Personal narratives in aphasia: Understanding narrative competence

摘要

Background: Personal narratives have been suggested as a way for persons post stroke to re-establish their identity. To relate tellable personal stories, narrative competence - along with its building blocks - is essential. Objective: The objective of this study was to describe narrative competence in persons with mild to moderate aphasia. It addressed the areas of coherence, clarity, temporal-causal structure, and reference in narratives. The study also examined the strategies used (evaluative language) as well as the topics and themes in personal narratives. Methods: Sixteen individuals with mild to moderate aphasia were asked to relate the story of their stroke and stories of a memorable and a frightening experience. Stories were elicited using a "willing listener" procedure. Responses were analyzed quantitatively in terms of the number of propositions and the instances of temporal-causal sequences, reference, and evaluation. Qualitative analysis was performed to determine the overall coherence and clarity of the narratives. Results: Narrative competence was present in the majority of participants. Although difficulties with reference were observed, high ratings of narrative coherence and clarity were attributed to sufficient amount of language, preserved temporal-causal sequencing, and the use of strategies (evaluative language). Conclusions: Narrative competence was exhibited in the personal narratives of individuals with mild to moderate aphasia. In addition to pinpointing essential elements of narrative competence, the use of personal narratives was deemed beneficial for both the clinician, by providing a better understanding of the individual with aphasia, and the individual with aphasia, by providing opportunities for self-disclosure.