and no new information is being
obtained (Bowen, 2008). Theoretical saturation occurs when no new categories or
themes are being identified in the data (Strauss & Corbin, 1990). Of the 78 studies reviewed, 5 explicitly reported that saturation was a criterion in data collection
and 5 additional articles implied saturation criteria. One article described methods of
determining saturation. Although it is possible that researchers employed a criterion
for judging the amount of data required, 94% did not report or implicate a rationale
or method for determining that sufficient data were collected. It is notable that several
studies involved relatively large participant pools, possibly with the expectation that
collecting large numbers would ensure sufficient data.

Data analysis
Methods of analysing qualitative data abound in the literature and, although most
employ some means of identifying and grouping content into units, categories or
themes, the specific data analysis approaches are highly varied and often complex.
Therefore, for the purposes of this review, explicit labels and citations in articles were
used to classify the data analysis method. When nonspecific descriptions were given
(e.g., coding, categorising), the data analysis method was identified as other/not specified. Reflecting the literature in general, the qualitative research in aphasia included
varied approaches to data analysis (see Table 2). Many of the qualitative articles
(30%) did not report a specific analytic framework or cite a methodological reference; rather, these articles provided general or vague descriptions of analysis methods
such as searching for themes in the data. The most common labelled method of
analysing data was qualitative content analysis (15 studies) (Graneheim & Lundman,
2004). Content analysis involves identifying meaning or content units that contain
related concepts, labelling meaning units with a code, aggregating the data into categories, then linking the categories into themes. The second most prevalent label used
to describe data analysis was thematic analysis (11 studies). Thematic analysis is often

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TABLE 2
Methods of analysing qualitative data reported in reviewed articles

Reported data analysis method

Qualitative content analysis
Theme analysis
Framework method
Narrative analysis
Qualitative software
Open, axial & selective coding
Constant comparison method
Interpretive phenomenological analysis
Other or not specified

Number of articles
15
11
10
6
5
3
2
2
24

used as a generic term to refer to a process of identifying themes in qualitative data.

It requires identifying, analysing and reporting patterns within data (Braun & Clarke,
2006). Typically, the analysis proceeds from description to interpretation. Thus, data
are initially organized to reflect patterns in semantic content, and then these patterns are subjected to interpretive analysis in order to glean the significance of the
patterns and their broader meanings and implications (Braun & Clarke, 2006, p. 13).
Framework analysis is another method of identifying themes in qualitative data (e.g.,
Richie & Spencer, 1994); this approach was reported in 10 studies. Framework analysis
involves stages including immersing oneself in the data, listing key or recurrent ideas,
sorting the ideas, labelling the ideas into manageable components or bites, rearranging
data to try out different themes and finally interpreting the themes into a conceptual framework (Richie & Spencer, 1994; Smith & Firth, 2011). Other approaches
reported were narrative analysis, Interpretative Phenomenological Analysis (IPA),
open, axial and selective coding and constant comparison. Narrative analysis represents various approaches that focus on identifying patterns within stories or narratives.
Riessman (1993) describes narrative analysis as a process of systematically interpreting the narrative interpretations of participants who tell their stories. IPA applies to
a particular phenomenological orientation in qualitative research. Analysis often proceeds from identifying or noting concepts in a core set of data (e.g., one transcript),
labelling potential themes, clustering and ordering themes and then cycling through
additional data sets to verify and interpret (Smith & Osborn, 2003). While this is similar to thematic analysis, IPA differs in that the guiding philosophy constrains the
analysis to focus on the meanings that particular experiences hold for participants
(Smith & Osborn, 2003). Open, axial and selective coding, associated with grounded
theory, involves coding data, identifying connections between coded categories or
subcategories of data and finally developing a hypothesis to explain how core categories interact to represent a theory or construct (Corbin & Strauss, 2008; Strauss &
Corbin, 1990). The constant comparative method, also associated with grounded theory, entails continuously moving back and forth between emerging findings and the
source data to verify themes and hypotheses (Paul & Sanders, 2010).
In addition to the type of data analysis, the depth of data analysis varied across
studies. Qualitative investigation involves two slightly different outcomes of data analysis: description and explanation (Ritchie & Lewis, 2003; Smith et al., 2011). Smith
et al. (2011) describe description as a detailed, meaningful and relevant account of the

