TELE- narraktiv : feasibility and early quality‑of‑life effects of telerehabilitation‑based delivery of the biographic‑narrative intervention narraktiv

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Background Persons with aphasia (PWA) often experience a reduced quality of life. Biographical work uses life-story telling to help people cope with critical life events. The biographic-narrative intervention narraktiv, consisting of individual and group sessions, has been shown to significantly improve quality of life in PWA. However, barriers, such as limited mobility and service coverage, hinder participation. To maximise access to this intervention, we adapted narraktiv to a telehealth format (TELE-narraktiv). A previous feasibility study showed that the digital delivery of the individual sessions was feasible and effective.Aims This paper presents the first investigation of TELE-narraktiv following the original narraktiv protocol and includes individual and group sessions. The aim is to evaluate the preliminary effectiveness of the intervention in terms of quality of life, as well as its feasibility.Method In a pre-post study design, five individual and seven group sessions were conducted via videoconference with up to four participants in each group. Health-related quality of life (SAQOL-39 g) and life satisfaction (SWLS) were measured at three time points: baseline (t0), after the 10-week intervention (t1) and at the three-months follow-up (t2). One-way repeated-measures ANOVAs were conducted. The feasibility of the intervention was assessed by documenting technical issues encountered by therapists during the sessions and attendance rates.Results Twenty-two PWA, divided into six groups, showed significant improvements in communicative quality of life (F(2, 42) = 8.12, p < .001) with a large effect size (η2p = .279). Physical and psychosocial domains, and the overall SAQOL-39 g scores showed no significant change. As hypothesized, SWLS scores remained unchanged. A total of 57 technical issues occurred in 152 sessions, primarily due to connection problems. While all participants attended every individual session, four participants missed one or two group sessions, primarily due to technical or scheduling challenges.Discussion TELE-narraktiv was feasible in an online setting and improved communicative quality of life. However, broader effects on quality of life would require more time as reflective processes develop gradually and are not immediately observable. Reduced session length may also have limited the scope for broader effects. Future work should examine dosage and non-specific influencing factors, such as digital therapeutic alliance.Conclusions This study shows that biographic‑narrative work can be delivered remotely with positive outcomes for PWA. Future research should examine non‑specific factors such as therapeutic alliance, group cohesion, and the use of multimodal aids to identify how biographic‑narrative interventions can be most effectively applied in teletherapy.

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