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Zingelman S, Cadilhac DA, Kim J, Stone M, Harvey S, Unsworth C, O'Halloran R, Hersh D, Mainstone K, Wallace SJ. 'A Meaningful Difference, but Not Ultimately the Difference I Would Want': A Mixed-Methods Approach to Explore and Benchmark Clinically Meaningful Changes in Aphasia Recovery. Health Expect 2024; 27:e14169. [PMID: 39105687 DOI: 10.1111/hex.14169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 07/07/2024] [Accepted: 07/20/2024] [Indexed: 08/07/2024] Open
Abstract
INTRODUCTION Outcome measurement instruments (OMIs) are used to gauge the effects of treatment. In post-stroke aphasia rehabilitation, benchmarks for meaningful change are needed to support the interpretation of patient outcomes. This study is part of a research programme to establish minimal important change (MIC) values (the smallest change above which patients perceive themselves as importantly changed) for core OMIs. As a first step in this process, the views of people with aphasia and clinicians were explored, and consensus was sought on a threshold for clinically meaningful change. METHODS Sequential mixed-methods design was employed. Participants included people with post-stroke aphasia and speech pathologists. People with aphasia were purposively sampled based on time post-stroke, age and gender, whereas speech pathologists were sampled according to their work setting (hospital or community). Each participant attended a focus group followed by a consensus workshop with a survey component. Within the focus groups, experiences and methods for measuring meaningful change during aphasia recovery were explored. Qualitative data were transcribed and analysed using reflexive thematic analysis. In the consensus workshop, participants voted on thresholds for meaningful change in core outcome constructs of language, communication, emotional well-being and quality of life, using a six-point rating scale (much worse, slightly worse, no change, slightly improved, much improved and completely recovered). Consensus was defined a priori as 70% agreement. Voting results were reported using descriptive statistics. RESULTS Five people with aphasia (n = 4, > 6 months after stroke; n = 5, < 65 years; n = 3, males) and eight speech pathologists (n = 4, hospital setting; n = 4, community setting) participated in one of four focus groups (duration: 92-112 min). Four themes were identified describing meaningful change as follows: (1) different for every single person; (2) small continuous improvements; (3) measured by progress towards personally relevant goals; and (4) influenced by personal factors. 'Slightly improved' was agreed as the threshold of MIC on the anchor-rating scale (75%-92%) within 6 months of stroke, whereas after 6 months there was a trend towards supporting 'much improved' (36%-66%). CONCLUSION Our mixed-methods research with people with aphasia and speech pathologists provides novel evidence to inform the definition of MIC in aphasia rehabilitation. Future research will aim to establish MIC values for core OMIs. PATIENT OR PUBLIC CONTRIBUTION This work is the result of engagement between people with lived experience of post-stroke aphasia, including people with aphasia, family members, clinicians and researchers. Engagement across the research cycle was sought to ensure that the research tasks were acceptable and easily understood by participants and that the outcomes of the study were relevant to the aphasia community. This engagement included the co-development of a plain English summary of the results. Advisors were remunerated in accordance with Health Consumers Queensland guidelines. Interview guides for clinicians were piloted by speech pathologists working in aphasia rehabilitation.
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Affiliation(s)
- Sally Zingelman
- School of Health and Rehabilitation Sciences, Queensland Aphasia Research Centre, The University of Queensland, St Lucia, Queensland, Australia
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Herston, Queensland, Australia
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
| | - Dominique A Cadilhac
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
| | - Joosup Kim
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
| | - Marissa Stone
- School of Health and Rehabilitation Sciences, Queensland Aphasia Research Centre, The University of Queensland, St Lucia, Queensland, Australia
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Herston, Queensland, Australia
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
- St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - Sam Harvey
- School of Health and Rehabilitation Sciences, Queensland Aphasia Research Centre, The University of Queensland, St Lucia, Queensland, Australia
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Herston, Queensland, Australia
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
| | - Carolyn Unsworth
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Institute of Health and Wellbeing, Federation University, Ballarat, Victoria, Australia
| | - Robyn O'Halloran
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
- St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
- Discipline of Speech Pathology, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Deborah Hersh
- Speech Pathology, Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
- School of Allied Health Science and Practice, University of Adelaide, Adelaide, South Australia, Australia
| | - Kathryn Mainstone
- School of Health and Rehabilitation Sciences, Queensland Aphasia Research Centre, The University of Queensland, St Lucia, Queensland, Australia
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Herston, Queensland, Australia
| | - Sarah J Wallace
- School of Health and Rehabilitation Sciences, Queensland Aphasia Research Centre, The University of Queensland, St Lucia, Queensland, Australia
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Herston, Queensland, Australia
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
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Dipper L, Devane N, Barnard R, Botting N, Boyle M, Cockayne L, Hersh D, Magdalani C, Marshall J, Swinburn K, Cruice M. A feasibility randomised waitlist-controlled trial of a personalised multi-level language treatment for people with aphasia: The remote LUNA study. PLoS One 2024; 19:e0304385. [PMID: 38875279 PMCID: PMC11178191 DOI: 10.1371/journal.pone.0304385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 05/10/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Stroke survivors with aphasia want to improve their everyday talking (discourse). In current UK practice, 90% of speech and language therapists believe discourse assessment and treatment is part of their role but are hampered by barriers in resources, time and expertise. There is a clinical need for well-articulated discourse assessment and treatments. LUNA is a multi-level treatment targeting words, sentences and discourse macrostructure in personal stories that addresses this clinical need. OBJECTIVES This study aimed to assess the feasibility and acceptability of LUNA trial procedures in a randomised waitlist-controlled trial; and to evaluate preliminary efficacy. METHODS This paper reports a phase II, waitlist-controlled, proof-of-concept feasibility trial. Participants with chronic aphasia (n = 28) were recruited from the community and randomised to an Immediate (n = 14) or Delayed (n = 14) group. LUNA treatment was delivered twice weekly for 10 weeks via the videoconferencing technology, Zoom. Feasibility was assessed in terms of participant recruitment and retention, adherence, missing data, and treatment fidelity. Preliminary treatment efficacy was assessed in terms of between group differences in outcome measures relating to discourse, language, and psychosocial state. RESULTS The remote LUNA trial was feasible: 85% of those eligible consented to the trial; trial retention was 86%; 87% of treatment sessions were delivered as scheduled, and 79% of participants completed 80%+ of the treatment programme; data was missing only for participants who withdrew; treatment fidelity was high at 92% adherence; and only one clinical outcome measure demonstrated ceiling effects. ANCOVA analysis of the clinical outcome measures revealed group differences with medium and large effect sizes, indicating, improvements in the production of words, sentences, discourse macrostructure, overall language functioning (WAB-R), and psychosocial state (VAMS) following LUNA treatment. For most outcomes measured, similar treatment benefits were suggested in a secondary, non-parametric analysis. CONCLUSIONS Large-scale evaluation of the clinical efficacy and cost-effectiveness of LUNA is warranted and supported by these findings. TRIAL REGISTRATION Clinical trials registration: NCT05847023 (clinical trials.gov).