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topic under study. Thick description paints a picture for the reader to provide a sense
of what the event, people or experience look, feel or sound like. To achieve adequate
description, the researcher summarises and synthesises the data in a way that captures
the key elements and represents the associations that tie the whole together. Finally,
the description is carried to a higher level by extracting core concepts or descriptive categories that represent the topic of study (Smith et al., 2011). Some qualitative
research stops with description. Thus, the project focuses on developing a taxonomy
or categorical description of a phenomenon, an event or a group.
A second goal of qualitative research is explanation (Smith et al., 2011).
Explanation involves seeking patterns or associations across the data that relate to the
core concepts, relating these patterns to broader issues in life, society or culture, developing hypotheses to explain these patterns, exploring the data and the wider literature,
and finally developing higher-order interpretive themes that provide meanings and/or
explanations of the core concepts (Smith et al., 2011). In other words, deep interpretation requires moving away from listings or categories and towards higher-order
explanations and/or interpretations of the phenomena.
An original plan for this review was to identify studies that were primarily descriptive versus studies that combined description and explanation. However, it proved
difficult to identify primarily descriptive versus explanatory approaches. The terms
category and theme were often used interchangeably, and the word interpretation
appeared to mean different things to different researchers. Rather than a distinction
between description and explanation, the studies appeared to fall along a continuum
from relatively concrete listings of categories to abstract, higher-order interpretations.
Three studies that each reported themes derived from data analysis will be briefly
described in order to demonstrate the different qualitative outcomes of studies.
A qualitative study by Kerr, Hilari, and Litosseliti (2010) aimed to identify information needs of people with and without aphasia. The authors conducted focus groups,
and from these data they used qualitative content analysis to arrive at 18 themes that
defined the information needs of informants. The reported themes varied from very
specific needs such as criteria for obtaining a disabled badge for the car to fairly broad
topics such as information about strokes. In other words, the authors reported a relatively concrete listing of categories representing a first-level sorting of qualitative data.
There was little attempt to move beyond this to in-depth description or explanation.
While the results are relatively concrete, the findings met the aim of the researchers
who wanted specific guidance on features to include on an information website.
A second study represents a higher level of description. Howe and colleagues
(2008) interviewed people with aphasia in order to learn about the environmental
barriers and facilitators to their participation in the community. The researchers
employed qualitative content analysis to analyse the interview data. The analysis
resulted in seven themes that helped describe environmental influences on community participation including: other peoples awareness of aphasia, opportunities for
participation, familiarity, availability of support, communication complexity, message
clarity and time available. These themes were distilled from a large volume of data in
order to represent the data in a descriptive way. In other words, Howe and colleagues
created a taxonomy that helps others understand participation in the community as
it relates to the environment. This descriptive taxonomy met the goal of identifying
environmental barriers and facilitators to participation for people with aphasia.
A third study provides an example of the highest level of interpretation in qualitative research. Parr (2007) used ethnographic investigation to explore life with severe

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aphasia. She observed and interviewed people with aphasia and others, and examined
relevant artefacts such as notes taken by caregivers or written policies of organisations.
Using framework methods to analyse the data, she identified four broad interacting
categories related to living with severe aphasia: infrastructure and resources, behaviour
of other people, settings and environments, and personal identity and narrative. The
construction of these categories is similar to the themes reported by Howe and colleagues; that is, the categories provide a condensed and informative description of the
factors that impact life with severe aphasia. However, Parr took the analysis a step
further to detail an overarching theme that cut across the results. Social exclusion was
a pervasive finding that permeated the lives of people with severe aphasia; this essence
of the study helped explain the experience of life with severe aphasia. In other words,
the theme of social exclusion has explanatory power that goes beyond description.
The reader begins to understand what it is like to have severe aphasia, what the impact
of internal and external factors are and why people with severe aphasia tend to be
socially isolated. Parr drew on social theory and the disability literature to explain the
marginalisation associated with severe aphasia.
The three studies described above exemplify different levels of analysis from relatively concrete description to higher-order interpretation represented in the qualitative
studies reviewed.

DISCUSSION
Publication of qualitative research in aphasia has increased in the past 20 years and,
as one might expect, the qualitative studies found in the aphasia literature reflect varied topics and methodologies. Despite the variability, several interesting findings and
trends warrant discussion, including a tendency for researchers to use a pragmatic
approach to qualitative research, prevalence of interviews in data collection, minimal
attention to reporting data sufficiency criteria and variation in the depth or level of
data analysis.

Research design or tradition

It is notable that 67% of the reviewed studies (52 out of 78) did not use a traditional qualitative philosophy to guide the investigation. Rather, the trend was to
employ pragmatic or practical approaches that involve using qualitative methods (e.g.,
theme analysis) detached from a broader philosophical tradition (e.g., phenomenology, ethnography). In fact, this tendency is not unique to aphasiology. There has been
a trend, particularly in the nursing literature, to design qualitative studies without
adhering to a specific guiding tradition. This approach has garnered several labels
including a pragmatic approach (Smith et al., 2011), a general inductive approach
(Thomas, 2006) or a basic qualitative description (Sandelowski, 2000). Characteristics
of these pragmatic approaches to qualitative research are: (1) no traditional qualitative
philosophy is used to guide the study, (2) investigators select one or more qualitative
data collection and/or analysis strategies to fit the research question(s), and (3) investigators are free to select aspects or criteria from any qualitative research paradigm
that they think will address the question or strengthen the study.
Proponents of the pragmatic approach to using qualitative methods independent of a driving qualitative philosophy argue that the approach is practical and

