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Brittlebank S, Light JC, Pope L. A scoping review of AAC interventions for children and young adults with simultaneous visual and motor impairments: Clinical and research Implications. Augment Altern Commun 2024; 40:219-237. [PMID: 38578299 DOI: 10.1080/07434618.2024.2327044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 01/23/2024] [Accepted: 02/29/2024] [Indexed: 04/06/2024] Open
Abstract
Individuals with multiple disabilities are among the most challenging to serve and AAC teams often lack direction in determining effective interventions. The purpose of this scoping review was to summarize the research evidence on AAC interventions for individuals with complex communication needs and simultaneous motor, and visual impairments as part of their multiple disabilities; to consider implications for practice; and to determine gaps and directions for future research. A total of 27 studies were identified and reviewed, involving 55 unique participants with multiple disabilities. Most studies focused on direct intervention to increase requesting or choice-making, with little focus on social communication. Only two studies focused on training communication partners. Results indicated that AAC interventions can be highly effective to increase communication for individuals with multiple disabilities. However, there is an urgent need for increased rigor and more detailed participant information in future AAC intervention research with this population. Future research should investigate AAC intervention to improve social communication and increase language development, not just expression of needs and wants. Future research should focus on the needs of individuals with multiple disabilities from culturally and linguistically diverse backgrounds and on implementation of AAC within natural environments.
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Affiliation(s)
- Savanna Brittlebank
- Communication Sciences and Disorders, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Janice C Light
- Communication Sciences and Disorders, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Lauramarie Pope
- Speech, Language and Hearing Sciences, Auburn University, Auburn, Alabama, USA
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LaValley M, Chavers-Edgar T, Wu M, Schlosser R, Koul R. Augmentative and Alternative Communication Interventions in Critical and Acute Care With Mechanically Ventilated and Tracheostomy Patients: A Scoping Review. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-20. [PMID: 39146218 DOI: 10.1044/2024_ajslp-23-00310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
PURPOSE Communication with nonspeaking patients is a critical challenge of person-centered care. This scoping review aimed to map the literature on augmentative and alternative communication (AAC) interventions for nonspeaking mechanically ventilated and tracheostomy patients in critical and acute care settings. METHOD Electronic database, ancestry, and forward citation searches were conducted using eligibility criteria established a priori. Data were extracted, synthesized, and summarized according to scoping review methodology. Studies were categorized by type of intervention and summarized in terms of purpose, participants, design, quality appraisal (including validity and reliability of selected efficacy measures), and efficacy. RESULTS Small-to-large treatment effect sizes indicated demonstrable impact on patient health and communication efficacy with high-tech and no-tech visual interface-based interventions and systematic nurse training interventions. Treatment effects primarily pertained to dependent variables of patient anxiety, communication satisfaction, comfort, symptom self-reporting, and nursing practice changes. CONCLUSIONS There is a paucity of high-quality AAC intervention research for mechanically ventilated and tracheostomy patients in critical and acute care settings. Emergent evidence suggests that select visual interface and nurse training interventions can impact efficacy of patient-provider communication and patients' overall health. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.26506102.
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Affiliation(s)
- Mimi LaValley
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin
| | | | - Mengxuan Wu
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin
| | - Ralf Schlosser
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, MA
| | - Rajinder Koul
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa
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Difazio RL, Strout TD, Dorste A, Berry JG, Vessey JA. Tools used to measure the impact of comorbidities on surgical outcomes in children with complex chronic conditions: A scoping review. Dev Med Child Neurol 2024. [PMID: 38679854 DOI: 10.1111/dmcn.15943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/13/2024] [Accepted: 03/21/2024] [Indexed: 05/01/2024]
Abstract
AIM To identify and describe assessment tools used to measure the impact of comorbidities on postoperative outcomes in children with complex chronic conditions (CCC). METHOD This was a scoping review using five electronic databases. The search was conducted in March 2022 by a medical librarian. There were no date or language restrictions. Included studies were full-text articles published in peer-reviewed journals that described a tool used to measure the impact of comorbidities in children with CCC to assess postoperative outcomes. A standardized data charting tool was used. RESULTS A total of 2157 articles were retrieved. Five studies reporting on six comorbidity measures met inclusion criteria. All were cohort studies and were secondary analyses of data from an administrative database (n = 4) or a patient registry (n = 1). Sample sizes ranged from 645 to 25 747 participants. One paper described the assessment of reliability. Only one form of validity - predictive validity - was assessed in three papers for five measures. INTERPRETATION Findings from this scoping review revealed a paucity of comorbidity assessment tools validated for use with children with CCC; significant conceptual and measurement challenges exist in the current scientific literature.