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Affiliation(s)
- Lucy Dipper
- Department of Language and Communication Science, School of Health and Psychological Sciences, City, University of London, London, United Kingdom
| | - Niamh Devane
- Department of Language and Communication Science, School of Health and Psychological Sciences, City, University of London, London, United Kingdom
| | - Rachel Barnard
- Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Nicola Botting
- Department of Language and Communication Science, School of Health and Psychological Sciences, City, University of London, London, United Kingdom
| | - Mary Boyle
- Montclair State University, Montclair, New Jersey, United States of America
| | - Lin Cockayne
- Department of Language and Communication Science, School of Health and Psychological Sciences, City, University of London, London, United Kingdom
| | - Deborah Hersh
- Curtin School of Allied Health and EnAble Institute, Curtin University, Perth, Australia
| | - Carla Magdalani
- Department of Language and Communication Science, School of Health and Psychological Sciences, City, University of London, London, United Kingdom
| | - Jane Marshall
- Department of Language and Communication Science, School of Health and Psychological Sciences, City, University of London, London, United Kingdom
| | - Kate Swinburn
- Department of Language and Communication Science, School of Health and Psychological Sciences, City, University of London, London, United Kingdom
| | - Madeline Cruice
- Department of Language and Communication Science, School of Health and Psychological Sciences, City, University of London, London, United Kingdom
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Shand R, Foster A, Baker C, O'Halloran R. Identifying communication difficulty and context-specific communication supports for patient-provider communication in a sub-acute setting: A prospective mixed methods study. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-20. [PMID: 38425157 DOI: 10.1080/17549507.2023.2289350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
PURPOSE To identify the sub-acute rehabilitation inpatients who have communication difficulty and the range of communication supports that can facilitate communicative success. METHOD A prospective cohort mixed methods study was conducted on two inpatient sub-acute rehabilitation wards. Nurses screened all new admissions for communication difficulty using the Inpatient Functional Communication Interview, Screening Questionnaire (IFCI-SQ). Patients identified as having communication difficulty were interviewed by a speech-language pathologist (SLP) using the Inpatient Functional Communication Interview (IFCI). During the interview, the SLP trialled different communication supports. The number of patients who had communication difficulty on the IFCI-SQ was calculated. The number and type of communication supports that improved communication within the patient-SLP interview were calculated. Deductive-dominant qualitative content analysis was conducted on the communication supports used during the IFCI. RESULT Seventy patients were screened. Nurses reported communication difficulty in 45/70 (64%) of patients. A total of 15/45 patients were interviewed by an SLP using the IFCI. The provision of communication supports improved communication for all patients within the context of the patient-SLP interview. CONCLUSION Many sub-acute rehabilitation inpatients have communication difficulty in the hospital setting. A range of communication supports facilitated communication. These insights could inform future communication partner training (CPT) programs.
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Affiliation(s)
- Rosalind Shand
- Monash Health, Melbourne, Australia
- Discipline of Speech Pathology, La Trobe University, Melbourne, Australia
| | - Abby Foster
- Monash Health, Melbourne, Australia
- Discipline of Speech Pathology, La Trobe University, Melbourne, Australia
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - Caroline Baker
- Monash Health, Melbourne, Australia
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
| | - Robyn O'Halloran
- Discipline of Speech Pathology, La Trobe University, Melbourne, Australia
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
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Cook CV, Pompon RH. Lessons on Health Literacy and Communication in Post-Stroke Rehabilitation:: A Primer and Proposal. Dela J Public Health 2023; 9:44-49. [PMID: 37701478 PMCID: PMC10494792 DOI: 10.32481/djph.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023] Open
Abstract
Health literacy, or the ability to find, understand, and use information to make well-informed health decisions, has been linked to post-stroke rehabilitation outcomes. Importantly, barriers to health literacy stem from stroke survivor characteristics, clinician practices, institutional norms, as well as systemic variables. These barriers impact recovery and rehabilitation outcomes. To address these obstacles, clinicians can learn from the evidence-based practices used by speech-language pathologists in their work with stroke survivors with aphasia, a language impairment that can follow stroke. These methods to overcome communication barriers are appropriate and recommended for patients and family members regardless of stroke impairment, and include a transdisciplinary care model, multimodal approaches to patient education, along with consistent engagement with patients and their care partners. These strategies may be adopted for both personal and organizational health literacy efforts and help optimize the rehabilitation and recovery outcomes of stroke survivors with and without aphasia.
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5
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Goodman C, Lambert K. Scoping review of the preferences of older adults for patient education materials. PATIENT EDUCATION AND COUNSELING 2023; 108:107591. [PMID: 36584555 DOI: 10.1016/j.pec.2022.107591] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/04/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To provide an overview of studies that describe the preferred mode and format of delivery of patient education materials to older adults. METHODS A scoping review was used to identify relevant literature published between January 2010 and June 2021, with specific attention given to studies conducted in high income countries with similar health systems. RESULTS A total of 3245 titles were identified, and 20 met the inclusion criteria and were included in this scoping review. Older adults preferred written information that could be accessed via health professionals or downloaded online. Other key features were identified including logical layout, signposted information, larger text size, labelled visual aids, and use of images appropriate and relevant to the target group were preferred. Audio visual resources were also considered valuable when well designed. Formats for patient education such as apps, group classes and online courses were less popular with older adults. CONCLUSIONS Patient education materials for older adults should be carefully designed, with attention to layout and content. Older adults indicated a preference for hard copy handouts or in a format that can be downloaded. PRACTICE IMPLICATIONS Regular engagement with older consumers about their preferences is important as technology for delivery of patient education materials evolve. Key features for specific attention during the design process include a logical layout (tested with consumers), signposted information, text size, labelled visual aids and appropriate images. The perspectives of other key groups of older adults such as those from minority populations or other disadvantaged groups are largely unexplored.
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Affiliation(s)
- Claudia Goodman
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia.
| | - Kelly Lambert
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia.
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Ahmadzadeh K, Bahrami M, Zare-Farashbandi F, Adibi P, Boroumand MA, Rahimi A. Patient education information material assessment criteria: A scoping review. Health Info Libr J 2023; 40:3-28. [PMID: 36637218 DOI: 10.1111/hir.12467] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 10/13/2022] [Accepted: 11/03/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Patient education information material (PEIM) is an essential component of patient education programs in increasing patients' ability to cope with their diseases. Therefore, it is essential to consider the criteria that will be used to prepare and evaluate these resources. OBJECTIVE This paper aims to identify these criteria and recognize the tools or methods used to evaluate them. METHODS National and international databases and indexing banks, including PubMed, Scopus, Web of Science, ProQuest, the Cochrane Library, Magiran, SID and ISC, were searched for this review. Original or review articles, theses, short surveys, and conference papers published between January 1990 and June 2022 were included. RESULTS Overall, 4688 documents were retrieved, of which 298 documents met the inclusion criteria. The criteria were grouped into 24 overarching criteria. The most frequently used criteria were readability, quality, suitability, comprehensibility and understandability. CONCLUSION This review has provided empirical evidence to identify criteria, tools, techniques or methods for developing or evaluating a PEIM. The authors suggest that developing a comprehensive tool based on these findings is critical for evaluating the overall efficiency of PEIM using effective criteria.
