從沈默到表達：腦中風患者失語症復原過程的意義建構

From Silence to Expression: Meaning Making in the Recovery Journey of Stroke Survivors with Aphasia

目的：失語症是中風後常見且影響深遠的語言障礙。既有研究多著重急性期量化語言恢復，較少探討患者對復健歷程的主觀經驗。本研究以質性方法描繪失語症患者的復健經驗，並探討語言能力與失語症類型轉變的意義。方法：納入16位失語症患者，追蹤六至十二個月，透過深度訪談、治療觀察與臨床測驗收集資料，進行主題分析並比較一年內與一年以上患者經驗差異。結果：歸納三主題：（1）語言重建的挑戰與突破，患者從沈默到能以短句表達，逐步建立溝通信心；（2）失語症類型轉變帶來心理提升，促進社交意願；（3）語言進步與生活品質互相強化，即便量表變化有限，患者仍感受更多參與與滿意。結論：語言治療不僅促進語言恢復，也支持情緒調適與社會角色重建。臨床應整合家庭與社會支持，並依病程長度提供差異化策略，以最大化治療效益。

Objectives. Aphasia is a common post-stroke disorder that disrupts communication and social participation. This study explored stroke survivors’subjective experiences of language rehabilitation and the meaning of aphasia type changes.
Methods. Sixteen participants were followed for 6-12 months. Data were collected through in-depth interviews, clinical observations, and language assessments, and analyzed thematically with cross-case comparison of patients within and beyond one year post-stroke.
Results. Three themes emerged: (1) challenges and breakthroughs in rebuilding language, as patients progressed from silence to short-sentence communication; (2) psychological significance of type conversion, where shifting from non-fluent to fluent aphasia increased confidence and social motivation; (3) reciprocal reinforcement between language gains and quality of life, even when standardized scores changed minimally.
Conclusion. Language therapy fosters not only linguistic recovery but also emotional adjustment and social reintegration. Tailored strategies according to time post-stroke and integration of family support may maximize rehabilitation outcomes.