Telepractice Treatment for Aphasia: Association Between Clinical Outcomes and Client Satisfaction

Abstract

Introduction: Health services research has demonstrated the association between patient satisfaction and treatment outcomes illustrating the importance of satisfaction in determining favorable treatment outcomes. Despite abundant evidence in the acute care setting, few researchers have explored these associations among patients receiving speech rehabilitation or therapeutic treatment particularly those receiving treatment through nontraditional delivery methods. Objective: To examine the satisfaction with a community-based telepractice approach for treating aphasia among stroke survivors who reside in rural areas and assess potential correlations between satisfaction and patient outcomes. Methods: In total, 22 adults with poststroke aphasia who resided in rural areas received comprehensive language-oriented treatment (LOT) for aphasia through community-based telepractice. Post-treatment satisfaction with the telepractice approach was assessed using the Client Satisfaction Questionnaire-8 (CSQ-8). Results: After 12 sessions of LOT, Western Aphasia Battery-revised (WAB-R) aphasia quotients (AQs) improved on average 4.64 U. Mean scores on the CSQ-8 averaged 31.0/32.0, indicating a high level of satisfaction with the telepractice approach. In addition, each 1 U of improvement in patient satisfaction was associated with a 1.75 U increase in the WAB-R AQ. Conclusions: Examination of post-treatment satisfaction indicated that satisfaction was highly predictive of effectiveness—a one-point increase in satisfaction was associated with a nearly two-point increase in WAB-R AQ. Results echo findings from acute care studies underscoring the importance of the patient experience in treatment efficacy.

Applications of Telemedicine in Speech‐Language Pathology: Evaluation of Patient Satisfaction

“…However, equally important and far less established is how patients perceive their experience with telehealth. Patient satisfaction plays a major role in the adoption of telehealth initiatives and can influence the success of treatment, making it an often overlooked but critical metric of healthcare quality 18,24–26 …”

“…Understanding how individuals of all backgrounds and clinical needs engage with telemedicine is essential to improve the patient experience, promote adherence and facilitate adoption across a wide variety of patient demographics. Importantly, patient satisfaction has been shown to be highly predictive of speech‐language therapy success, highlighting the importance of the patient experience in promoting treatment efficacy 18 …”

“…10,11 Despite the growing body of literature regarding treatment efficacy, provider acceptability, and cost-effectiveness of telehealth, [12][13][14][15] limited studies have assessed patient satisfaction with speech-language rehabilitation services delivered via telehealth. Of these studies, the majority are limited to delivery of specific types of therapy (e.g., speech, swallow), [16][17][18][19] or specific patient populations (e.g., rural). 8,20 Understanding how individuals of all backgrounds and clinical needs engage with telemedicine is essential to improve the patient experience, promote adherence and facilitate adoption across a wide variety of patient demographics.…”

The Rationale for Economic Evaluation in Speech and Language: Cost, Effectiveness, and Cost-effectiveness

“…Jacobs et al studied comprehensive language-oriented treatment for aphasia through community-based telepractice. 8 One could label telepractice approach “Treatment 1” and consider it in relation to the non-telepractice approach “Treatment 2.” Fig. 2 illustrates options to treat a patient four times where there are two treatment approaches—Treatment 1 (telepractice) and Treatment 2 (non-telepractice).…”

“…Jacobs et al studied comprehensive languageoriented treatment for aphasia through community-based telepractice. 8 One could label telepractice approach "Treatment 1" and consider it in relation to the non-telepractice approach "Treatment 2." Fig.…”