Digital technology has become increasingly important for creating and maintaining relationships, yet people with aphasia face unique challenges using these tools. Aphasia, a communication disorder that often results from stroke, affects millions of people worldwide and can make traditional methods of staying connected with friends extremely difficult. We interviewed 44 people including individuals with aphasia, their significant others, and friends to understand how information and communication technology (ICT) - such as smartphones, social media, texting, and video calls - plays a role in maintaining friendships after aphasia. Over 90% of participants emphasized technology's vital importance in keeping friendships alive. Our analysis revealed three key themes: flexibility is essential (both the inherent adaptability of technology and the willingness of friends to be flexible), technology serves as a powerful tool for identity negotiation (allowing people with aphasia to control how they present themselves and maintain pre-stroke identities), and technology functions as a lifeline (particularly crucial in early recovery stages and for increasing social contact). The findings highlight aspects often overlooked in rehabilitation, such as training needs for digital technology use, the importance of including friends in intervention planning, and the need for flexible approaches that adapt to individual communication preferences and abilities.
This research addresses a critical gap in understanding how people with aphasia navigate our increasingly digital world to maintain essential social connections. While previous studies have documented the "digital divide" affecting people with aphasia, few have explored the specific strategies and practices they use to stay connected with friends through technology. Our findings have immediate clinical implications by demonstrating that technology training should be a priority in aphasia rehabilitation, particularly given that over 90% of participants relied on digital tools for friendship maintenance. The research provides concrete evidence for including technology-focused goals in therapy and involving friends in intervention planning. As our world becomes more digitally dependent, ensuring people with aphasia can effectively use these tools becomes essential for reducing social isolation and supporting mental health. The three themes we identified offer a framework for developing more effective, person-centered interventions that acknowledge both the challenges and opportunities of digital communication for this population.
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