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Freeman-Sanderson A, Hemsley B, Thompson K, Rogers KD, Knowles S, Hammond NE. Communication functions of adult patients admitted to intensive care: A multicentre, binational point prevalence study. Aust Crit Care 2023; 36:1084-1089. [PMID: 37198003 DOI: 10.1016/j.aucc.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 01/30/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Patient communication is profoundly impacted during the intensive care unit (ICU) stay. While the impacts of altered communication are recognised, there is a paucity of data on the prevalence of communication attempts as well as modes utilised by patients and unit practices to manage communication function. OBJECTIVE The objectives of this study were to describe the prevalence and characteristics of observed communication attempts (nonverbal, verbal, and use of the staff call bell) in adult ICU patients and report on unit-level practices on communication management. METHODS A prospective, binational, cross-sectional point-prevalence study was conducted across 44 Australia and New Zealand adult ICUs. Data on communication attempts, modes, ICU-level guidelines, training, and resources were collected in June 2019. RESULTS Across 44 ICUs, 470 of 623 (75%) participants, including ventilated and nonventilated patients, were attempting to communicate on the study day. Of those invasively ventilated via an endotracheal tube for the entire study day, 42 of 172 (24%) were attempting to communicate and 39 of 45 (87%) patients with a tracheostomy were attempting to communicate. Across the cohort, the primary mode of communication was verbal communication, with 395 of 470 (84%) patients using speech; of those 371 of 395 (94%) spoke English and 24 of 395 (6%) spoke a language other than English. Participants attempting to communicate on the study day had a shorter length of stay (LOS), a mean difference of 3.8 days (95% confidence interval: 0.2; 5.1) shorter LOS in the ICU than those not attempting to communicate, and a mean difference 7.9 days (95% confidence interval: 3.1; 12.6) shorter LOS in hospital overall. Unit-level practices and supports were collected. Six of 44 (14%) ICUs had a protocol for communication management, training was available in 11 of 44 (25%) ICUs, and communication resources were available in 37 of 44 (84%) ICUs. CONCLUSION Three-quarters of patients admitted to the ICU were attempting to communicate on the study day, with multiple methods used to support verbal and nonverbal communication regardless of ventilation status. Guidance and training were absent from the majority of ICUs, indicating a need for development and implementation of policies, training, and resources.
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Affiliation(s)
- Amy Freeman-Sanderson
- Graduate School of Health, University of Technology, Sydney, NSW, Australia; Royal Prince Alfred Hospital, Sydney, NSW, Australia; Critical Care Division, The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Sydney, Australia; Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Bronwyn Hemsley
- Graduate School of Health, University of Technology, Sydney, NSW, Australia; The University of Newcastle, NSW, Australia
| | - Kelly Thompson
- Critical Care Division, The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Sydney, Australia; Nepean Blue Mountains Local Health District, Sydney, NSW, Australia
| | - Kris D Rogers
- Graduate School of Health, University of Technology, Sydney, NSW, Australia; Statistics Division, The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Sydney, Australia
| | - Serena Knowles
- Critical Care Division, The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Sydney, Australia
| | - Naomi E Hammond
- Critical Care Division, The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Sydney, Australia; Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, Sydney, Australia
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Nancarrow S, McGill N, Baldac S, Lewis T, Moran A, Harris N, Johnson T, Mulcair G. Diversity in the Australian speech-language pathology workforce: Addressing Sustainable Development Goals 3, 4, 8, and 10. Int J Speech Lang Pathol 2023; 25:119-124. [PMID: 36773003 DOI: 10.1080/17549507.2023.2165149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
PURPOSE Individuals have multiple intersecting identities, unique perspectives, and experiences which provide opportunities for new ways to interact, support inclusion and equity, and address the Sustainable Development Goals (SDGs). This commentary explores the diversity of the speech-language pathology workforce in Australia. RESULT A survey of Australian speech-language pathologists (SLPs; n = 1,638) distributed in November and December 2021 explored personal characteristics and experiences of the workforce. Almost 30% of SLPs who responded reported having experiences or perspectives that were relevant to service users and a quarter described other lived experiences, which included disability, cultural and linguistic background, mental health, caring responsibilities, neurodiversity, and being LGBTQI+. CONCLUSION This commentary affirms the value of diversity among allied health professions to enrich practice with individuals and communities. By understanding the diversity of the speech-language pathology workforce and perspectives of historically marginalised or invisible groups, the profession can introduce strategies to more meaningfully engage and support people with diverse backgrounds and perspectives in the workforce and enhance service equity and accessibility for people with communication and swallowing disabilities. This commentary focusses on SDG 3, SDG 4, SDG 8, SDG 10.
