Stroke patients communicating their healthcare needs in hospital: a study within the ICF framework

O’Halloran, Robyn; Worrall, Linda; Hickson, Louise

doi:10.1111/j.1460-6984.2011.00077.x

Cited by 29 publications

(24 citation statements)

References 17 publications

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“…The team's charter was to critically evaluate stroke assessment and outcome measures within the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework [12][13][14][15][16][17][18][19][20]. This structure assured that the interdisciplinary team assessed the full spectrum of function from individual impairment to participation in society.…”

Section: Introductionmentioning

confidence: 99%

Standardization of Interdisciplinary Clinical Practice and Assessment in Stroke Rehabilitation

Kinney¹

2013

Int J Phys Med Rehabil

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Section: Introductionmentioning

confidence: 99%

Standardization of Interdisciplinary Clinical Practice and Assessment in Stroke Rehabilitation

Kinney¹

2013

Int J Phys Med Rehabil

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“…wanted this stuff… they [I] understood that this stuff, which was encurling [encouraging? ], they were [I was] beginning to say 'yeah' this stuff is good (20)." In these quotes, he used "they" but it was interpreted to mean that he was referring to himself, therefore, the implied meaning is included in parentheses.…”

Section: Treatment: "Challenge… Head… Helped Your Brain (P03 04)"mentioning

confidence: 99%

“…Other research has found that persons with aphasia have goals that align with the ICF. [18][19][20] An ICAP is structured to provide comprehensive care that addresses functional goals related to activity and participation. [18][19][20] Another model focuses specifically on aspects that contribute to living successfully with aphasia.…”

Section: Service Delivery For Aphasia Treatment In the United Statesmentioning

confidence: 99%

Outcomes of an Intensive Comprehensive Aphasia Program

Babbitt¹

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Intensive comprehensive aphasia programs (ICAP) have increased over the last decade in the US and abroad. The increase in the number of clinical programs has outpaced the research that is necessary to establish the efficacy and effectiveness of these specialized treatment programs. The ICAP model incorporates principles from neuroplasticity, that is, intensive treatment provides a platform for the massed practice and repetition required to change the brain. It also incorporates comprehensive treatment that addresses not only impairment-based language deficits but also personal goals related to participation.Programs which offer intensive comprehensive treatment can provide up to 120 hours of treatment over several weeks (e.g., six hours a day, five days a week for four weeks). ICAPs are different from other types of aphasia services which generally provide two to three hours of therapy a week. This thesis examined one ICAP in depth to describe the structure, process, and outcomes using Donabedian's model of health care evaluation. This thesis also described the experiences of the ICAP from the perspectives of the primary stakeholders.Study One (Chapter Two) was a retrospective quantitative study using behavioral measures from an existing database that documented the outcomes of participants with aphasia. It found that first-time participants improved significantly in impairment-and participationbased measures, demonstrating moderate to large effect sizes. Participant characteristics were examined to determine if improvements were related to age, time post-onset, or type and severity of aphasia. None of these factors had an impact on the amount of change measured. Given that some participants did not make significant gains on a primary outcome measure, the Western Aphasia Battery -Revised Aphasia Quotient (WAB-R AQ), Study Two (Chapter Three) examined whether participant characteristics at baseline could predict who would make significant gains on the WAB-R AQ. Age and months post-onset were significantly different between the responder and the non-responder groups. Those who showed most gains on average were younger and a longer time post-onset. A logistic regression was performed and results indicated that only age (younger participants) predicted who would respond to treatment. Time post-onset, type and severity of aphasia, naming, non-verbal cognition, and communication confidence did not show significance in a predictive model. Studies Three and Four were qualitative studies involving interviews with therapists (Chapter Four) and people with aphasia and their families (Chapter Five). Both studies were 3 conducted using a phenomenological approach which allowed for the interviewees to describe their experiences in a semi-structured interview. The clinicians described the intensity of the therapy, the rewards, and challenges of the program. Therapists also considered that the ICAP model of service delivery had several positive benefits for them, but acknowledged that the intensity of therapy was challe...