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straightforward, and avoids the complexities associated with the traditional qualitative philosophies (Sandelowski, 2000). Practical applications of qualitative methods
are useful for describing something in detail when the investigator is not interested
in higher-level interpretations related to social or cultural themes. Moreover, investigators can pick and choose relevant methods that fit the question, and are not
constrained by the conventions associated with well-known traditions.
However, some consider that pragmatic approaches take the easy way out resulting in a lower-quality, undisciplined product (Morse, Barrett, Mayen, Olson, &
Spiers, 2002; Rolfe, 2006; Smythe, 2012). Since pragmatic approaches might encourage
description of results in a relatively straightforward manner, then the method could
encourage superficial or oversimplified treatment of topics. Furthermore, pragmatic
approaches allow researchers to avoid a deeper understanding of the highly developed
philosophies that guide traditional qualitative paradigms (Braun & Clarke, 2006).
Some critics suggest that qualitative research devoid of a theoretical framework might
result in a lack of methodological coherence, which potentially affects a studys validity (Morse et al., 2002; Rolfe, 2006). An underlying philosophy or research tradition
provides guidance on the choice of questions, design and analysis; these are recognisable and required elements (Smythe, 2012). Therefore, use of a guiding tradition might
aid the researcher and the consumer of research because they can identify missing
elements and determine adherence to quality criteria.
During this review of qualitative research in aphasia, it was sometimes clear that the
researcher had made a conscious and informed decision to use a pragmatic approach
that suited the aims of the project. However, at other times, it was unclear if the use of a
qualitative method independent of a guiding tradition was an explicit choice or simply
a lack of experience or knowledge. Although there is often justification in employing
pragmatic approaches, the high proportion of pragmatic studies in the aphasia literature begs the question: does this represent best research practice? Aphasia researchers
might consider the relative benefits of pragmatic- versus philosophy-driven traditions.
We might also wonder if the high occurrence rate of pragmatic qualitative research has
been self-perpetuating, with qualitative scientists imitating what they read. While this
review does not suggest a right or wrong approach for future researchers, it raises the
issue for further discussion and consideration.

Data collection
Another issue of interest is the prevalence of interviews in the reviewed research.
Of 54 studies involving people with aphasia as participants, 51 studies included
interviews with participants with aphasia. This finding suggests that, despite the
communication disability, people with aphasia have been recruited to participate in
qualitative interviews. It is encouraging that true insiders have been included in studies
related to aphasia. To facilitate participation of people with aphasia in interviews, several researchers used communication support methods. In fact, one of the qualitative
studies reviewed focused on the ability of people with aphasia to participate in interviews when given sufficient support (Luck & Rose, 2007). The authors concluded that
Valuable data can be obtained from participants with aphasia when the interview
method is altered appropriately to meet their communicative needs (p. 208).
Along with this positive finding that people with aphasia are being recruited to provide their own perspectives, we might wonder about the preponderance of one data
collection strategy across qualitative studies in aphasia: 96% (75 out of 78) of the

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reviewed studies involved interviews, either one-on-one or in focus groups. Of these,

60 studies used interview as the only data collection strategy. While qualitative interviewing is a powerful strategy for gathering insider information, interviews provide
one perspective on a phenomenonthe informants perspective. This is appropriate
when the aim of the study is to learn what people think or feel about some event
or phenomenon. However, what people believe, perceive or interpret does not always
reflect actual events. For example, in a study of aphasia therapy, Simmons-Mackie,
Damico, and Damico (1999) reported that SLPs often acted in ways that did not
match their stated goals for patients. For example, a therapist with a stated goal of
improving gestures was observed to preferentially reinforce spoken productions during a gestural activity. Detailed observation provided a richer understanding of how
SLPs crafted goals, and how other factors (e.g., cultural biases, habituated behaviours)
altered the actual implementation of goals. Similarly, studies that aim to understand
the effects of aphasia on various aspects of daily life can include not only interviews
to determine how people with aphasia feel about or perceive experiences, but also
include observations to determine what actually happens. The study of life with severe
aphasia described above (Parr, 2007) would likely have achieved a different result if
only interviews were obtained. For example, a PWA might report feeling uncomfortable at a social event or report that friends no longer visit. Such an informant might
not be aware of the myriad behavioural or environmental manifestations that create
these feelings. Direct observation would likely identify such factors that contribute to
social isolation and help explain interview findings.
Given the potential to gain a richer understanding of phenomena, we might wonder why other data collection approaches such as observation and video recording
have not been more widely used. There are a number of issues such as confidentiality, liability and time that could be deterrents to various data collection approaches.
Observation and video recording require the investigator to accompany a participant
into natural situations where unexpected events might occur. For example, confidentiality issues arise in a hospital setting where a participant observer might inadvertently see other patients receiving treatments or overhear confidential doctorpatient
discussions. Liability issues might arise when an investigator accompanies a participant outside of an insured facility. Finally, observations might require additional time
and effort. However, if observation would contribute to deeper understanding and
expanded knowledge, then researchers might address the barriers to using this data
collection strategy.
Another finding regarding data collection was the minimal reporting of methods
for determining that sufficient data had been collected to achieve the aims of the
research. As noted, it is possible that data sufficiency was addressed in studies but
was not reported. However, the qualitative research literature suggests that there are
probably reasons that researchers have difficulty with criteria such as the saturation
criterion. First, the concept of saturation is vague with minimal information available
regarding how one demonstrates that saturation has been achieved (Francis et al.,
2010; Walker, 2012). Second, researchers often need to specify the number of participants, settings, events and time required a priori in order to satisfy funding sources or
supervisors. Given the time accountability standards in many work settings, it is difficult to employ a procedure that does not allow the investigator to know in advance
how much time or resources will be required. However, since sufficient data are a requisite for trustworthy and valid findings, aphasia researchers might begin to address
this gap in qualitative design and/or reporting.