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Affiliation(s)
- Khadijeh Ahmadzadeh
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Student Research Commitee, Sirjan School of Medical Sciences, Sirjan, Iran
| | - Masoud Bahrami
- Department of Adult Health Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firoozeh Zare-Farashbandi
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Payman Adibi
- Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Ali Boroumand
- Department of Medical Library and Information Sciences, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Rahimi
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Beauchamp JES, Sharrief A, Chaoul A, Casameni Montiel T, Love MF, Cron S, Prossin A, Selvaraj S, Dishman D, Savitz SI. Feasibility of a meditation intervention for stroke survivors and informal caregivers: a randomized controlled trial. BMC Psychol 2023; 11:9. [PMID: 36635775 PMCID: PMC9838004 DOI: 10.1186/s40359-022-01031-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 12/23/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Depressive symptoms are a significant psychological complication of stroke, impacting both survivors and informal caregivers of survivors. Randomized controlled trials are needed to determine optimal non-pharmacological strategies to prevent or ameliorate depressive symptoms in stroke survivors and their informal caregivers. METHODS A prospective, randomized, parallel-group, single-center, feasibility study. Participants were assigned to a 4-week meditation intervention or expressive writing control group. The intervention comprised four facilitator-led group meditation sessions, one session per week and building upon prior session(s). Descriptive statistics were used to examine the proportion of eligible individuals who enrolled, retention and adherence rates, and the proportion of questionnaires completed. Data were collected at baseline, immediately after the 4-week intervention period, and 4 and 8 weeks after the intervention period. Secondary analysis tested for changes in symptoms of depression (Center for Epidemiologic Studies-Depression [CES-D]), anxiety [State-Trait Anxiety Inventory for Adults (STAI)], and pain (Brief Pain Inventory-Short Form) in the intervention group via paired t tests. Linear mixed models were used to compare longitudinal changes in the measures between the groups. Intervention and trial design acceptability were preliminary explored. RESULTS Seventy-one (77%) individuals enrolled and 26 (37%) completed the study (baseline and 8-week post-intervention visits completed). Forty-two (66%) participants completed baseline and immediate post-intervention visits. Mean questionnaire completion rate was 95%. The median meditation group session attendance rate for the intervention group was 75.0%, and the mean attendance rate was 55%. Non-significant reductions in CES-D scores were found. Paired t tests for stroke survivors indicated a significant reduction from baseline through week 8 in BPI-sf severity scores (p = 0.0270). Repeated measures analysis with linear mixed models for informal caregivers indicated a significant reduction in in STAI-Trait scores (F [3,16.2] = 3.28, p = 0.0479) and paired t test showed a significant reduction from baseline to week 4 in STAI-Trait scores (mean = - 9.1250, 95% CI [- 16.8060 to 1.4440], p = 0.0262). No between-group differences were found. CONCLUSIONS Future trials will require strategies to optimize retention and adherence before definitive efficacy testing of the meditation intervention. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03239132. Registration date: 03/08/2017.
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Affiliation(s)
- Jennifer E. S. Beauchamp
- grid.267308.80000 0000 9206 2401Cizik School of Nursing Department of Research and the Institute for Stroke and Cerebrovascular Disease, University of Texas Health Science Center at Houston, 6901 Bertner Avenue, Suite 580D, Houston, TX 77030 USA
| | - Anjail Sharrief
- grid.267308.80000 0000 9206 2401McGovern Medical School Department of Neurology and the Institute for Stroke and Cerebrovascular Disease, The University of Texas Health Science Center at Houston, 6410 Fannin St, Suite 1014, Houston, TX 77030 USA
| | - Alejandro Chaoul
- Mind Body Spirit Institute, The Jung Center of Houston, 5200 Montrose Ave., Houston, TX 77006 USA
| | - Tahani Casameni Montiel
- grid.267308.80000 0000 9206 2401Cizik School of Nursing Department of Research, The University of Texas Health Science Center at Houston, 6901 Bertner Avenue, Suite 582, Houston, TX 77030 USA
| | - Mary F. Love
- grid.266436.30000 0004 1569 9707College of Nursing, University of Houston, 14000 University Boulevard, #367G, Sugar Land, Houston, TX 77479 USA
| | - Stanley Cron
- grid.267308.80000 0000 9206 2401Cizik School of Nursing, University of Texas Health Science Center at Houston, 6901 Bertner Avenue, Suite SON 561, Houston, TX 77030 USA
| | - Alan Prossin
- grid.267308.80000 0000 9206 2401McGovern Medical School Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Road, Suite BBS 2310, Houston, TX 77054 USA
| | - Sudhakar Selvaraj
- grid.267308.80000 0000 9206 2401Louis Faillace Department of Psychiatry and Behavioral Science, McGovern Medical School, The University of Texas Health Science Center at Houston, 1941 East Road, Suite BBS 3152, Houston, TX 77054 USA
| | - Deniz Dishman
- grid.267308.80000 0000 9206 2401Cizik School of Nursing Department of Research, The University of Texas Health Science Center at Houston, 6901 Bertner Avenue, Suite SON580C, Houston, TX 77030 USA
| | - Sean I. Savitz
- grid.267308.80000 0000 9206 2401McGovern Medical School Department of Neurology and the Institute for Stroke and Cerebrovascular Disease, The University of Texas Health Science Center at Houston, 6431 Fannin, Suite MSB-7.128, Houston, TX 77030-1503 USA
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Brown SE, Scobbie L, Worrall L, Mc Menamin R, Brady MC. Access G-AP: development of an accessible goal setting and action planning resource for stroke survivors with aphasia. Disabil Rehabil 2022:1-11. [PMID: 35695078 DOI: 10.1080/09638288.2022.2085331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Goal setting is key to stroke rehabilitation, but access for people with aphasia is challenging. Based on the Goal setting and Action Planning (G-AP) framework, we developed an accessible goal setting resource (Access G-AP). METHODS Access G-AP was designed using a three-phase, user-centred design process. Phase 1: Access G-AP Draft A was designed using evidence-based recommendations. Phase 2: Draft A was reviewed by stroke survivors with aphasia (focus groups 1&2) and rehabilitation staff (questionnaire). Phase 3: Suggested recommendations informed Access G-AP Draft B, which was further reviewed by stroke survivors with aphasia (focus group 3). The final version of Access G-AP was approved by stroke survivors with aphasia at a debrief meeting. Data were analysed using content analysis. RESULTS Recommended design improvements included reducing text, adding bullet points, and diversifying images. Both participant groups highlighted that Access G-AP should be used collaboratively to support stroke survivor involvement. Staff recommended Access G-AP training and additional resources to support stroke survivors with severe aphasia. CONCLUSIONS Access G-AP was co-developed to support people with aphasia to access and engage in stroke rehabilitation goal setting. Further research is required to establish the feasibility of Access G-AP in clinical practice.IMPLICATIONS FOR REHABILITATIONEvidence-based accessible formatting strategies and an iterative design process can inform the design of accessible goal setting resources.Accessible goal setting materials should be relevant to stroke survivors with aphasia and responsive to their needs.Rehabilitation staff require training and support to use accessible goal setting resources (like Access G-AP) with stroke survivors with aphasia, especially those with severe aphasia.Evaluation of the feasibility of Access G-AP in clinical practice is now required.
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Affiliation(s)
| | - Lesley Scobbie
- NMAHP Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Linda Worrall
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | | | - Marian C Brady
- NMAHP Research Unit, Glasgow Caledonian University, Glasgow, UK.,School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
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Cheng BBY, Ryan BJ, Copland DA, Wallace SJ. Prognostication in post-stroke aphasia: Perspectives of people with aphasia on receiving information about recovery. Neuropsychol Rehabil 2022; 33:871-902. [PMID: 35297737 DOI: 10.1080/09602011.2022.2051565] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Many people with aphasia (language impairment post-stroke) want to know their prognosis for recovery, yet current understanding of their experience of receiving prognoses is limited. Such insight is necessary to inform clinical practice in formulating and delivering aphasia prognoses, especially given the psycho-emotional distress and secondary adverse effects on recovery associated with conversations about prognosis. We sought an in-depth understanding of the perspectives of people with aphasia in relation to receiving prognoses post-stroke, with the aim of informing an evidence-based approach to aphasia prognostication in clinical practice. Semi-structured interviews, facilitated by communication support strategies, were conducted one-to-one with eight people with aphasia (ranging from mild to very severe) 3-12 months post-stroke. Reflexive thematic analysis was used to analyse the qualitative data, yielding two over-arching themes: (1) How would you know without knowing me?; (2) I need to know, but I don't want to know. Our findings illustrate issues of mistrust within the patient-clinician relationship, and complex emotions relating to hope and post-stroke adjustment. The present insight into the lived experience of receiving aphasia prognoses highlights the need for focused consideration of personal definitions of normalcy, measures for fostering trust, and the role of prognostic uncertainty.
