Which treatment outcomes are most important to aphasia clinicians and managers? An international e-Delphi consensus study

Wallace, Sarah; Worrall, Linda; Rose, Tanya; Dorze, Guylaine Le

doi:10.1080/02687038.2016.1186265

Cited by 65 publications

(42 citation statements)

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“…A recent international study of aphasia clinicians and managers revealed consensus that dyadic communication, that is, the ability of both the person with aphasia and CP to communicate with each other, was the most agreed treatment outcome of aphasia rehabilitation (Wallace, Worrall, Rose, & LeDorze, 2016b). It is possible that clinicians perceive it to be efficient to work jointly with clients and their CPs.…”

Section: Delivering Conversation Therapymentioning

confidence: 99%

Professionals’ perspectives on delivering conversation therapy in clinical practice

2017

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Background: Aphasia and other acquired language impairments have the potential to impact greatly on quality of life by disrupting everyday conversation. Different intervention approaches are available to speech and language therapists (SLTs), such as targeting the language impairment itself and/or addressing activity or participation barriers. Conversation therapy is one approach that is gaining in popularity, with a growing evidence base. However, it is not clear how SLTs currently use conversation approaches and what factors may influence delivery. Aims: To investigate how SLTs (i) define conversation therapy, (ii) deliver it in clinical practice, and identify (iii) any challenges faced. Methods & Procedures: An online survey and focus group explored how SLTs working in the south east of England currently deliver conversation therapy to support people with a range of communication disorders, in particular aphasia. Data were analysed using descriptive statistics and thematic content analysis. Outcomes & Results: A total of 50 SLTs completed the survey and 6 participants attended the focus group. Conversation therapy was found to be widely employed by participants, however there was considerable variation in the approaches used, and a number of major challenges were raised. SLTs reported delivering conversation therapy with a range of client groups and preferably working with the client and partner together. Conversation goals predominantly reflected an approach based on: (i) strategy use and/or total communication (TC), and (ii) Conversation Analysis. Three overarching themes around conversation therapy emerged from the focus group: (1) What is conversation therapy? (2) showing it works, and (3) complexities of delivering it. SLTs acknowledged the benefit of conversation therapy but felt they lacked the tools and skills needed to deliver it. Conclusions: SLTs wanted to use conversation therapy and desired clear outcome measures to demonstrate its effectiveness, but were not accessing the available evidence base, highlighting the ongoing difficulty of translating research into clinical practice. Whilst these data are limited by the small number of participants, the study provides a first view of how conversation therapy is articulated in practice. Further investigation of conversation therapy delivery is warranted with a larger sample of SLTs based across the United Kingdom, as is comparison with practice in other countries.

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Section: Delivering Conversation Therapymentioning

confidence: 99%

Professionals’ perspectives on delivering conversation therapy in clinical practice

2017

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“…Further stakeholder perspectives are needed to gain a comprehensive picture of important outcomes from aphasia treatments. Accordingly two further studies have been conducted examining clinician (Wallace, Worrall, Rose, and Le Dorze, 2016a).and reseracher perspectives on treatment outcomes (Wallace, Worrall, Rose, and Le Dorze, 2016b). This information will be paired with a systematic review and meta-analysis of outcome measures in a final consensus process to develop a COS for aphasia treatment research.…”

Section: Limitations and Future Researchmentioning

confidence: 99%

Which outcomes are most important to people with aphasia and their families? an international nominal group technique study framed within the ICF