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Data analysis: Description and explanation

The final issue that merits discussion is the wide variation in the level of description
and interpretation in qualitative research in aphasia. The three examples described
in the results section demonstrate studies that represent different levels of analysis.
While different levels of analysis are typically designed to meet study goals, investigators were often unclear regarding their level of interpretation or intended outcomes.
For example, all three studies described above used the term theme to refer to their
findings. In fact, the theme label was used to describe the results in the majority of the
research reports. Yet, themes ranged from simple groupings or listings to higher-order
interpretations. By conflating the labels in this way, it is sometimes difficult to determine the depth of analysis that the researcher meant to achieve. Terminology such as
meaning units, core concepts, categories and themes are applied to different levels of
data by different researchers. When researchers report first-level qualitative data (e.g.,
concrete listings) as themes, it can be confusing to readers. Morse (2008), the editor
of Qualitative Health Research, suggested that qualitative researchers should distinguish qualitative themes from categories. She defines a category as a collection of
similar data sorted into the same place, and this arrangement enables the researchers
to identify and describe the characteristics of the category (Morse, 2008, p. 727).
Thus, categories are groupings of similar data that can be compared and contrasted.
Categories help to describe the data. A theme, on the other hand, is a meaningful essence that runs through the data. Just as a theme in opera occurs over and
over again, sometimes in the foreground, sometimes in the background and sometimes co-occurring with other tunes, so does the theme in our research (Morse,
2008, p. 727). The theme cuts across the descriptive categories and addresses more
wide-reaching issues. While qualitative research often results in multiple descriptive
categories, usually the interpretive themes of a study are fewer in number. Future
reports of qualitative research in aphasia might more clearly define the levels of data
reported with these definitions in mind.
Also related to a discussion of the level of interpretation, the majority of the
studies reviewed involved analysis of core concepts and description of meaning
units or categories. Very few studies involved higher-level explanatory interpretation. In considering the level of interpretation in qualitative investigation, we might
liken qualitative analysis to cooking soup. The cook begins with a list of ingredients
(chicken, onions, carrots, celery, salt, pepper). These ingredients are semantic concepts that can be grouped into descriptive categories (meats, vegetables, spices) or they
can be contrasted into larger categories (wet versus dry ingredients; main ingredients versus seasonings). However, as the soup cooks, the flavours come together to
create an essence that is more than the sum of the partsa chicken soupness that
defines the product and possibly evokes broader social or cultural meanings (e.g.,
curative powers of chicken soup; memories of childhood). Like a soup, qualitative
research might involve consideration of the basic ingredients or core concepts of a
phenomenon (as in Kerr et al., 2010), analysis of these into descriptive categories or
taxonomies (as in Howe et al., 2008) and extraction of the essence or themes that
cut across the categories and offer explanation (as in Parr, 2007). This delineation
is not intended as a criticism since the aims of studies differ and require different
levels of interpretation. Rather, the pattern of existing studies can raise awareness
and provoke consideration of potential areas of growth in qualitative investigation in
aphasia.