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Affiliation(s)
- Bonnie B Y Cheng
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia.,Queensland Aphasia Research Centre, The University of Queensland, Herston, Australia
| | - Brooke J Ryan
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia.,Queensland Aphasia Research Centre, The University of Queensland, Herston, Australia.,NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Brisbane, Australia.,Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, Australia
| | - David A Copland
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia.,Queensland Aphasia Research Centre, The University of Queensland, Herston, Australia.,NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Brisbane, Australia
| | - Sarah J Wallace
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia.,Queensland Aphasia Research Centre, The University of Queensland, Herston, Australia.,NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Brisbane, Australia
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Grobler S, Casey S, Farrell E. Making information accessible for people with aphasia in healthcare. ADVANCES IN CLINICAL NEUROSCIENCE & REHABILITATION 2022. [DOI: 10.47795/wkdo3084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
People with aphasia are often unable to access healthcare due to difficulties understanding and using spoken and written language, which impacts every step of their healthcare journey and outcomes. This article argues that it is important to apply the principles of the NHS England Accessible Information Standards (2017) to people with aphasia so they can meet their health information needs and rights. The processes to enable people with aphasia to access and participate in spoken and written communication in healthcare and the methods for training and supporting healthcare staff need to be considered at an individual, service, and organisational level.
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Anemaat L, Palmer VJ, Copland DA, Mainstone K, Druery K, Druery J, Aisthorpe B, Binge G, Mainstone P, Wallace SJ. Using experience-based codesign to coproduce aphasia rehabilitation services: study protocol. BMJ Open 2021; 11:e047398. [PMID: 34794985 PMCID: PMC8603293 DOI: 10.1136/bmjopen-2020-047398] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Aphasia is an impairment of language that occurs in 30%-40% of stroke survivors. This often chronic condition results in poor outcomes for the individual with aphasia and their family. Long-term aphasia management is limited, with few people receiving sufficient services by 6-12 months postonset. We present a protocol for the development of coproduced aphasia service elements. We will use experience-based codesign (EBCD), an approach that enables service users and providers to collaboratively develop services and care pathways. Drawing on the experiences of people with aphasia, their families and clinicians we will establish priorities for the development of new services and later work together to codesign them. METHODS AND ANALYSIS This research will be coproduced with people with aphasia (n=30-60), their families (n=30-60) and speech pathologists (n=30-60) in Queensland, Australia, using EBCD. A consumer advisory committee will provide oversight and advice throughout the research. In phase 1, we will use semistructured interviews and the nominal group technique to explore experiences and unmet needs in aphasia rehabilitation. Data will be analysed using thematic analysis and the resulting themes will be prioritised in multistakeholder focus groups. Outcomes of phase 1 will inform future research (phase 2) to codesign services. Financial costs and participant experiences of EBCD will be measured. ETHICS AND DISSEMINATION Human Research Ethics Committee approval for phase 1 has been obtained (HREC/2020/QRBW/61368). Results will be reported in peer-reviewed journal articles, presented at relevant conferences and, following EBCD suggested best practice, fed back to participants and community members at a celebratory event at completion of the project. The inclusion of service users in all stages of research will facilitate an integrated approach to knowledge translation. A summary of research findings will be made available to participating sites.
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Affiliation(s)
- Lisa Anemaat
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
- Queensland Aphasia Research Centre, The University of Queensland, Herston, Queensland, Australia
| | - Victoria J Palmer
- The ALIVE National Centre for Mental Health Research Translation, The University of Melbourne, Melbourne, Victoria, Australia
| | - David A Copland
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
- Queensland Aphasia Research Centre, The University of Queensland, Herston, Queensland, Australia
| | - Kathryn Mainstone
- Queensland Aphasia Research Centre, The University of Queensland, Herston, Queensland, Australia
| | - Kent Druery
- Queensland Aphasia Research Centre, The University of Queensland, Herston, Queensland, Australia
| | - Julia Druery
- Queensland Aphasia Research Centre, The University of Queensland, Herston, Queensland, Australia
| | - Bruce Aisthorpe
- Queensland Aphasia Research Centre, The University of Queensland, Herston, Queensland, Australia
| | - Geoffrey Binge
- Queensland Aphasia Research Centre, The University of Queensland, Herston, Queensland, Australia
| | - Penelope Mainstone
- Queensland Aphasia Research Centre, The University of Queensland, Herston, Queensland, Australia
| | - Sarah J Wallace
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
- Queensland Aphasia Research Centre, The University of Queensland, Herston, Queensland, Australia
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12
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Cohen ML, Harnish SM, Lanzi AM, Brello J, Victorson D, Kisala PA, Nandakumar R, Tulsky DS. Adapting a Patient-Reported Outcome Bookmarking Task to be Accessible to Adults With Cognitive and Language Disorders. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4403-4412. [PMID: 34699261 DOI: 10.1044/2021_jslhr-21-00071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Background Patient-reported outcome (PRO) measures produce scores that do not always have obvious clinical meaning. The PRO-bookmarking procedure is a new and promising way to make PRO measures more meaningful and interpretable. However, the materials and procedures of the task may benefit from adaptations to be more accessible to individuals with cognitive and language disorders. Aims This study aims to provide an overview of the iterative refinement process used to modify the materials and procedures of the PRO-bookmarking task so that they are more accessible to adults with acquired cognitive and language impairments. Method and Procedures Our team of health psychologists, neuropsychologists, and speech-language pathologists (SLPs) conducted two focus groups with SLPs and care partners of people with aphasia using the same PRO-bookmarking materials and procedures as previous reports. These PRO-bookmarking materials and procedures were then refined iteratively based on discussion with those who participated in focus groups and among the research team, and three more times in the course of 16 additional focus groups of different stakeholders: people with Parkinson's disease, aphasia, or traumatic brain injury; care partners of people with those conditions; and SLPs who have experience with those, and other adult-acquired conditions. Outcomes and Results The PRO-bookmarking materials and procedures underwent four iterations to make them clearer, simpler, and more accessible. For example, the materials included more structured text and graphic supports where appropriate and the procedures were clustered into smaller discrete tasks and displayed graphically when possible and appropriate. Conclusions PRO-bookmarking materials and procedures were made simpler and more structured to increase their accessibility to adults with cognitive and language impairments. In fact, these adaptations made the tasks simpler and clearer for all types of stakeholders.
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Affiliation(s)
- Matthew L Cohen
- Department of Communication Sciences and Disorders, University of Delaware, Newark
- Center for Health Assessment Research and Translation, University of Delaware, Newark
| | - Stacy M Harnish
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - Alyssa M Lanzi
- Department of Communication Sciences and Disorders, University of Delaware, Newark
| | - Jennifer Brello
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - David Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Pamela A Kisala
- Center for Health Assessment Research and Translation, University of Delaware, Newark
| | | | - David S Tulsky
- Center for Health Assessment Research and Translation, University of Delaware, Newark
- Department of Physical Therapy, University of Delaware, Newark
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13
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Cohen ML, Lanzi A, Boulton AJ. Clinical Use of PROMIS, Neuro-QoL, TBI-QoL, and Other Patient-Reported Outcome Measures for Individual Adult Clients with Cognitive and Language Disorders. Semin Speech Lang 2021; 42:192-210. [PMID: 34261163 PMCID: PMC9297691 DOI: 10.1055/s-0041-1731365] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Patient-reported outcome measures (PROMs) assess health outcomes from the patient's perspective. The National Institutes of Health has invested in the creation of numerous PROMs that comprise the PROMIS, Neuro-QoL, and TBI-QoL measurement systems. Some of these PROMs are potentially useful as primary or secondary outcome measures, or as contextual variables for the treatment of adults with cognitive/language disorders. These PROMs were primarily created for clinical research and interpretation of group means. They also have potential for use with individual clients; however, at present there is only sparse evidence and direction for this application of PROMs. Previous research by Cohen and Hula (2020) described how PROMs could support evidence-based practices in speech-language pathology. This companion article extends upon that work to present clinicians with implementation information about obtaining, administering, scoring, and interpreting PROMs for individual clients with cognitive/language disorders. This includes considerations of the type and extent of communication support that is appropriate, implications of the relatively large measurement error that accompanies individual scores and pairs of scores, and recommendations for applying minimal detectable change values depending on the clinician's desired level of measurement precision. However, more research is needed to guide the interpretation of PROM scores for an individual client.
