Investigation of the implementation of a Communication Enhanced Environment model on an acute/slow stream rehabilitation and a rehabilitation ward: A before-and-after pilot study

D’Souza, Sarah; Godecke, Erin; Ciccone, Natalie; Hersh, Deborah; Armstrong, Elizabeth; Tucak, Claire; Janssen, Heidi

doi:10.1177/02692155211032655

Cited by 7 publications

(4 citation statements)

References 37 publications

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“…With the majority of stroke survivors returning home after their hospital admission (Stroke Foundation, 2020), it is critical to optimize communication so that PWA and their loved ones experience frequent, enjoyable and significant conversations. Successful communication is likely to foster improved language function by establishing an enriched communication environment (D'Souza et al., 2022) that enhances neuroplasticity (Hannan & Nithianantharajah, 2006), enabling family caregivers to maintain their carer role in the long‐term and support the person with aphasia's community participation.…”

Section: Introductionmentioning

confidence: 99%

Communication partner training with familiar partners of people with aphasia: A systematic review and synthesis of barriers and facilitators to implementation

Shrubsole

Power

Hallé

2022

Intl J Lang & Comm Disor

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Background: Factors influencing the implementation of communication partner training (CPT) with familiar partners of people with aphasia (PWA) have previously been documented using disparate approaches. To date there has been no synthesis of these factors using a common theoretical framework. Investigating CPT implementation factors using a common theoretical framework may further our understanding of universal barriers and guide future development of tailored, theoretically informed implementation strategies. Aims:(1) To determine the perceived and/or observed barriers and facilitators to implementing CPT with familiar partners of adults with aphasia; (2) to map extracted barriers and facilitators to a common theoretical framework;(3) to synthesize extracted barriers and facilitators; and (4) to identify potential implementation strategies to address the most frequently identified barriers and facilitators. Methods & Procedures: A systematic review was conducted in accordance withPreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four electronic databases (MEDLINE, EMBASE, CINAHL, Web of Science) were systematically searched in April 2021. Empirical qualitative and/or quantitative research studies reporting barriers/facilitators to speech-language therapists (SLTs) implementing CPT with familiar partners of adults with aphasia were included. The search was limited to English or French articles with no date limit applied. Methodological quality of included studies was assessed using the Mixed-Methods Appraisal Tool (MMAT). A framework and content analysis was then conducted to extract and synthesize the implementation factors in alignment with the Theoretical Domains Framework (TDF), followed by a theoretically informed mapping exercise to identify potential implementation strategies.

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Section: Introductionmentioning

confidence: 99%

Communication partner training with familiar partners of people with aphasia: A systematic review and synthesis of barriers and facilitators to implementation

Shrubsole

Power

Hallé

2022

Intl J Lang & Comm Disor

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“…In the current study, participants described entertainment options (eg, television programming/system navigation required complex language) as unsuitable or overstimulating and suggested simple music options or available (and quiet) green spaces. Recent studies in Australia and the UK have explored the feasibility of enriching hospital environments 59 and alternative ways to improve well-being for PWA. 60 …”

Section: Discussionmentioning

confidence: 99%

Understanding experiences, unmet needs and priorities related to post-stroke aphasia care: stage one of an experience-based co-design project