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Affiliation(s)
- Susan Nancarrow
- HealthWork International, Brisbane, Australia
- Southern Cross University, Lismore, Australia
| | - Nicole McGill
- Speech Pathology Australia, Melbourne, Australia
- Charles Sturt University, Bathurst, Australia
- University of Melbourne, Shepparton, Australia
| | | | - Tara Lewis
- Speech Pathology Australia, Melbourne, Australia
| | - Anna Moran
- University of Melbourne, Shepparton, Australia
- Unplex, Albury, Australia
| | | | | | - Gail Mulcair
- Speech Pathology Australia, Melbourne, Australia
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Turnbull H, Dark L, Carnemolla P, Skinner I, Hemsley B. A systematic review of the health literacy of adults with lifelong communication disability: Looking beyond accessing and understanding information. Patient Educ Couns 2023; 106:151-162. [PMID: 36283904 DOI: 10.1016/j.pec.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To determine the a) extent to which people with lifelong communication disability are included in health literacy research, b) level of health literacy of people with lifelong communication disability, c) methods applied to measure the health literacy of people with lifelong communication disability, d) barriers and facilitators mediating the health literacy of people with lifelong communication disability, and e) outcomes of health literacy interventions for people with lifelong communication disability. METHODS We searched for studies relating to health literacy, people with lifelong communication disability, and key areas of the Sørensen et al. (2012) health literacy model (i.e., accessing, understanding, appraising, applying health information, personal/environmental/systemic barriers and facilitators). RESULTS Analysis of 60 studies demonstrated that this population is not well represented. Insufficient research exists to inform statements on level of health literacy or methods used to measure health literacy of this population. Barriers and facilitators appear consistent with those applicable to the general population. Health literacy intervention outcomes were variable. CONCLUSION Significant gaps exist in the research which has primarily focused on people with intellectual disability accessing and understanding health information. PRACTICE IMPLICATIONS Findings can inform policies, practice, and future research on health literacy and people with lifelong communication disability.
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Affiliation(s)
- Harmony Turnbull
- Graduate School of Health, University of Technology Sydney, Ultimo, Australia.
| | - Leigha Dark
- Communication & Inclusion Resource Centre (CIRC), Scope Australia, Hawthorn, Australia.
| | - Phillippa Carnemolla
- School of Built Environment, University of Technology Sydney, Ultimo, Australia.
| | - Ian Skinner
- School of Allied Health Exercise & Sports Sciences, Charles Sturt University, Port Macquarie, Australia.
| | - Bronwyn Hemsley
- Graduate School of Health, University of Technology Sydney, Ultimo, Australia; Faculty of Education and the Arts, The University of Newcastle, Newcastle, Australia.
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Baker C, Foster AM, D'Souza S, Godecke E, Shiggins C, Lamborn E, Lanyon L, Kneebone I, Rose ML. Management of communication disability in the first 90 days after stroke: a scoping review. Disabil Rehabil 2022; 44:8524-8538. [PMID: 34919449 DOI: 10.1080/09638288.2021.2012843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION People with communication disability after stroke need interventions to optimise healthcare communication and rehabilitation outcomes. Current evidence syntheses do not adequately inform the management of communication disability during the first 90 days post-stroke. PURPOSE To explore the scope of literature for the management of communication disability in the first 90 days after stroke. MATERIALS AND METHODS A scoping review was conducted using a systematic keyword search of six databases. A descriptive synthesis was generated using communication-related domains related to the biopsychosocial framework of the International Classification of Functioning, Disability, and Health (ICF). RESULTS A total of 129 studies met eligibility criteria. Aphasia was the most frequently addressed communication disability after stroke (76/129 studies) with a paucity of evidence investigating other acquired neurogenic communication impairments. Management predominantly focused on communication-related: body functions and structures (62 studies) (e.g., linguistic-behavioural therapies), followed by environmental factors (39 studies) (e.g., communication partner training/support); activities and participation (15 studies) (e.g., augmentative and alternative communication); and personal factors (13 studies) (e.g., assessment of depression after aphasia). CONCLUSION A coordinated, integrated approach to developing and testing acute and subacute interventions for all communication disabilities across all communication-related domains is required.IMPLICATIONS FOR REHABILITATIONInterdisciplinary stroke clinicians need to manage communication disabilities in the first 90 days after stroke to optimise healthcare communication and rehabilitation outcomes.There is some evidence to guide clinicians in aphasia management but less in other disabilities of speech and cognitive functioning.Most interventions to inform clinical practice address communication-related body functions and structures (e.g., linguistic and speech therapies). Clinicians need to address all domains and more evidence is needed to address environmental factors (e.g., communication support); activities and participation (e.g., person-centred goal setting); and personal factors (e.g., psychological care).