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CONCLUSION
This review suggested that publication of qualitative research in aphasia has increased
over the past several years, contributing to a growing literature reflecting the perspectives of key stakeholders such as people with aphasia and their family members.
The findings provide both concrete direction (e.g., improve reporting of methods
for determining data sufficiency) and also raise a variety of questions for debate
and self-reflection (e.g., should more aphasia researchers apply methods from established qualitative traditions? Should aphasia research include more data collection
methods? Should researchers strive to increase the depth of data analysis to achieve
higher-order interpretations?) Additionally, the inclusion of people with aphasia as
research informants has been a positive direction that reflects increasing sensitivity to
the importance of the insider perspective. Since the publication of qualitative research
in aphasia and efforts to understand the insider experience of aphasia appear to be
increasing, it is important to review our research methods and consider possibilities
for the future. This review revealed several trends and raised a number of questions to
ponder as qualitative researchers continue to contribute to knowledge and practice in
aphasiology.
Manuscript received 26 February 2013
Manuscript accepted 17 June 2013
First published online 29 July 2013

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APPENDIX A
Articles included in the Review of Qualitative Research in Aphasia
Andersson, S., & Fridlund, B. (2002).The aphasic persons views of the encounter with other people: A
grounded theory analysis. Journal of Psychiatric & Mental Health Nursing, 9(3), 285292.
Armstrong, E., Hersh, D., Hayward, C., & Brown, M. (2012). Living with aphasia: Three Indigenous
Australian stories. International Journal of Speech-Language Pathology, 14(3), 271280.
Ashton, C., Aziz, N. A., Barwood, C., French, R., Savina, E., & Worrall, L. (2008). Communicatively
accessible public transport for people with aphasia: A pilot study. Aphasiology, 22(3), 305320.
Barrow, R. (2008). Listening to the voice of living life with aphasia: Annes story. International Journal of
Language & Communication Disorders, 43(Supplement 1), 3046.
Bronken, B., Kirkevold, M., Martensen, R., & Kvigne, K. (2012). The aphasic storyteller: Co-constructing
stories to promote psychosocial well-being after stroke. Qualitative Health Research, 22(10), 13031316.
Brown, K., McGahan, L., Alkhaledi, M., Seah, D., Howe, T., & Worrall, L. (2006). Environmental factors
that influence the community participation of adults with aphasia: The perspective of service industry
workers. Aphasiology, 20(7), 595615.
Brown, K., Worrall, L., Davidson, B., & Howe, T. (2010). Snapshots of success: An insider perspective on
living successfully with aphasia. Aphasiology, 24(10), 12671295.
Brown, K., Worrall, L., Davidson, B., & Howe, T. (2011). Exploring speech-language pathologists perspectives about living successfully with aphasia. International Journal of Language & Communication
Disorders, 46(3), 300311.
Bruce, C., Parker, A., & Renfrew, L. (2006). Helping or something: Perceptions of students with aphasia
and tutors in further education. International Journal of Language & Communication Disorders, 41(2),
137154.
Cherney, L., Halper, A., & Kaye, R. (2011). Computer-based script training for aphasia: Emerging themes
from post-treatment interviews. Journal of Communication Disorders, 44(4), 493501.
Cruice, M., Hill, R., Worrall, L., & Hickson, L. (2010). Conceptualising quality of life for older people with
aphasia. Aphasiology, 24(3), 327347.
Cruice, M., Worrall, L., & Hickson, L. (2006). Perspectives of quality of life by people with aphasia and
their family: Suggestions for successful living. Topics in Stroke Rehabilitation, 13(1), 1424.
Dalemans, R., de Witte, L., Wade, D., & van den Heuvel, W. (2010). Social participation through the eyes
of people with aphasia. International Journal of Language and Communication disorders, 45(5), 537550.
Davidson, B., Howe, T., Worrall, L., Hickson, L. & Togher, L. (2008). Social participation for older people
with aphasia: the impact of communication disability on friendships. Topics in Stroke Rehabilitation,
15(4), 325340.
Davidson, B., Worrall, L., & Hickson, L. (2003). Identifying the communication activities of older people
with aphasia: Evidence from naturalistic observation. Aphasiology, 17(3), 243264.
Davidson, B., Worrall, L., & Hickson, L. (2006). Social communication in older age: Lessons from people
with aphasia. Topics in Stroke Rehabilitation, 13(1), 113.
Davidson, B., Worrall, L., & Hickson, L. (2008). Exploring the interactional dimension of social communication: A collective case study of older people with aphasia. Aphasiology, (3), 235257.