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“…The provision of communication support also has the potential to increase the capacity of an individual with aphasia to express their healthcare needs, and participate in their own healthcare journey (O'Halloran, Worrall, & Hickson, 2012). For example, the provision of augmentative and alternative communication tools, communicative strategies, and techniques (Kagan, 1998) can facilitate an individual's ability to communicate their healthcare needs, including understanding their medical diagnosis, describing the medical history, asking questions about their care, telling care providers about pain or discomfort, and understanding descriptions of medical procedures (O'Halloran, Worrall, & Hickson, 2012).…”

Section: The Implications For People With Aphasia and Their Familiesmentioning

confidence: 99%

“…For example, the provision of augmentative and alternative communication tools, communicative strategies, and techniques (Kagan, 1998) can facilitate an individual's ability to communicate their healthcare needs, including understanding their medical diagnosis, describing the medical history, asking questions about their care, telling care providers about pain or discomfort, and understanding descriptions of medical procedures (O'Halloran, Worrall, & Hickson, 2012). Communicative support additionally has the potential to decrease the number of negative events within the hospital setting (Hemsley, Werninck, & Worrall, 2013).…”

Section: The Implications For People With Aphasia and Their Familiesmentioning

confidence: 99%

“Communication is taking a back seat”: An exploration of aphasia management in acute hospital settings

Foster¹

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While in the past the focus of speech pathologists working in the acute hospital setting has been service provision to people with communication disorders and their families, their primary role is now in dysphagia. In the limited literature regarding aphasia management in acute hospital settings, there is a lack of consistency regarding the type and amount of intervention being provided to people with aphasia; however, there is consensus that current practice is inconsistent with bestpractice recommendations. Given that aphasia intervention has been identified as being central to improved communicative outcomes, an increased capacity to effectively communicate healthcare needs, a decrease in hospital negative events, and an increased sense of satisfaction for people with aphasia, this is of concern. Little is known about the reasons underlying this evidence-practice gap.The overall aim of this thesis was to provide an understanding of current acute aphasia management practice and the factors that influence it. Specifically, the research aimed to: (a) provide an in-depth understanding of the current aphasia management pathway in the acute hospital setting; (b) explore acute speech-language pathologists' conceptualisation, experiences, and perceptions of post-stroke aphasia management, and provide a greater understanding of the factors that influence their practice; and, (c) understand the factors that influence acute aphasia management from the perspectives of speech pathologists, people with aphasia, and their close others, through a cultural lens.In order to address the research aims, the empirical aspects of this research were conducted in two Phases. Phase One, an interpretative phenomenological investigation, aimed to provide a deep understanding of aphasia management from the perspective of acute speech pathologists. Semistructured, in-depth interviews were undertaken with 15 Australian speech pathologists working with people with aphasia (one of which was later excluded resulting in a total n=14). Interviews were transcribed verbatim, and data were analysed using a thematic analysis. Key themes identified included: role perception; competing priorities; the de-prioritisation of aphasia; and, the sense of disempowerment experienced by speech pathologists as a result of their relationship with evidencebased practice for acute aphasia management. In addition, a qualitative content analysis was undertaken to describe the current aphasia management pathway. Grounded within the guiding construct, First contact with the profession, the findings represented the significant diversity in the ii pathways of care for people with aphasia and their families in the acute hospital setting. Overall, analysis revealed the complex, diverse, and multi-faceted nature of the phenomenon.Phase Two was designed based on the findings of Phase One. It examined the culture of acute aphasia management by speech pathologists in depth, through the use of focused ethnography in a single acute stroke unit. Three participant triads...

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Stroke patients communicating their healthcare needs in hospital: a study within the ICF framework

Cited by 29 publications

References 17 publications

Standardization of Interdisciplinary Clinical Practice and Assessment in Stroke Rehabilitation

Standardization of Interdisciplinary Clinical Practice and Assessment in Stroke Rehabilitation

Outcomes of an Intensive Comprehensive Aphasia Program

“Communication is taking a back seat”: An exploration of aphasia management in acute hospital settings

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