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Affiliation(s)
- Caroline Baker
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia.,Speech Pathology Department, Monash Health, Melbourne, Australia
| | - Abby M Foster
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia.,Speech Pathology Department, Monash Health, Melbourne, Australia.,School of Primary & Allied Health Care, Monash University, Melbourne, Australia
| | - Sarah D'Souza
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia.,School of Medical and Health Science, Edith Cowan University, Joondalup, Australia
| | - Erin Godecke
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia.,School of Medical and Health Science, Edith Cowan University, Joondalup, Australia
| | - Ciara Shiggins
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia.,School of Health Sciences, University of East Anglia, Norwich, UK
| | - Edwina Lamborn
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Lucette Lanyon
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Ian Kneebone
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia.,Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Broadlands, Australia
| | - Miranda L Rose
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
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Lawton M, Haddock G, Conroy P, Serrant L, Sage K. People with aphasia's perspectives of the therapeutic alliance during speech-language intervention: A Q methodological approach. Int J Speech Lang Pathol 2020; 22:59-69. [PMID: 30987440 DOI: 10.1080/17549507.2019.1585949] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 10/17/2018] [Accepted: 12/10/2018] [Indexed: 06/09/2023]
Abstract
Purpose: To identify which elements of the therapeutic alliance are important to people with aphasia (PWA) attending speech-language pathology post-stroke.Method: A Q methodology design was adopted to explore which elements of the therapeutic alliance were valued by PWA. Statements (n = 453) relevant to the research question were extrapolated from the literature and qualitative interviews. A representative sample of statements (n = 38) was identified from the expansive data set. PWA (n = 23) sorted statements hierarchically according to whether they thought the statement was important or unimportant. Completed Q sorts were analysed using a by-person factor analysis.Result: Analysis yielded a five-factor solution, representing five distinct viewpoints: (1) acknowledge me, help me to understand; (2) respect me, listen to me; (3) challenge me, direct me; (4) understand me, laugh with me; and (5) hear me, encourage me.Conclusion: The findings highlight the need for clinicians to adopt a flexible and idiosyncratic approach to therapeutic alliance construction in order to meet the relational needs of a heterogeneous population. This is the first study to use Q methodology with PWA, demonstrating that Q methodology is an effective and viable method for investigating subjectivity in this population.
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Affiliation(s)
- Michelle Lawton
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK
| | - Gillian Haddock
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK
| | - Paul Conroy
- Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, UK
| | - Laura Serrant
- Faculty of Health and Wellbeing, Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK
| | - Karen Sage
- Faculty of Health and Wellbeing, Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK
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Taylor C, Sotiropoulou Drosopoulou C, Rochus D, Marshall J. Street-connected children with communication disabilities and their caregivers in Western Kenya: experiences, beliefs and needs. Disabil Rehabil 2019; 43:2342-2352. [PMID: 31829046 DOI: 10.1080/09638288.2019.1699174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Although street-connected children with communication disability have been identified in Western Kenya, little is currently known about the impact of communication disability on this group. In order to inform future service development, this qualitative study sought to understand the experiences, views and needs of street-connected children with communication disability, and of their caregivers at home and at school. MATERIALS AND METHODS 13 children, 12 caregivers and 12 school-based Learning Support Assistants participated in interactive sessions, semi-structured interviews and focus groups respectively. Interviews were translated, transcribed and analysed thematically, using framework analysis. RESULTS Six main themes, with sub-themes, were identified: understanding and awareness of communication disability; the role of others; needs of the children and what might help; impact on those supporting the children; caregiver and Learning Support Assistant needs: support to better help the child; thoughts about the future. Participants' responses highlighted the importance of improving others' attitudes, awareness and willingness to adapt their communication, as well as a need for trusted relationships and some specialist help. CONCLUSION Organisations working with street-connected children should take communication disability into account in their services and interventions. Input based on a social model of disability is likely to be acceptable.Implications for rehabilitationThe attitudes and behaviour of others affect how communication disability is experienced by street-connected children and their families.Intervention based on a social model of disability and aimed at improving the communication environment around the child is likely to be acceptable to children, caregivers and education support workers.Caregivers and education support workers want more training and support alongside specialist intervention.Communication at the level of the child is central to building trusted relationships, which are important to the success of street-connected children's rehabilitation and re-integration.