Wallace

Worrall

Rose

et al. 2016

Disability and Rehabilitation

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191

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This is the accepted version of the paper.This version of the publication may differ from the final published version. Permanent repository link:http://openaccess.city.ac.uk/15003/ Link to published version: http://dx.doi.org/10. 1080/09638288.2016.1194899 Copyright and reuse: City Research Online aims to make research outputs of City, University of London available to a wider audience. Copyright and Moral Rights remain with the author(s) and/or copyright holders. URLs from City Research Online may be freely distributed and linked to. City Research Online: http://openaccess.city.ac.uk/ publications@city.ac.uk City Research OnlineAbstract Purpose: To identify important treatment outcomes from the perspective of people with aphasia and their families using the ICF as a frame of reference. Methods:The nominal group technique was used with people with aphasia and their family members in seven countries to identify and rank important treatment outcomes from aphasia rehabilitation. People with aphasia identified outcomes for themselves; and family members identified outcomes for themselves and for the person with aphasia. Outcomes were analysed using qualitative content analysis and ICF linking.Results: A total of 39 people with aphasia and 29 family members participated in one of 16 nominal groups. Inductive qualitative content analysis revealed the following six themes: (1) Improved communication; (2) Increased life participation; (3) Changed attitudes through increased awareness and education about aphasia; (4) Recovered normality; (5) Improved physical and emotional well-being; and (6) Improved health (and support) services.Prioritised outcomes for both participant groups linked to all ICF components; primarily Activity/Participation (39%) and Body Functions (36%) for people with aphasia, and Activity/Participation (49%) and Environmental Factors (28%) for family members.Outcomes prioritised by family members relating to the person with aphasia, primarily linked to Body Functions (60%). Conclusions:People with aphasia and their families identified treatment outcomes which span all components of the ICF. This has implications for research outcome measurement and clinical service provision which currently focuses on the measurement of Body Function outcomes. The wide range of desired outcomes generated by both people with aphasia and their family members, highlights the importance of collaborative goal setting within a familycentred approach to rehabilitation. These results will be combined with other stakeholder perspectives to establish a core outcome set for aphasia treatment research. Achieving outcomes that are important to consumers is a key factor in maximising the value of healthcare (Porter & Lee, 2013). This conceptualisation of value reflects a broader shift in health care towards person-centred services which seek to meet individual needs in holistic ways (World Health Organization., 2007). In aphasia rehabilitation, the value of measuring consumer-important outcomes has steadily gained momentum in ...

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“…Further stakeholder perspectives are needed to gain a comprehensive picture of important outcomes from aphasia treatments. Accordingly two further studies have been conducted examining clinician (Wallace, Worrall, Rose, and Le Dorze, 2016a).and researcher perspectives on treatment outcomes (Wallace, Worrall, Rose, and Le Dorze, 2016b). This information will be paired with a systematic review and meta-analysis of outcome measures in a final consensus process to develop a COS for aphasia treatment research.…”

Section: Limitations and Future Researchmentioning

confidence: 99%

“…Classification of outcomes using the common metric of the ICF was used to enable the comparison of results from this study, with the results from other participant groups within the ROMA project (Wallace, Worrall, Rose, & Le Dorze, 2016a;Wallace, Worrall, Rose, Le Dorze, et al, 2016b). ICF linking rules developed by Cieza and associates (2002;, and…”

Section: Roundmentioning

confidence: 99%

“…The current study is one of three studies examining stakeholder perspectives on aphasia treatment outcomes. The perspectives of people with aphasia and their families (Wallace, Worrall, Rose, Le Dorze, et al, 2016a), and aphasia clinicians and managers have also been gathered (Wallace, Worrall, Rose, & Le Dorze, 2016b). The current study aimed to identify outcome constructs which aphasia researchers consider essential to measure in all aphasia treatment research.…”

Section: Introductionmentioning

confidence: 99%

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Improving research outcome measurement in aphasia: Development of a core outcome set

Wallace¹

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Aphasia treatment research lacks a consistent approach to outcome measurement. There is heterogeneity in the outcome measures used across treatment trials and a lack of research evidence exploring the outcome constructs which are most important to key stakeholders. The efficiency, relevancy, transparency, and overall quality of aphasia treatment research could be increased through the development of a core outcome set (COS)-an agreed standardised set of outcomes for use in treatment trials. The overarching aim of this research was to generate evidence-based recommendations for outcome constructs and outcome measures for a COS for aphasia treatment research.The thesis is comprised of a review of the literature (chapter 2) and two phases of research:(1) a trilogy of stakeholder consensus studies and a synthesis of the results; and (2)

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Which treatment outcomes are most important to aphasia clinicians and managers? An international e-Delphi consensus study

Cited by 65 publications

References 42 publications

Professionals’ perspectives on delivering conversation therapy in clinical practice

Professionals’ perspectives on delivering conversation therapy in clinical practice

Which outcomes are most important to people with aphasia and their families? an international nominal group technique study framed within the ICF

Improving research outcome measurement in aphasia: Development of a core outcome set

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