Bernard Michallet

The needs of spouses caring for severely aphasic persons

This qualitative research aimed to identify and describe the needs perceived by spouses of persons with severe aphasia. The analyses revealed different categories of needs: (1) information, (2) need to acquire an effective mode of communication with the aphasic partner, (3) better interpersonal relationships, (4) need to be considered as a partner in the caring process, (5) support, (6) respite. These needs were not static but in interaction with one another. Moreover, they varied within a temporal axis and appeared at different time periods: within the acute hospitalisation phase, rehabilitation phase, and after the aphasic person returned home. Taking into consideration the needs of spouses of persons with severe aphasia requires an eco-systemic and interdisciplinary approach aiming for the social reintegration of the person with aphasia. Services should be developed in order to respond to the unique and individual experiences and needs of people affected by aphasia. Speech language pathologists play a pivotal role within this approach because communication problems are central to the consequences of severe aphasia.

Looking for capacities rather than vulnerabilities: the moderating effect of health assets on the associations between adverse social position and health

To increase capacities and control over health, it is necessary to foster assets (i.e. factors enhancing abilities of individuals or communities). Acting as a buffer, assets build foundations for overcoming adverse conditions and improving health. However, little is known about the distribution of assets and their associations with social position and health. In this study, we documented the distribution of health assets and examined whether these assets moderate associations between adverse social position and self-reported health. A representative population-based cross-sectional survey of adults in the Eastern Townships, Quebec, Canada (n = 8737) was conducted in 2014. Measures included assets (i.e. resilience, sense of community belonging, positive mental health, social participation), self-reported health (i.e. perceived health, psychological distress), and indicators of social position. Distribution of assets was studied in relation to gender and social position. Logistic regressions examined whether each asset moderated associations between adverse social position and self-reported health. Different distributions of assets were observed with different social positions. Women were more likely to participate in social activities while men were more resilient. Resilience and social participation were moderators of associations between adverse social position (i.e. living alone, lower household income) and self-reported health. Having assets contributes to better health by increasing capacities. Interventions that foster assets and complement current public health services are needed, especially for people in unfavorable situations. Health and social services decision-makers and practitioners could use these findings to increase capacities and resources rather than focusing primarily on preventing diseases and reducing risk factors.