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Elman, R. J., & Bernstein-Ellis, E. (1999). Psychosocial aspects of group communication treatment:
Preliminary findings. Seminars in Speech & Language, 20(1), 6572.
Ferguson, A., Duffield, G., & Worrall, L. (2010). Legal decision-making by people with aphasia: Critical
incidents for speech. International Journal of Language and Communication Disorders, 45(2), 244258.
Fox, L., Poulsen, S., Bawden, K., & Packard, D. (2004). Critical elements and outcomes of a residential,
family-based intervention for aphasia caregivers. Aphasiology, 18, 11771199.
Garcia, L., Barrette, J., & Laroche, C. (2000). Perceptions of the obstacles to work reintegration for persons
with aphasia. Aphasiology, 14(3), 269288.
Greig, C., Harper, R., Hirst, T., Howe, T., & Davidson, B. (2008). Barriers and facilitators to mobile phone
use for people with aphasia. Topics in Stroke Rehabilitation, 15(4), 307324.
Grohn, B., Worrall, L., Simmons-Mackie, N., & Brown, K. (2012). The first 3-months post-stroke: What
facilitates successfully living with aphasia? International Journal of Speech-Language Pathology, 14(4),
390400.
Hall, M., Duhamel, F., & Le Dorze, G. (2011). The daughter-mother relationship in the presence of
aphasia: How daughters view changes over the first year poststroke. Qualitative Health Research, 21(4),
549562.
Hersh, D. (2003). Weaning clients from aphasia therapy: Speech pathologists strategies for discharge.
Aphasiology, 17, 10071029.
Hersh, D. (2009). How do people with aphasia view their discharge from therapy? Aphasiology, 23(3):
331350.
Hersh, D. (2010). Aphasia therapists stories of ending the therapeutic relationship. Topics in Stroke
Rehabilitation, 17(1), 3038.
Hersh, D., Sherratt, S., Howe, T., Worrall, L., Davidson, B., & Ferguson, A. (2012). An analysis of the
goal in aphasia rehabilitation. Aphasiology, 26(8), 971984.
Hinckley, J. (2005). The piano lesson: An autoethnography about changing clinical paradigms in aphasia
practice. Aphasiology, 19, 765779.
Howe, T., Davidson, B., Worrall, L., Hersh, D., Ferguson, A., Sherratt, S., & Gilbert, J. (2012). You needed
to rehab... families as well: Family members own goals for aphasia rehabilitation. International Journal
of Language & Communication Disorders, 47(5), 511521.
Howe, T., Worrall, L., & Hickson, L. (2008a). Interviews with people with aphasia: Environmental factors
that influence their community participation. Aphasiology, 22(10), 10921120.
Howe, T., Worrall, L., & Hickson, L. (2008b). Observing people with aphasia: Environmental factors that
influence their community participation. Aphasiology, 22(6), 618643.
Ireland, C., & Wotton, G. (1996). Time to talk: Counselling for people with dysphasia. Disability &
Rehabilitation, 18(11), 585591.
Johansson, M. B., Carlsson, M., Sonnander, K. (2012). Communication difficulties and the use of communication strategies: From the perspective of individuals with aphasia. International Journal of Language
& Communication Disorders, 47(2), 144155.
Jones, F., Mandy, A., & Partridge, C. (2008). Reasons for recovery after stroke: A perspective based on
personal experience. Disability & Rehabilitation, 30(7), 507516.
Kardosh, B., & Damico, J. (2009). The contribution of language in shaping clinical culture: Palestinian
aphasics and families living in Israel. Asia Pacific Journal of Speech, Language & Hearing, 12(3),
243252.
Kerr, J., Hilari, K., & Litosseliti, L. (2010). Information needs after stroke: What to include and how to
structure it on a website. A qualitative study using focus groups and card sorting. Aphasiology, 24(10),
11701196.
Knight, K., Worrall, L., Rose, T., & Roth, E. (2006). The provision of health information to stroke patients
within an acute hospital setting: What actually happens and how do patients feel about it? Topics in
Stroke Rehabilitation, 13(1), 7897.
Larsson, I., & Thoren-Jonsson, A. (2007) The Swedish speech interpretation service: An exploratory
study of a new communication support provided to people with aphasia. Augmentative and Alternative
Communication, 23(4), 312322.
Le Dorze, G., & Brassard, C. (1995). A description of the consequences of aphasia on aphasic persons and
their relatives and friends, based on the WHO model of chronic diseases. Aphasiology, 9(3), 239255.
Le Dorze, G., Brassard, C., Larfeuil, C., & Allaire, J. (1996). Auditory comprehension problems in aphasia
from the perspective of aphasic persons and their families and friends. Disability & Rehabilitation,
18(11), 550558.