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Affiliation(s)
- Matthew L. Cohen
- Department of Communication Sciences & Disorders; University of Delaware; Newark, DE, USA
- Center for Health Assessment Research and Translation; University of Delaware; Newark, DE, USA
| | - Alyssa Lanzi
- Department of Communication Sciences & Disorders; University of Delaware; Newark, DE, USA
| | - Aaron J. Boulton
- Center for Health Assessment Research and Translation; University of Delaware; Newark, DE, USA
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14
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Baker A, Cornwell P, Gustafsson L, Lannin NA. An exploration of goal-setting practices in Queensland rehabilitation services. Disabil Rehabil 2021; 44:4368-4378. [PMID: 33961530 DOI: 10.1080/09638288.2021.1906957] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Goals are vital in rehabilitation; however, how goal-setting occurs varies widely in clinical practice. This study aims to review goal-setting practices across the rehabilitation continuum within varied case mix services in Queensland, Australia. METHOD A descriptive multisite qualitative case study with medical record audits and interviews of adult rehabilitation clients was used to evaluate four propositions across three inpatient and two community rehabilitation services. The propositions evaluated the process in which goal-setting occurs, action planning and review of goals, as well as the type, specificity and client-centeredness of goals set. RESULTS Goals (n = 1120) were often poorly defined, focussed on short term physical functioning and were predominantly set by individual disciplines with the client rather than using an interdisciplinary approach. Clients were not consistently given action plans to pursue goals (n = 59, 18%) and the review of goal progress (n = 60, 18%) was limited. Few clients reported receiving copies of their rehabilitation goals (n = 16, 25%). CONCLUSION Goal-setting in rehabilitation should be specific, meaningful and include the client in action planning, feedback and review. However, goal-setting in rehabilitation is often multidisciplinary and unstructured.Implications for rehabilitationBest-practice rehabilitation team goal-negotiation and goal-setting should include a common goal focus and incorporate components of staff and client action planning, coping planning, feedback and review.Rehabilitation clients prefer shared-decision making approaches to setting meaningful and personalised goals, however, require time and support to engage in the goal-setting and negotiation process.Rehabilitation clinicians need training and support to improve their goal negotiation and goal writing skills to create specific, understandable and meaningful goals with rehabilitation clients.
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Affiliation(s)
- Amanda Baker
- School of Allied Health Sciences, Griffith University, Brisbane, Australia.,Statewide Rehabilitation Clinical Network, Clinical Excellence Division, Queensland Health, Brisbane, Australia.,Allied Health, Department of Physiotherapy, Sunshine Coast Hospital and Health Service, Queensland Health, Nambour, Australia
| | - Petrea Cornwell
- School of Allied Health Sciences, Griffith University, Brisbane, Australia
| | - Louise Gustafsson
- School of Allied Health Sciences, Griffith University, Brisbane, Australia
| | - Natasha A Lannin
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia.,Alfred Health, Melbourne, Australia
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15
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Manning M, Cuskelly C, Russ E, Franklin S. Supporting people with post-stroke aphasia to live well: A cross-sectional survey of Speech & Language Therapists in Ireland. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:2105-2116. [PMID: 32462685 DOI: 10.1111/hsc.13021] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 04/02/2020] [Accepted: 04/19/2020] [Indexed: 06/11/2023]
Abstract
Living well with post-stroke aphasia is supported by responsive, collaborative heath and related services, aphasia information and training for people with aphasia (PWA) and their social networks, and opportunities to contribute and participate autonomously in their communities. Several international surveys indicate shortcomings in the provision of long-term support and, in Ireland, while there is a lack of data around service provision for PWA, there is evidence that post-acute stroke services are fragmented and under-resourced. The aim of this study was to survey Speech & Language Therapists (SLTs), due to their unique role in aphasia management, to understand what SLT and related support services and aphasia information and training are currently available to support living well with aphasia in Ireland. We developed and piloted a self-administered, web-based cross-sectional survey with questions informed by a systematic review and qualitative evidence synthesis around living well with aphasia, and with input from a Public and Patient Involvement aphasia advisory group. Data from 95 SLTs working with PWA were analysed using descriptive statistics. Although SLT was generally available for PWA, the results highlight access barriers and evidence-practice gaps in terms of the amount, intensity and timing of SLT to be maximally effective and there was a lack of PWA input into service design and evaluation. Access to other relevant supports such as mental health services was inconsistent and there was a lack of community support for families. There were shortcomings in access to aphasia information/training for PWA, families, friends and other healthcare professionals. There is a need for a coordinated and standardised approach to supporting PWA across Ireland. This study addresses an evidence gap around the provision of stroke services for PWA and is part of a larger project aiming to produce recommendations for improving person-centred support to facilitate living well with aphasia.
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Affiliation(s)
- Molly Manning
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Republic of Ireland
| | - Ciara Cuskelly
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Republic of Ireland
| | - Erin Russ
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Republic of Ireland
| | - Sue Franklin
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Republic of Ireland
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16
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Knollman-Porter K, Burshnic VL. Optimizing Effective Communication While Wearing a Mask During the COVID-19 Pandemic. J Gerontol Nurs 2020; 46:7-11. [DOI: 10.3928/00989134-20201012-02] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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17
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Pitt R, Theodoros D, Hill AJ, Russell T. The impact of the telerehabilitation group aphasia intervention and networking programme on communication, participation, and quality of life in people with aphasia. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 21:513-523. [PMID: 30200788 DOI: 10.1080/17549507.2018.1488990] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 04/16/2018] [Accepted: 06/07/2018] [Indexed: 06/08/2023]
Abstract
Purpose: Aphasia group therapy can result in improvements in communication, participation and quality of life (QOL). However, evidence for aphasia group interventions with combined aims across the International Classification of Functioning, Disability and Health (ICF) is limited. TeleGAIN is a holistic aphasia group intervention that can be delivered via telepractice. This study builds on prior pilot work and addresses the need for additional research into the effectiveness of TeleGAIN. The aim of this study was to describe changes in aphasia severity, communication related QOL and participation, for people with chronic aphasia following TeleGAIN. Method: Nineteen participants with aphasia were assessed on a range of outcome measures before and after a twelve-week block of TeleGAIN delivered via web based videoconferencing. Treatment provided opportunities to participate in conversation, engage with others with aphasia and complete functional communication activities. Result: Statistical analyses revealed statistically significant improvements in communication related QOL, increased engagement in communicative activities, and decreased aphasia severity. Conclusion: Results from this study suggest that the online delivery of a multi-purpose group intervention for people with aphasia can result in improved communication, communicative participation, and QOL. It also highlights the potential for intervention provided via telepractice to offer an alternative to face-to-face services.
