Proactive changes in clinical practice as a result of the COVID-19 pandemic: Survey on use of telepractice by Quebec speech-language pathologists

BACKGROUND

The coronavirus disease2019 (COVID-19) pandemic has led to important challenges in health and education service delivery.

AIMS

The present study aimed to document: (i) changes in the use of telepractice by speech-language pathology (SLP) professionals in Quebec since the start of the COVID-19 outbreak; (ii) perceptions of the feasibility of telepractice by SLPs; (iii) barriers to the use of telepractice; and (iv) the perceptions of SLP professionals regarding the main issues of telepractice.

METHODS & PROCEDURES

An online survey with closed and open, Likert scale and demographic questions was completed by 83 SLPs in Quebec in June and July 2020.

OUTCOMES & RESULTS

The survey responses showed that within the cohort responding, telepractice use has increased significantly as a response to the COVID-19 pandemic. Most respondents planned to continue using telepractice after the pandemic ends. In addition, the respondents considered telepractice to be adequate for many clinical practices but less so for others (e.g., swallowing disorders, hearing impairment). Most of the reported barriers to the use of telepractice concerned technological problems and a lack of clinical materials for online use. Confidentiality and privacy issues were also raised.

CONCLUSIONS & IMPLICATIONS

SLP professionals rapidly took advantage of existing technologies in their clinical settings to cope with the pandemic's effects on service delivery. The discrepancy between their perceptions and the evidence in the literature for some practices and populations strengthens the need for more information and education on telepractice.

WHAT THIS PAPER ADDS

What is already known on the subject The proportion of speech-language pathologists (SLPs) in Canada who use telepractice for clinical activities is unknown. Knowing this information became crucial in the context of the coronavirus disease 2019 (COVID-19) pandemic because non-essential activities were interrupted to halt the spread of the disease. What this paper adds to existing knowledge The findings from this survey study confirmed that the use of telepractice in SLP in Quebec increased significantly during the COVID-19 pandemic. Moreover, the majority of the respondents began using telepractice because of the pandemic, and most planned to continue doing so after it ends. This demonstrates how SLP professionals rapidly took advantage of existing technologies in their clinical settings to cope with the pandemic's effects on service delivery. What are the potential or actual clinical implications of this work? Although the SLPs expressed an overall positive perception of telepractice, they also highlighted barriers to its optimal use. The findings of this study should help employers and regulatory bodies in Quebec to bring down those barriers and make telepractice in SLP a durable, effective and efficient service delivery model.

Mental State Inferences Abilities Contribution to Verbal Irony Comprehension in Older Adults with Mild Cognitive Impairment

OBJECTIVE

The present study examined mentalizing capacities as well as the relative implication of mentalizing in the comprehension of ironic and sincere assertions among 30 older adults with mild cognitive impairment (MCI) and 30 healthy control (HC) subjects.

METHOD

Subjects were administered a task evaluating mentalizing by means of short stories. A verbal irony comprehension task, in which participants had to identify ironic or sincere statements within short stories, was also administered; the design of the task allowed uniform implication of mentalizing across the conditions.

RESULTS

Findings indicated that participants with MCI have second-order mentalizing difficulties compared to HC subjects. Moreover, MCI participants were impaired compared to the HC group in identifying ironic or sincere stories, both requiring mental inference capacities.

CONCLUSION

This study suggests that, in individuals with MCI, difficulties in the comprehension of ironic and sincere assertions are closely related to second-order mentalizing deficits. These findings support previous data suggesting a strong relationship between irony comprehension and mentalizing.

[LAST-Q: Adaptation and normalisation in Quebec of the Language Screening Test]

The goal of the present study was to adapt and to establish normative data for the recently developed Language Screening Test (LAST; Flamand-Roze et al., 2011) in the French-Canadian population according to age and level of education. After an adaptation process, 100 French-Canadian speakers were evaluated with the LAST-Q. As expected, a perfect score of 15/15 was obtained for all high level education participants, and a score of 14/15 was obtained for all participants with a lowest level of education or aged 80 years or more. Thanks to this adaptation, LAST-Q can be used in acute patients in stroke unit in Quebec.

A new lexical card-sorting task for studying fronto-striatal contribution to processing language rules

The role of fronto-striatal regions in processing different language rules such as semantic and (grapho) phonological ones is still under debate. We have recently developed a lexical analog of the Wisconsin card sorting task which measures set-shifting abilities where the visual rules color, number, shape were replaced by three language ones: semantic, rhyme and syllable onset (attack). In the present study we aimed to compare fronto-striatal activations between the different lexical rules that are required for matching the test words to the response ones. Using functional magnetic resonance imaging (fMRI), fourteen healthy, native French-speaking participants were scanned. The results showed that some regions within the brain language network are differentially involved in semantic and phonological processes. Semantic decisions activated significantly the ventrolateral prefrontal cortex, the dorsolateral prefrontal cortex, the fusiform gyrus, the ventral temporal lobe and the caudate nucleus, while phonological decisions produced significant activation in posterior Broca's area (area 44), the temporoparietal junction and motor cortical regions. These findings provide critical support for the existence of a ventral subcortical semantic pathway and a more dorsal phonological stream as proposed by Duffau, Leroy, and Gatignol (2008). Furthermore, we propose that the strong involvement of area 47/12 of the ventrolateral prefrontal cortex and caudate nucleus observed in semantic processing, is not specific to language, but to the fact that a category or a rule has to be retrieved amongst competing ones in memory, similarly to what is observed when planning a set-shift in the original (non-lexical) version of the Wisconsin card sorting task.

[Nurses' uniforms as seen by patients, nurses and nursing faculty]

The exact role of the way people dress up on the nonverbal communication is still unknown. Nevertheless, we know that it influences the interpersonal answers and, in some situations, they are the main determinants of those answers. The objective of this study was to determinate differences between the perception os the nurse uniform through the answers of 100 patients, 30 nurses and 15 nursing school faculty. The data were collected by showing nine photographs of hospitals of the city of São Paulo (Brazil). White trousers and blouse was the favorite one among patients, nurses and nursing school faculty regarding personal care. White skirt above knees, white blouse and blazer was the most rejected one by three groups.

[The use of new dressing resources in the nursing consultation]

The author performed the treatment of infected or non-infected wounds with the association of papain and 2 types of synthetic dressings: activated charcoal cloth dressing and hydrocolloid dressing. Eighteen (18) patients, mean age 58.4 years, were followed during 20 dressings. The treatment period was 2 1/2 months-3 months. The infected wounds were treated with the activated charcoal cloth dressing and the non-infected wounds with the hydrocolloid dressing. The evolution of wound healing until the tenth dressing, (about 1 month of treatment) showed that area initially affected was reduced between 48.6% and 89.7% until the twentieth dressing.

[Use of papain in curative nursing actions]

São apresentados os resultados obtidos com o uso da papaína em escaras e soluções de continuidade de outras etiologias. Mostra a ação bioquímica da papaína, as facilidades do seu uso e descreve desde sua experiência com o uso do mamão em lesões de pele e escaras, até a implantação de um curativo com papaína em dois importantes hospitais de São Paulo.