Anemaat,

Palmer,

Copland

et al. 2024

BMJ Open

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Objective People with post-stroke aphasia (language/communication impairment) and their supporters report mixed satisfaction with stroke and aphasia care. To date, however, their journey of care and the key service interactions that shape their experience have not been comprehensively explored. We aimed to investigate the lived experience of post-stroke aphasia care, across the continuum of care and by geographical location, to establish priorities for service design. Design This is the first stage of an experience-based co-design study. We purposively sampled people with aphasia (PWA) and significant others (SOs) across 21 hospital and health service sites, community groups and by self-referral. Participants shared experiences of care in online interviews and focus groups. Touchpoints (key moments that shape experience) and unmet needs were identified using qualitative thematic analysis. Priorities for service design were established using an adapted nominal group technique. Setting Sites spanned remote, regional and metropolitan areas in Queensland, Australia. Participants PWA (n=32; mild=56%; moderate=31%; severe=13%) and SOs (n=30) shared 124 experiences of acute, rehabilitation and community-based care in 23 focus groups and 13 interviews. Results Both positive and negative healthcare experiences occurred most frequently in hospital settings. Negative experiences regularly related to communication with health professionals, while positive experiences related to the interpersonal qualities of healthcare providers (eg, providing hope) for PWA, or witnessing good rapport between a PWA and their health professional for SOs. To improve services, PWA prioritised communicatively accessible education and information and SOs prioritised access to psychological and peer support. Conclusions We identified key aspects of post-stroke aphasia care that shape experience. The needs of PWA and SOs may be better met through health professional training in supported communication, increased service availability in regional and remote areas, communication-accessible hospital environments, increased access to psychological and peer support, and meaningful involvement of SOs in rehabilitation.

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“… 18 The broad nature of the facilitative environment is illustrated by the essential features of stroke unit care: 69 , 70 Structured assessment procedures Policies on early stages of management of common problems Policy on the ongoing rehabilitation Expertise in stroke management and rehabilitation with regular team education Multidisciplinary teamwork with regular planned team meetings Involvement of patients and families Other studies have shown that: Planned changes in the physical environment alter the behaviour of patients, increasing their activities. 71 – 74 Social factors influence adaptation; for example, after a stroke, community activity is influenced by social networks 75 and being with other people is associated with more movement of the affected arm. 76 The harm caused by inappropriate environments is also clear.…”

Section: Discussionmentioning

confidence: 99%

“…Planned changes in the physical environment alter the behaviour of patients, increasing their activities. 71 – 74 …”

Section: Discussionmentioning

confidence: 99%

A general theory of rehabilitation: Rehabilitation catalyses and assists adaptation to illness

Wade

2023

Clin Rehabil

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Background There is no general theory of rehabilitation, only definitions and descriptions, with the biopsychosocial model of illness as a structure. Objective To develop a general theory of rehabilitation that explains how healthcare rehabilitation changes outcomes and to evaluate its validity. Need A general rehabilitation theory would help research, improve services, increase understanding, modify resource allocation and explain some anomalies, such as how rehabilitation helps when no natural recovery occurs. Building blocks People adapt to change throughout their lives. Illness is a change, and people adapt to their illness. Adaptation's purpose is to maintain an equilibrium in a person's life. The balanced components are related to Maslow's five needs: basic, safety, affiliation, status and self-fulfilment. The general theory of behaviour suggests that a person's behaviours change to maintain balance, regulated by a central homeostatic mechanism. The theory Rehabilitation aids adaptation to changes associated with illness through accurate diagnosis and formulation, catalysing adaptation, optimising the environment and assisting the person in making necessary changes by safely practising activities and teaching self-management. Implications The theory makes the person the central active agent, emphasises the importance of the environment in facilitating adaptation, explains why all conditions may benefit, including progressive and static conditions, suggests that health can be equated to someone maintaining their equilibrium and explains why a small dose may be very effective. Conclusion The general theory of rehabilitation emphasises the catalytic effects of rehabilitation in facilitating and guiding adaptation and suggests areas for research and improvement.

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Investigation of the implementation of a Communication Enhanced Environment model on an acute/slow stream rehabilitation and a rehabilitation ward: A before-and-after pilot study

Cited by 7 publications

References 37 publications

Communication partner training with familiar partners of people with aphasia: A systematic review and synthesis of barriers and facilitators to implementation

Communication partner training with familiar partners of people with aphasia: A systematic review and synthesis of barriers and facilitators to implementation

Understanding experiences, unmet needs and priorities related to post-stroke aphasia care: stage one of an experience-based co-design project

A general theory of rehabilitation: Rehabilitation catalyses and assists adaptation to illness

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