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Affiliation(s)
- Rachelle Pitt
- School of Health and Rehabilitation Sciences, University of Queensland , Australia
- Centre for Research in Telerehabilitation, University of Queensland , Australia , and
| | - Deborah Theodoros
- School of Health and Rehabilitation Sciences, University of Queensland , Australia
- Centre for Research in Telerehabilitation, University of Queensland , Australia , and
- RECOVER Injury Research Centre, University of Queensland , Australia
| | - Anne J Hill
- School of Health and Rehabilitation Sciences, University of Queensland , Australia
- Centre for Research in Telerehabilitation, University of Queensland , Australia , and
| | - Trevor Russell
- School of Health and Rehabilitation Sciences, University of Queensland , Australia
- Centre for Research in Telerehabilitation, University of Queensland , Australia , and
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18
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Carragher M, Ryan B, Worrall L, Thomas S, Rose M, Simmons-Mackie N, Khan A, Hoffmann TC, Power E, Togher L, Kneebone I. Fidelity protocol for the Action Success Knowledge (ASK) trial: a psychosocial intervention administered by speech and language therapists to prevent depression in people with post-stroke aphasia. BMJ Open 2019; 9:e023560. [PMID: 31061014 PMCID: PMC6502036 DOI: 10.1136/bmjopen-2018-023560] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Treatment fidelity is a complex, multifaceted evaluative process which refers to whether a studied intervention was delivered as intended. Monitoring and enhancing fidelity is one recommendation of the TiDIER (Template for Intervention Description and Replication) checklist, as fidelity can inform interpretation and conclusions drawn about treatment effects. Despite the methodological and translational benefits, fidelity strategies have been used inconsistently within health behaviour intervention studies; in particular, within aphasia intervention studies, reporting of fidelity remains relatively rare. This paper describes the development of a fidelity protocol for the Action Success Knowledge (ASK) study, a current cluster randomised trial investigating an early mood intervention for people with aphasia (a language disability caused by stroke). METHODS AND ANALYSIS A novel fidelity protocol and tool was developed to monitor and enhance fidelity within the two arms (experimental treatment and attention control) of the ASK study. The ASK fidelity protocol was developed based on the National Institutes of Health Behaviour Change Consortium fidelity framework. ETHICS AND DISSEMINATION The study protocol was approved by the Darling Downs Hospital and Health Service Human Research Ethics Committee in Queensland, Australia under the National Mutual Acceptance scheme of multicentre human research projects. Specific ethics approval was obtained for those participating sites who were not under the National Mutual Agreement at the time of application. The monitoring and ongoing conduct of the research project is in line with requirements under the National Mutual Acceptance. On completion of the trial, findings from the fidelity reviews will be disseminated via publications and conference presentations. TRIAL REGISTRATION NUMBER ACTRN12614000979651.
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Affiliation(s)
- Marcella Carragher
- School of Allied Health, Human Services and Sport, La Trobe University—Melbourne Campus, Melbourne, Victoria, Australia
| | - Brooke Ryan
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Linda Worrall
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Shirley Thomas
- Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK
| | - Miranda Rose
- School of Allied Health, Human Services and Sport, La Trobe University—Melbourne Campus, Melbourne, Victoria, Australia
| | - Nina Simmons-Mackie
- Department of Health and Human Sciences, Southeastern Louisiana University, Hammond, Louisiana, USA
| | - Asad Khan
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Tammy C Hoffmann
- Centre for Research in Evidence-Based Practice, Bond University, Gold Coast, Queensland, Australia
| | - Emma Power
- Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Leanne Togher
- Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Ian Kneebone
- Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Neumann S, Quinting J, Rosenkranz A, de Beer C, Jonas K, Stenneken P. Quality of life in adults with neurogenic speech-language-communication difficulties: A systematic review of existing measures. JOURNAL OF COMMUNICATION DISORDERS 2019; 79:24-45. [PMID: 30851625 DOI: 10.1016/j.jcomdis.2019.01.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 01/04/2019] [Accepted: 01/21/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Sandra Neumann
- Pedagogics and Therapy in Speech-Language Disorders, Faculty of Human Sciences, University of Cologne, Klosterstr. 79b, 50931 Cologne, Germany.
| | - Jana Quinting
- Pedagogics and Therapy in Speech-Language Disorders, Faculty of Human Sciences, University of Cologne, Klosterstr. 79b, 50931 Cologne, Germany.
| | - Anna Rosenkranz
- Pedagogics and Therapy in Speech-Language Disorders, Faculty of Human Sciences, University of Cologne, Klosterstr. 79b, 50931 Cologne, Germany.
| | - Carola de Beer
- SFB 1287 - Project B01, University of Potsdam, Campus Golm, Haus 14, 2.04, Karl-Liebknecht-Straße 24-25, 14476 Potsdam, Germany.
| | - Kristina Jonas
- Pedagogics and Therapy in Speech-Language Disorders, Faculty of Human Sciences, University of Cologne, Klosterstr. 79b, 50931 Cologne, Germany.
| | - Prisca Stenneken
- Pedagogics and Therapy in Speech-Language Disorders, Faculty of Human Sciences, University of Cologne, Klosterstr. 79b, 50931 Cologne, Germany.
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Brown JA, Wallace SE, Knollman-Porter K, Hux K. Comprehension of Single Versus Combined Modality Information by People With Aphasia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:278-292. [PMID: 30054630 DOI: 10.1044/2018_ajslp-17-0132] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Purpose Every adult with aphasia displays a unique constellation of language comprehension skills and varies in the benefit derived from different content presentation formats. For many, multiple modality presentation enhances comprehension. This study's purpose was to determine the comprehension benefits for people with mild, moderate, and severe aphasia when hearing, reading, or simultaneously hearing and reading single sentences. Method Twenty-seven adults with aphasia performed a repeated-measures experiment across 3 conditions. Participants read and/or listened to sentence stimuli and selected from 4 images the 1 matching the sentence. Participants also indicated condition preference. Results Participants demonstrated significantly greatest accuracy during simultaneous written and auditory stimulus presentation. Performance patterns varied within aphasia severity groups. Individuals with mild and moderate aphasia demonstrated minimal performance differences across conditions, and people with severe aphasia were significantly more accurate in the combined modality than the written-only modality. Overall, participants required the longest response time in the written-only condition; however, participants were most efficient with auditory content. Condition preferences did not always mirror accuracy; however, the majority reported a preference for combined content presentation. Conclusions Results suggest some people with aphasia may benefit from combined auditory and written modalities to enhance comprehension efforts.
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Affiliation(s)
- Jessica A Brown
- Department of Speech, Language & Hearing Sciences, University of Arizona, Tucson
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21
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Hunting Pompon R, Amtmann D, Bombardier C, Kendall D. Modifying and Validating a Measure of Chronic Stress for People With Aphasia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:2934-2949. [PMID: 30515511 DOI: 10.1044/2018_jslhr-l-18-0173] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 06/25/2018] [Indexed: 06/09/2023]
Abstract
PURPOSE Chronic stress is likely a common experience among people with the language impairment of aphasia. Importantly, chronic stress reportedly alters the neural networks central to learning and memory-essential ingredients of aphasia rehabilitation. Before we can explore the influence of chronic stress on rehabilitation outcomes, we must be able to measure chronic stress in this population. The purpose of this study was to (a) modify a widely used measure of chronic stress (Perceived Stress Scale [PSS]; Cohen & Janicki-Deverts, 2012) to fit the communication needs of people with aphasia (PWA) and (b) validate the modified PSS (mPSS) with PWA. METHOD Following systematic modification of the PSS (with permission), 72 PWA completed the validation portion of the study. Each participant completed the mPSS, measures of depression, anxiety, and resilience, and provided a sample of the stress hormone cortisol extracted from the hair. Pearson's product-moment correlations were used to examine associations between mPSS scores and these measures. Approximately 30% of participants completed the mPSS 1 week later to establish test-retest reliability, analyzed using an interclass correlation coefficient. RESULTS Significant positive correlations were evident between the reports of chronic stress and depression and anxiety. In addition, a significant inverse correlation was found between reports of chronic stress and resilience. The mPSS also showed evidence of test-retest reliability. No association was found between mPSS score and cortisol level. CONCLUSION Although questions remain about the biological correlates of chronic stress in people with poststroke aphasia, significant associations between chronic stress and several psychosocial variables provide evidence of validity of this emerging measure of chronic stress.