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Affiliation(s)
- Rachel L Difazio
- Department of Orthopedic Surgery and Sports Medicine, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Harvard University, Boston, MA, USA
| | - Tania D Strout
- Department of Emergency Medicine, Maine Medical Center, Portland, ME, USA
- Tufts University School of Medicine, Boston, MA, USA
| | - Anna Dorste
- Medical Library, Boston Children's Hospital, Boston, MA, USA
| | - Jay G Berry
- Harvard Medical School, Harvard University, Boston, MA, USA
- Complex Care, Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Judith A Vessey
- Medical, Surgical, and Behavioral Health Nursing Programs, Boston Children's Hospital, Boston, MA, USA
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Chavers TN, Schlosser RW, Cheng C, Koul R. Effects of Interventions Involving Speech Output Technologies on Communication Outcomes for Individuals With Developmental Disabilities: A Scoping Review. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2248-2267. [PMID: 35969850 DOI: 10.1044/2022_ajslp-22-00039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE This scoping review aimed to map the literature on the effects of interventions involving speech output technologies on communication outcomes for individuals with developmental disabilities other than autism spectrum disorder. METHOD A scoping review methodology was used to limit bias in searching, selecting, coding, and synthesizing relevant intervention studies. This involved a multifaceted search for studies conducted between 1991 and March 2021 using various electronic databases, ancestry searches, and forward citation searches from selected articles. Studies had to meet stringent inclusion criteria. Each study was summarized in terms of authors, purpose, participants, design, speech output, outcomes, effectiveness, and quality appraisal. RESULTS Twenty-five single-case experimental design studies (88 participants) and one group design studies (62 participants) qualified for inclusion. Most of the participants had multiple diagnoses followed by a diagnosis of cerebral palsy and Down syndrome. Most studies focused on requesting behaviors and to a much lesser extent on syntactic structure and word identification. A dearth of high-quality studies was identified. CONCLUSIONS Overall, there is a paucity of high-quality research investigating the effects of speech output technologies for children with developmental disabilities. Additionally, several directions for future research are posited. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.20468928.
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Affiliation(s)
- Tiffany N Chavers
- Department of Speech, Hearing, and Language Sciences, The University of Texas at Austin
| | - Ralf W Schlosser
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, MA
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa
| | - Cissy Cheng
- Department of Speech, Hearing, and Language Sciences, The University of Texas at Austin
| | - Rajinder Koul
- Department of Speech, Hearing, and Language Sciences, The University of Texas at Austin
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa
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Fennell K. Conceptualisations of Leadership and Relevance to Health and Human Service Workforce Development: A Scoping Review. J Multidiscip Healthc 2021; 14:3035-3051. [PMID: 34737575 PMCID: PMC8558050 DOI: 10.2147/jmdh.s329628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/13/2021] [Indexed: 12/24/2022] Open
Abstract
PURPOSE This scoping review was undertaken to determine leadership definitions and approaches relevant to health and human service (H&HS) workforce development. This review provides a preliminary analysis of the potential size and scope of available research literature to inform ongoing research with the ultimate aim to inform a future systematic review in relation to leadership development interventions. METHODS Following the methodology proposed by Arksey and O'Malley and using PRISMA-ScR, a systematic search was conducted using seven databases (PubMed, Health Business Elite, Medline, CINAHL, Ovid, Scopus, and Web of Science). Articles were screened and assessed for eligibility. From eligible studies, data were extracted to summarize, collate, and make a narrative account of the findings. RESULTS Employing pre-selected criteria, a total of 424 records were identified and 171 full-text articles were assessed. The majority of the papers were studies undertaken by researchers based in North America. Leadership in the H&HS sector was addressed in 35% of the articles. The narrow disciplinary or workforce fields of the nursing and medical professions in hospitals and acute care settings dominated the literature. CONCLUSION The findings suggest that while leadership has been studied extensively in the health system, there is a paucity of leadership development research specific to the broader H&HS sector. This review emphasises the need for further research, including a more critical examination of leadership development interventions and their application to the H&HS sector.
