Who am I now? A scoping review on identity changes in post-stroke aphasia

Purpose
Provide an overview of existing knowledge on the concept of identity and identity changes and formation of people with language disorders of aphasia. To date, there has been limited exploration of identity changes of people with aphasia as communication difficulties have been perceived as a barrier to participation by researchers.

Method
A scoping review was performed utilizing Arksey and O’Malley’s methodological framework. The databases PubMed, PsycINFO, CINAHL, and Cochrane Library were searched, and both descriptive and thematic analysis were conducted.

Results
The search yielded 492 records, of which 20 studies were included. The analysis revealed various theories and definitions of identity. There was limited uniformity in defining identity in the publications. A recurrent theme was, that identity is a social construct and storytelling is the vehicle through which it is navigated. Language and communication are essential in this process.

Conclusions
The model of Narrative Identity might be useful to clarify identity and its dynamic nature, since it integrates various theories of identity referred to in the publications. Different aspects of identity should be considered in future research to add to existing knowledge of identity changes and formation in people with aphasia and to tailor future interventions if necessary.

IMPLICATIONS FOR REHABILITATION

Identity formation is a complex and ongoing process for people with post-stroke aphasia, significantly influenced by language disorders. Continuous attention to this process is essential during rehabilitation.

Effective interventions include peer support through aphasia groups and elicitation of personal narratives, prominently through Guided Self-Determination, Biographic Narrative Intervention, and the My Story project.

People with aphasia exhibit diverse experiences, encompassing internal variation and ambiguity within themselves, while concurrently navigating dilemmas throughout the process of identity formation.

The “Narrative Identity Model” might be useful to comprehend identity and its dynamic nature, since it integrates various theories of identity referenced in publications about identity changes in people with aphasia.