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Affiliation(s)
- Rebecca Hunting Pompon
- Department of Speech and Hearing Sciences, University of Washington, Seattle
- VA Puget Sound Health Care System, Seattle, WA
| | - Dagmar Amtmann
- Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Charles Bombardier
- Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Diane Kendall
- Department of Speech and Hearing Sciences, University of Washington, Seattle
- VA Puget Sound Health Care System, Seattle, WA
- Speech-Language Pathology and Audiology, University of Pretoria, South Africa
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22
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Clunne SJ, Ryan BJ, Hill AJ, Brandenburg C, Kneebone I. Accessibility and Applicability of Currently Available e-Mental Health Programs for Depression for People With Poststroke Aphasia: Scoping Review. J Med Internet Res 2018; 20:e291. [PMID: 30514696 PMCID: PMC6299232 DOI: 10.2196/jmir.9864] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 07/19/2018] [Accepted: 08/21/2018] [Indexed: 02/07/2023] Open
Abstract
Background Depression affects approximately 60% of people with aphasia 1 year post stroke and is associated with disability, lower quality of life, and mortality. Web-delivered mental health (e-mental health) programs are effective, convenient, and cost-effective for the general population and thus are increasingly used in the management of depression. However, it is unknown if such services are applicable and communicatively accessible to people with poststroke aphasia. Objective The aim of this study was to identify freely available e-mental health programs for depression and determine their applicability and accessibility for people with poststroke aphasia. Methods A Web-based search was conducted to identify and review freely available e-mental health programs for depression. These programs were then evaluated in terms of their (1) general features via a general evaluation tool, (2) communicative accessibility for people with aphasia via an aphasia-specific communicative accessibility evaluation tool, and (3) empirical evidence for the general population and stroke survivors with and without aphasia. The program that met the most general evaluation criteria and aphasia-specific communicative accessibility evaluation criteria was then trialed by a small subgroup of people with poststroke aphasia. Results A total of 8 programs were identified. Of these, 4 had published evidence in support of their efficacy for use within the general population. However, no empirical evidence was identified that specifically supported any programs’ use for stroke survivors with or without aphasia. One evidence-based program scored at least 80% (16/19 and 16/20, respectively) on both the general and aphasia-specific communicative accessibility evaluation tools and was subject to a preliminary trial by 3 people with poststroke aphasia. During this trial, participants were either unable to independently use the program or gave it low usability scores on a post-trial satisfaction survey. On this basis, further evaluation was considered unwarranted. Conclusions Despite fulfilling majority of the general evaluation and aphasia-specific evaluation criteria, the highest rated program was still found to be unsuitable for people with poststroke aphasia. Thus, e-mental health programs require substantial redevelopment if they are likely to be useful to people with poststroke aphasia.
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Affiliation(s)
- Stephanie Jane Clunne
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Brooke Jade Ryan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Annie Jane Hill
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Caitlin Brandenburg
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Ian Kneebone
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology, Sydney, Ultimo, Australia
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Brown J, Thiessen A. Using Images With Individuals With Aphasia: Current Research and Clinical Trends. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 27:504-515. [PMID: 29497760 DOI: 10.1044/2017_ajslp-16-0190] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 06/19/2017] [Indexed: 06/08/2023]
Abstract
PURPOSE Visuographic supports in the form of images are utilized during assessment and treatment for individuals with aphasia to supplement speech, language, and cognitive losses limiting communication. Clinicians rely on prior experience and intuition to make decisions regarding image-based support design and selection (e.g., augmentative and alternative communication strategies). Researchers have begun to focus on the relationship between the images and the benefits they provide for adults with aphasia. METHOD The aim of this review-resulting from a roundtable discussion at the 2016 Clinical Aphasiology Conference-was to disseminate summaries of current and past researches regarding image use by individuals with aphasia and to highlight areas of need within research and practice. RESULTS Review of the literature illuminated 4 major themes: (a) image creation, capture, and sharing; (b) image characteristics; (c) image use across linguistic domains and contexts; and (d) implications for clinical and research practices. CONCLUSIONS Reviewing current knowledge and practice regarding the use of visual supports for individuals with aphasia is essential to advancing therapeutic practices and providing evidence-based protocols for creating, selecting, and implementing images within augmentative and alternative communication strategies. Several gaps in knowledge were identified as future research needs (e.g., caregiver training and enhanced image feature investigation).
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Affiliation(s)
- Jessica Brown
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis, MN
| | - Amber Thiessen
- Department of Communication Sciences and Disorders, University of Houston, TX
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Munro P, Siyambalapitiya S. Improved word comprehension in Global aphasia using a modified semantic feature analysis treatment. CLINICAL LINGUISTICS & PHONETICS 2016; 31:119-136. [PMID: 27548515 DOI: 10.1080/02699206.2016.1198927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Limited research has investigated treatment of single word comprehension in people with aphasia, despite numerous studies examining treatment of naming deficits. This study employed a single case experimental design to examine efficacy of a modified semantic feature analysis (SFA) therapy in improving word comprehension in an individual with Global aphasia, who presented with a semantically based comprehension impairment. Ten treatment sessions were conducted over a period of two weeks. Following therapy, the participant demonstrated improved comprehension of treatment items and generalisation to control items, measured by performance on a spoken word picture matching task. Improvements were also observed on other language assessments (e.g. subtests of WAB-R; PALPA subtest 47) and were largely maintained over a period of 12 weeks without further therapy. This study provides support for the efficacy of a modified SFA therapy in remediating single word comprehension in individuals with aphasia with a semantically based comprehension deficit.
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Affiliation(s)
- Philippa Munro
- a Discipline of Speech Pathology, James Cook University , Townsville , Australia
| | - Samantha Siyambalapitiya
- a Discipline of Speech Pathology, James Cook University , Townsville , Australia
- b Menzies Health Institute Queensland, Griffith University , Gold Coast , Australia
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Wilson L, Read J. Do particular design features assist people with aphasia to comprehend text? An exploratory study. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2016; 51:346-354. [PMID: 26611362 DOI: 10.1111/1460-6984.12206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 07/31/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Much of the evidence underlying guidelines for producing accessible information for people with aphasia focuses on client preference for particular design features. There is limited evidence regarding the effects of these features on comprehension. AIMS To examine the effects of specific design features on text comprehension. It was hypothesized that font style, letter case and supporting images would all have a significant impact on people with aphasias' ability to comprehend text. METHODS & PROCEDURES Participants (N = 9) read 35 paragraphs and selected the most appropriate word or phrase from a choice of four to finish the final sentence. Reading comprehension was assessed in three conditions: font style, letter case and text with a supporting image. One-way analyses of variance (ANOVAs) with Bonferroni post-hoc tests were used to test the effect of each design feature on reading comprehension. OUTCOMES & RESULTS People with aphasia comprehended significantly more written information when presented in sans-serif font than in a serif style (p = .01) and when presented in lower case than in upper case (p = .03). The inclusion of a single supporting image to illustrate a paragraph of text did not have a significant effect on comprehension. CONCLUSIONS & IMPLICATIONS This research supports the premise that font style and letter case have a significant effect on text comprehension, but that illustrating a paragraph of text with a single image may not significantly improve comprehension when text is written at a low readability level. Although it is critical to produce accessible information, improving comprehension is only one rationale for modified text presentation and therefore these results must be viewed in the context of other recommendations.