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Affiliation(s)
- Kate Fennell
- Health and Human Services Leadership, University of Tasmania, Tasmanian School of Medicine, College of Health and Medicine, Medical Science Precinct, Hobart, Tasmania, 7000, Australia
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Abstract
INTRODUCTION Phenylketonuria (PKU) is a disorder of protein metabolism resulting in an accumulation of phenylalanine in the body. Dietary management consists of altering the sources of ingested protein to limit phenylalanine intake. Current dietary protein guidelines for PKU are based on limited scientific evidence, thus it remains unclear whether current practice leads to optimal protein status in people with PKU. To date, no attempt has been made to systematically evaluate the protein status of people with PKU, using a combination of validated anthropometric, biochemical and functional measurement tools. Furthermore, factors known to influence protein status in the general population warrant consideration when determining protein status in individuals with PKU, alongside factors unique to PKU such as the type of protein substitute consumed. Understanding the impact of these variables on protein status is crucial to developing a personalised approach to protein recommendations for optimising health and functional outcomes in people with PKU. Therefore, the aim of this scoping review is to examine existing evidence regarding the protein status of people with PKU, and to investigate the nutritional and lifestyle variables that influence protein status. METHODS AND ANALYSIS This review will be guided by Arksey and O'Malley's framework, along with guidance from Levac et al, Pawliuk et al and the Joanna Briggs Institute. The following databases will be searched: MEDLINE (Ovid), Embase, CENTRAL, Web of Science and Scopus, alongside grey literature. Identified literature will be assessed by two independent reviewers for inclusion. Descriptive numerical analysis will be performed and a narrative summary will accompany the tabulated results describing how study findings relate to the review questions. ETHICS AND DISSEMINATION This review protocol does not require ethical approval. Findings will be disseminated through peer-reviewed publication, presented at relevant conferences, and shared with a patient research advisory group to inform discussions on future research.
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Affiliation(s)
- Sarah Firman
- Department of Nutritional Sciences, King's College London, London, UK
- Adult Inherited Metabolic Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Radha Ramachandran
- Adult Inherited Metabolic Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Kevin Whelan
- Department of Nutritional Sciences, King's College London, London, UK
| | - Oliver C Witard
- Department of Nutritional Sciences, King's College London, London, UK
- Centre for Human and Applied Physiological Sciences, King's College London, London, UK
| | - Majella O'Keeffe
- Department of Nutritional Sciences, King's College London, London, UK
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
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Shojaie D, Hoffman AS, Amaku R, Cabanillas ME, Sosa JA, Waguespack SG, Zafereo ME, Hu MI, Grubbs EE. Decision Making When Cancer Becomes Chronic: Needs Assessment for a Web-Based Medullary Thyroid Carcinoma Patient Decision Aid. JMIR Form Res 2021; 5:e27484. [PMID: 34269691 PMCID: PMC8325074 DOI: 10.2196/27484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/08/2021] [Accepted: 04/13/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND In cancers with a chronic phase, patients and family caregivers face difficult decisions such as whether to start a novel therapy, whether to enroll in a clinical trial, and when to stop treatment. These decisions are complex, require an understanding of uncertainty, and necessitate the consideration of patients' informed preferences. For some cancers, such as medullary thyroid carcinoma, these decisions may also involve significant out-of-pocket costs and effects on family members. Providers have expressed a need for web-based interventions that can be delivered between consultations to provide education and prepare patients and families to discuss these decisions. To ensure that these tools are effective, usable, and understandable, studies are needed to identify patients', families', and providers' decision-making needs and optimal design strategies for a web-based patient decision aid. OBJECTIVE Following the international guidelines for the development of a web-based patient decision aid, the objectives of this study are to engage potential users to guide development; review the existing literature and available tools; assess users' decision-making experiences, needs, and design recommendations; and identify shared decision-making approaches to address each need. METHODS This study used the decisional needs assessment approach, which included creating a stakeholder advisory panel, mapping decision pathways, conducting an environmental scan of existing materials, and administering a decisional needs assessment questionnaire. Thematic analyses identified current decision-making pathways, unmet decision-making needs, and decision support strategies for meeting each need. RESULTS The stakeholders reported wide heterogeneity in decision timing and pathways. Relevant existing materials included 2 systematic reviews, 9 additional papers, and multiple educational websites, but none of these met the criteria for a patient decision aid. Patients and family members (n=54) emphasized the need for plain language (46/54, 85%), shared decision making (45/54, 83%), and help with family discussions (39/54, 72%). Additional needs included information about uncertainty, lived experience, and costs. Providers (n=10) reported needing interventions that address misinformation (9/10, 90%), foster realistic expectations (9/10, 90%), and address mistrust in clinical trials (5/10, 50%). Additional needs included provider tools that support shared decision making. Both groups recommended designing a web-based patient decision aid that can be tailored to (64/64, 100%) and delivered on a hospital website (53/64, 83%), focuses on quality of life (45/64, 70%), and provides step-by-step guidance (43/64, 67%). The study team identified best practices to meet each need, which are presented in the proposed decision support design guide. CONCLUSIONS Patients, families, and providers report multifaceted decision support needs during the chronic phase of cancer. Web-based patient decision aids that provide tailored support over time and explicitly address uncertainty, quality of life, realistic expectations, and effects on families are needed.
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Affiliation(s)
- Danielle Shojaie
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Aubri S Hoffman
- Department of Gynecological Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Ruth Amaku
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Maria E Cabanillas
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Julie Ann Sosa
- Department of Surgery, University of California San Francisco, San Francisco, CA, United States
| | - Steven G Waguespack
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Mark E Zafereo
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Mimi I Hu
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Elizabeth E Grubbs
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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