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Review
. 2025 Mar;47(5):1081-1099.
doi: 10.1080/09638288.2024.2367606. Epub 2024 Jun 19.

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

Rianne Brinkman  1   2   3 , Karin Neijenhuis  1 , Mieke Cardol  1 , Carlo Leget  2
Affiliations
Review

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

Rianne Brinkman et al. Disabil Rehabil. 2025 Mar.

Abstract

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.

Keywords: Stroke; aphasia; communication; healthcare professionals; identity; narrative.

Plain language summary

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.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Image of the selection process of publications included via scientific databases in a scoping review on identity changes in people with aphasia. Initially, 492 records were identified in the databases. Eventually, 20 reports were included in the review.
Figure 1.
Number of publications included in each step of the review. Based on the PRISMA 2020 flow diagram [37].
Image of the sequence of discussion of theory in studies on identity changes of people with aphasia. It begins with how life changes after post-stroke aphasia and the relationship between identity formation and storytelling. Then is discussed how language disorders affect identity formation, ending with how people with aphasia integrate identity changes in their lives.
Figure 2.
Step-by-step introduction of theory of the concept of identity in the reports.
Image of the different dimensions of the “Narrative Identity Model” and how they interact. This model visualizes the personal dimensions (the bottom of the model) and the social dimensions (the top of the model). Narrative identity is symbolized by the head with interconnected gears in the middle of the model and becomes visible at the crossroads of the personal and social dimensions.
Figure 3.
The “Narrative Identity Model.”
Image of the “Narrative Identity Model” filled in with the various sub-themes emerging from a thematic analysis of the literature on identity changes of people with aphasia.
Figure 4.
The sub-themes incorporated in the “Narrative Identity Model.”
See this image and copyright information in PMC

References

    1. Berns PEG, Jünger N, Boxum E, et al. . Logopedische richtlijn ‘Diagnostiek en behandeling van afasie bij volwassenen’ [Speech pathology guideline ‘Diagnosis and treatment of aphasia in adults’]. Woerden: Ned Ver Logopedie Foniatrie; 2015. Dutch.
    1. Strong K, Shadden BB.. The power of story in identity renegotiation: clinical approaches to supporting persons living with aphasia. Perspect ASHA Special Interest Gr. 2020;5:371–383.
    1. Burr V. Social constructionism. New York (NY): Routledge; 2015.
    1. Ricoeur P. Oneself as another. Kathleen Blamey, Trans. Chigago (IL): University of Chicago Press; 1992.
    1. Ganzevoort R. Narratieve benaderingen in de praktische theologie [Narrative approaches in practical theology]. Tijdschr Humanis. 2011;12(47):61–70. Dutch.

Grants and funding

This work was supported by the Dutch Research Council (NWO) [grant number 023.079.074].

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