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Affiliation(s)
- Lucy Wilson
- Speech and Language Therapy Department, Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust, Blackburn, UK
| | - Jennifer Read
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
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Paige SR, Stellefson M, Chaney BH, Alber JM. Pinterest as a Resource for Health Information on Chronic Obstructive Pulmonary Disease (COPD): A Social Media Content Analysis. AMERICAN JOURNAL OF HEALTH EDUCATION 2015. [DOI: 10.1080/19325037.2015.1044586] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Power E, Thomas E, Worrall L, Rose M, Togher L, Nickels L, Hersh D, Godecke E, O'Halloran R, Lamont S, O'Connor C, Clarke K. Development and validation of Australian aphasia rehabilitation best practice statements using the RAND/UCLA appropriateness method. BMJ Open 2015; 5:e007641. [PMID: 26137883 PMCID: PMC4499686 DOI: 10.1136/bmjopen-2015-007641] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Revised: 05/05/2015] [Accepted: 06/03/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To develop and validate a national set of best practice statements for use in post-stroke aphasia rehabilitation. DESIGN Literature review and statement validation using the RAND/UCLA Appropriateness Method (RAM). PARTICIPANTS A national Community of Practice of over 250 speech pathologists, researchers, consumers and policymakers developed a framework consisting of eight areas of care in aphasia rehabilitation. This framework provided the structure for the development of a care pathway containing aphasia rehabilitation best practice statements. Nine speech pathologists with expertise in aphasia rehabilitation participated in two rounds of RAND/UCLA appropriateness ratings of the statements. Panellists consisted of researchers, service managers, clinicians and policymakers. MAIN OUTCOME MEASURES Statements that achieved a high level of agreement and an overall median score of 7-9 on a nine-point scale were rated as 'appropriate'. RESULTS 74 best practice statements were extracted from the literature and rated across eight areas of care (eg, receiving the right referrals, providing intervention). At the end of Round 1, 71 of the 74 statements were rated as appropriate, no statements were rated as inappropriate, and three statements were rated as uncertain. All 74 statements were then rated again in the face-to-face second round. 16 statements were added through splitting existing items or adding new statements. Seven statements were deleted leaving 83 statements. Agreement was reached for 82 of the final 83 statements. CONCLUSIONS This national set of 82 best practice statements across eight care areas for the rehabilitation of people with aphasia is the first to be validated by an expert panel. These statements form a crucial component of the Australian Aphasia Rehabilitation Pathway (AARP) (http://www.aphasiapathway.com.au) and provide the basis for more consistent implementation of evidence-based practice in stroke rehabilitation.
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Affiliation(s)
- Emma Power
- Speech Pathology, Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
- Centre for Clinical Research Excellence in Aphasia Rehabilitation
| | - Emma Thomas
- Centre for Clinical Research Excellence in Aphasia Rehabilitation
- School of Health and Rehabilitation Sciences, the University of Queensland, St Lucia, Queensland, Australia
| | - Linda Worrall
- Centre for Clinical Research Excellence in Aphasia Rehabilitation
- School of Health and Rehabilitation Sciences, the University of Queensland, St Lucia, Queensland, Australia
| | - Miranda Rose
- Centre for Clinical Research Excellence in Aphasia Rehabilitation
- Department of Human Communication Sciences, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia
| | - Leanne Togher
- Speech Pathology, Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
- Centre for Clinical Research Excellence in Aphasia Rehabilitation
| | - Lyndsey Nickels
- Centre for Clinical Research Excellence in Aphasia Rehabilitation
- Department of Cognitive Science, ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, New South Wales, Australia
| | - Deborah Hersh
- Centre for Clinical Research Excellence in Aphasia Rehabilitation
- Speech Pathology, School of Psychology and Social Science, Edith Cowan University, Perth, Western Australia, Australia
| | - Erin Godecke
- Centre for Clinical Research Excellence in Aphasia Rehabilitation
- Speech Pathology, School of Psychology and Social Science, Edith Cowan University, Perth, Western Australia, Australia
| | - Robyn O'Halloran
- Centre for Clinical Research Excellence in Aphasia Rehabilitation
- Department of Human Communication Sciences, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia
| | - Sue Lamont
- Department of Speech Pathology, Monash Health, Melbourne, Victoria, Australia
| | - Claire O'Connor
- NSW Agency for Clinical Innovation, Chatswood, New South Wales, Australia
| | - Kim Clarke
- Speech Pathology, Country Health SA Local Health Network, Strathalbyn, South Australia, Australia
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Jayes M, Palmer R. Initial evaluation of the Consent Support Tool: a structured procedure to facilitate the inclusion and engagement of people with aphasia in the informed consent process. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2014; 16:159-168. [PMID: 23826849 DOI: 10.3109/17549507.2013.795999] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study evaluated the Consent Support Tool (CST), a procedure developed to identify the optimum format in which to present research information to people with different severities of aphasia, in order to support their understanding during the informed consent process. Participants were a convenience sample of 13 people with aphasia who had mixed comprehension ability. The CST was used to profile each participant's language ability and identify an information format that should maximize her/his understanding. Next, participants were shown information presented in three formats: standard text and two 'aphasia-friendly' versions providing different levels of support. Participants' understanding of the information was measured for each format. The format recommended by the CST was compared with the format observed to maximize understanding for each participant. The CST accurately predicted the optimum format for 11/13 participants and differentiated people who could understand fully with support from those who could not in 12/13 cases. All participants interviewed (10/10) found the adapted formats helpful and 9/10 preferred them to the standard version. These findings suggest that the CST could usefully support researchers to determine whether a person with aphasia is likely to be able to provide informed consent, and which information format will maximize that individual's understanding. The CST and different information formats are available as Supplementary Appendices to be found online at http://www.informahealthcare.com/doi/abs/10.3109/17549507.2013.795999 .
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Affiliation(s)
- Mark Jayes
- Sheffield Teaching Hospitals NHS Foundation Trust , Sheffield , UK
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Krzych ŁJ, Ratajczyk D. Awareness of the patients' rights by subjects on admission to a tertiary university hospital in Poland. J Forensic Leg Med 2013; 20:902-5. [DOI: 10.1016/j.jflm.2013.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Revised: 05/07/2013] [Accepted: 06/16/2013] [Indexed: 10/26/2022]
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Worrall LE, Howe T, O'Callaghan A, Hill AJ, Rose M, Wallace SJ, Rose T, Brown K, Power E, O'Halloran R, Rohde A. The World Report on Disability as a blueprint for international, national, and local aphasia services. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2013; 15:106-112. [PMID: 23101515 DOI: 10.3109/17549507.2012.721004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This commentary aims to extend the debate of the lead article authors (Wylie, McAllister, Davidson, and Marshall, 2013) by translating the nine recommendations of the World Report on Disability into a plan of action for the aphasia community. Solutions for the advancement of aphasia science and services are presented at international (macro), national (meso), and local (micro) levels. Implications for speech-language pathologists and aphasia service delivery are discussed. An overarching call to action is the need for speech-language pathologists to support a strong and vibrant aphasia community at all levels, so that the voices of people with aphasia can be heard.
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Affiliation(s)
- Linda E Worrall
- Centre for Clinical Research Excellence in Aphasia Rehabilitation, The University of Queensland, Brisbane, Australia.
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