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Le Dorze, G., Julien, M., Brassard, C., Durocher, J., & Boivin, G. (1994). An analysis of the communication
of adult residents of a long-term care hospital as perceived by their caregivers. European Journal of
Disorders of Communication, 29(3), 241268.
Le Dorze, G., & Signori, F. (2010). Needs, barriers and facilitators experienced by spouses of people with
aphasia. Disability & Rehabilitation, 32(13), 10731087.
Le Dorze, G., Tremblay, V., & Croteau, C. (2009). A qualitative longitudinal case study of a daughters
adaptation process to her fathers aphasia and stroke. Aphasiology, 23(4), 483502.
Legg, L., Stott, D., Ellis, G., & Sellars, C. (2007). Volunteer stroke service (VSS) groups for patients with
communication difficulties after stroke: A qualitative analysis of the value of groups to their users.
Clinical Rehabilitation, 21(9), 794804.
Luck, A., & Rose, M. (2007). Interviewing people with aphasia: Insights into method adjustments from a
pilot study. Aphasiology, 21(2), 208224.
Lynch, K., Damico, J., Damico, H., Tetnowski, J., & Tetnowski, J. (2009). Reading skills in an individual
with aphasia: The usefulness of meaning-based clinical applications. Asia Pacific Journal of Speech,
Language & Hearing, 12(3), 221234.
Michallet, B., Le Dorze, G., & Tetreault, S. (2001). The needs of spouses caring for severely aphasic persons.
Aphasiology, 15, 731747.
Michallet, B., Tetreault, S., & Le Dorze, G. (2003). The consequences of severe aphasia on the spouses of
aphasic people: A description of the adaptation process. Aphasiology, 17, 835859.
Mitchell, K., Skirton, H., & Monrouxe, L. (2011). Amelioration, regeneration, acquiescent and discordant:
An exploration of narrative types and metaphor use in people with aphasia. Disability & Society, 26(3),
321335.
Mumby, K., & Whitworth, A. (2012). Evaluating the effectiveness of intervention in long-term aphasia
post-stroke: The experience from CHANT (Communication Hub for Aphasia in North Tyneside).
International Journal of Language & Communication Disorders, 47(4), 398412.
Nakano, E., & Hinckley, J. (2010). Therapy discharge becomes part of the life story. Topics in Stroke
Rehabilitation, 17(1), 3946.
Ntterlund, B. (2010). A new life with aphasia: Everyday activities and social support. Scandinavian Journal
of Occupational Therapy, 17, 117129.
Ntterlund, B. (2010). Being a close relative of a person with aphasia. Scandinavian Journal of Occupational
Therapy, 17(1), 1828.
Nordehn, G., Meredith, A., Bye, L., & Roth, E. (2006) A preliminary investigation of barriers to achieving
patient-centered communication with patients who have stroke-related communication disorders. Topics
in Stroke Rehabilitation, 13(1), 6877.
Northcott, S., & Hilari, K. (2011). Why do people lose their friends after a stroke? International Journal of
Language & Communication Disorders, 46(5), 524534.
OHalloran, R., Worrall, L., & Hickson, L. (2011). Environmental factors that influence communication
between patients and their healthcare providers in acute hospital stroke units: An observational study.
International Journal of Language and Communication Disorders, 46(1), 3047.
Parr, S. (1994). Coping with aphasia: Conversations with 20 aphasic people. Aphasiology, 8(5), 457466.
Parr, S. (1995). Everyday reading and writing in aphasia: Role change and the influence of pre-morbid
literacy practice. Aphasiology, 9(3), 223238.
Parr, S. (2001). Psychosocial aspects of aphasia: Whose perspectives? Folia Phoniatrica et Logopaedica,
53(5), 266288.
Parr, S. (2007). Living with severe aphasia: Tracking social exclusion. Aphasiology, 21(1), 98123.
Paul, N., & Sanders, G. (2010). Applying an ecological framework to education needs of communication
partners of individuals with aphasia. Aphasiology, 24(9), 10951112.
Pearl, G., Sage, K., & Young, A. (2011). Involvement in volunteering: An exploration of the personal
experience of people with aphasia. Disability & Rehabilitation, 33(19/20), 18051821.
Penn, C., Frankel, T., Watermeyer, J., & Muller, M. (2009). Informed consent and aphasia: Evidence of
pitfalls in the process. Aphasiology, 23(1), 332.
Pound, C., Parr, S., & Duchan, J. (2001), Using partners autobiographical reports to develop, deliver, and
evaluate services in aphasia. Aphasiology, 15(5), 477493.
Purves, B., Logan, H., & Marcella, S. (2011). Intersections of literal and metaphorical voices in aphasia.
Aphasiology, 25(67), 688699.
Rohde, A., Townley-ONeill, K., Trendall, K., Worrall, L., & Cornwell, P. (2012). A comparison of client
and therapist goals for people with aphasia: A qualitative exploratory study Aphasiology, 26(10),
12981315.

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Rose, T., Worrall, L., Hickson, L., & Hoffmann, T. (2011). Aphasia friendly written health information:
Content and design characteristics. International Journal of Speech-Language Pathology, 13(4), 335347.
Sherratt, S., Worrall, L., Pearson, C., Howe, T., Hersh, D., & Davidson, B. (2011). Well it has to be
language-related: Speech-language pathologists goals for people with aphasia and their families.
International Journal of Speech-Language Pathology, 13(4), 317328.
Simmons-Mackie, N., Damico, J., & Damico, H. (1999). A qualitative study of feedback in aphasia
treatment. American Journal of Speech-Language Pathology, 8(3), 218230.
Simmons-Mackie, N., Kagan, A., ONeill-Christie, C., Huijbregts, M., McEwen, S., & Willems, J. (2007).
Communicative access and decision making for people with aphasia: Implementing sustainable health
care systems change. Aphasiology, 21(1), 3966.
Sorin-Peters, R. (2004). The evaluation of a learner-centered training programme for spouses of adults with
chronic aphasia using qualitative case study methodology. Aphasiology, 18(10), 951975.
Sundin, K., Astrid, N., & Jansson, L. (2001). The meaning of skilled care providers relationships with
stroke and aphasia patients. Qualitative Health Research, 11(3), 308321.
True, G., Bartlett, M., Fink, R., Linebarger, M., & Schwartz, M. (2010). Perspectives of persons with
aphasia towards SentenceShaper to Go: A qualitative study. Aphasiology, 24(9), 10321050.
van der Gaag, A., Smith, L., Davis, S., Moss, B., Cornelius, V., Laing, S., & Mowles, C. (2005). Therapy and
support services for people with long-term stroke and aphasia and their relatives: A six-month follow-up
study. Clinical Rehabilitation, 19(4), 372380.
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APPENDIX B
Information extracted for each article under review
(1) Topic: What is the broad topic of the investigation (e.g., early hospital experiences
of people with aphasia, life as a child of someone with aphasia)?
(2) Participants: Describe the type of participants (e.g., people with aphasia, family
members, doctors).
(3) Research Tradition/Design: What is the tradition or design that guided the
study (e.g., ethnography, phenomenology)? This should reflect the label explicitly
used to describe the tradition or design as stated in the article, not an inference
about the design based on reading the article. Enter the exact description that was
given in the article.
(4) Data Collection
(A) Sampling method: What was the method of obtaining the sample (e.g., convenience, purposeful)? An explicit statement of the method is required; if
not explicitly stated in the article, enter as not stated.
(B) Data collection method: What method of data collection was employed (e.g.,
observation, interview, video recording)?
(C) Is there a statement regarding data sufficiency?
! Yes or No: Is there an explicit mention of an attempt to determine data
sufficiency or attempt to obtain saturation in the article? To meet this
criterion, the authors need not describe how this was done, only refer to
an effort to obtain sufficient data.
(D) Method of obtaining data sufficiency (saturation) is described

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SIMMONS-MACKIE AND LYNCH

! Yes or No: The actual method of determining data sufficiency was

described.
(5) Data Analysis
(A) Data analysis methods: What was the stated method of analysing the data
(e.g., thematic analysis)? Enter the exact label used and the relevant citation.
For generic descriptions, enter the language used to describe the analysis
(e.g., categorising data)
(B) Level of analysis
! Descriptive: the analysis provides a detailed, meaningful and relevant
account of the topic under study; the project develops a descriptive
taxonomy or categorical description of a phenomenon, an event or a
group.
! Explanatory: the analysis provides a deep interpretation that goes
beyond listings or categories and towards higher-order explanations
and/or interpretations of the phenomena, event or group.

APPENDIX C
Categories derived from a qualitative analysis of the extracted data
Topics of study derived from the extracted data

! Investigates the experience of aphasia (for PWA, SLPs, Family, others) (e.g., quality
!
!
!
!
!
!
!

of life, living successfully with aphasia, what it is like for family members living with
aphasia).
Investigates an intervention, treatment or program
Investigates discharge from intervention or program
Investigates or identifies goals or needs of PWA, family or others
Investigates issues associated with culture and aphasia
Investigates environmental factors or issues
Investigates activity or participation (e.g., what people do, communication activities, relationships, work, leisure)
Other (does not fit in the above topics)

Types of participants derived from the extracted data

!
!
!
!
!

PWA
Family or Caregivers
SLPs
Other Service providers (e.g., nurses, attendants)
Others

Research Tradition or design derived from the extracted data

! Qualitative studynonspecific (used for articles where no explicit tradition is given

!
!
!
!

as in qualitative methods or qualitative study or when a pragmatic approach is

referenced as in descriptive qualitative investigation). Note the exact terminology
used in the article.
Phenomenology (used for any type of phenomenological investigation)
Grounded theory
Ethnography
Narrative

QUALITATIVE RESEARCH IN APHASIA

!
!
!
!
!
!
!

1301

Data collection method

!
!
!
!
!
!
!

Interview(s)
Focus group(s)
Observation
Diaries
Video or audio recording
Review of artefacts
Other
Sampling method
Convenience sample
Random or semi-random sampling
Snowball sampling
Purposeful sampling
Maximum variation sampling
Other
Not stated

! Not stated or nonspecific analysis (e.g., qualitative analysis, sorting and coding,

Data analysis methods

!
!
!
!
!
!
!
!
!

classifying, categorising)
Qualitative content analysis
Thematic analysis
Framework analysis
Open, axial and selective coding
NUD-IST (QSR International, Doncaster, Victoria, Australia) or other qualitative
analysis software
Narrative analysis
Constant comparative method
Interpretive phenomenological analysis (IPA)
Other

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