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Affiliation(s)
- Carol Taylor
- Health Professions Department, Manchester Metropolitan University, Manchester, UK
| | | | | | - Julie Marshall
- Health Professions Department, Manchester Metropolitan University, Manchester, UK.,University of KwaZulu Natal, Durban, South Africa
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Hemsley B, Steel J, Worrall L, Hill S, Bryant L, Johnston L, Georgiou A, Balandin S. A systematic review of falls in hospital for patients with communication disability: Highlighting an invisible population. J Safety Res 2019; 68:89-105. [PMID: 30876524 DOI: 10.1016/j.jsr.2018.11.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 08/23/2018] [Accepted: 11/28/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Patients with communication disability, associated with impairments of speech, language, or voice, have a three-fold increased risk of adverse events in hospital. However, little research yet examines the causal relationship between communication disability and risk for specific adverse events in hospital. OBJECTIVE To examine the impact of a patient's communication disability on their falls risk in hospital. METHODS This systematic review examined 61 studies on falls of adult hospital patients with communication disability, and patients at high risk of communication disability, to determine whether or not communication disability increased risk for falls, and the nature of and reasons for any increased risk. RESULTS In total, 46 of the included studies (75%) reported on participants with communication disability, and the remainder included patients with health conditions placing them at high risk for communication disability. Two thirds of the studies examining falls risk identified communication disability as contributing to falls. Commonly, patients with communication disability were actively excluded from participation; measures of communication or cognition were not reported; and reasons for any increased risk of falls were not discussed. CONCLUSIONS There is some evidence that communication disability is associated with increased risk of falls. However, the role of communication disability in falls is under-researched, and reasons for the increased risk remain unclear. Practical applications: Including patients with communication disability in falls research is necessary to determine reasons for their increased risk of adverse events in hospital. Their inclusion might be helped by the involvement of speech-language pathologists in falls research teams.
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Affiliation(s)
- Bronwyn Hemsley
- Speech Pathology, Graduate School of Health, The University of Technology, Sydney, Building 7 (Faculty of Science and Graduate School of Health Building), 67 Thomas Street, Ultimo, NSW 2007, Australia.
| | - Joanne Steel
- Speech Pathology, Graduate School of Health, The University of Technology, Sydney, Building 7 (Faculty of Science and Graduate School of Health Building), 67 Thomas Street, Ultimo, NSW 2007, Australia.
| | - Linda Worrall
- School of Health and Rehabilitation Sciences, University of Queensland Level 3, Therapies Annexe (84A), University of Queensland, Brisbane, St Lucia, QLD 4072, Australia.
| | - Sophie Hill
- Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, VIC 3086, Australia.
| | - Lucy Bryant
- Speech Pathology, Graduate School of Health, The University of Technology, Sydney, Building 7 (Faculty of Science and Graduate School of Health Building), 67 Thomas Street, Ultimo, NSW 2007, Australia.
| | - Leanne Johnston
- School of Health and Rehabilitation Sciences, University of Queensland Level 3, Therapies Annexe (84A), University of Queensland, Brisbane, St Lucia, QLD 4072, Australia.
| | - Andrew Georgiou
- Centre for Health Systems and Safety Research, Macquarie University, Room L6 36, Level 6, 75 Talavera Road, Sydney, NSW 2109, Australia.
| | - Susan Balandin
- Faculty of Health, School of Health & Social Development, Deakin University, Melbourne, Burwood Campus, 221 Burwood Highway, Burwood, VIC 3125, Australia.
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Hopf SC, McLeod S, McDonagh SH, Wang C, Rakanace EN. Communication disability in Fiji: Community self-help and help-seeking support. Int J Speech Lang Pathol 2018; 20:554-568. [PMID: 28683579 DOI: 10.1080/17549507.2017.1337226] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 05/16/2017] [Accepted: 05/27/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE To understand how a Fijian community supports people with communication disability (PWCD) and whether their support is associated with participant demographics. METHOD Thematic analysis of 144 questionnaires that asked about participants' actions to support a fictional child and adult with communication disability. RESULT Participant responses fell into two categories: what they would do directly (self-help) and people and places where they would seek assistance (help-seeking). Self-help behaviours included: making a change to their own communication style or mode; trying to change their own and others' behaviour; teaching new skills; praying; changing the physical environment; seeking information independently; assessing or observing; and, using traditional medicine, western medicine, or traditional belief practices. Help-seeking behaviours included seeking help from: other community members; education professionals; a professional in another country; spiritual leaders; traditional belief practitioners; traditional medicine practitioners; western health care practitioners; or, an alternative provider (e.g. home, orphanage, nursing home). Younger participants and those of iTaukei Fijian ethnicity were more likely to seek help from other community members. CONCLUSION This Fijian community actively supports people with communication disability within available networks. Development of speech-language pathology services for people with communication disability living in similar communities should harness the informal knowledge within these networks.
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Affiliation(s)
- Suzanne C Hopf
- a School of Teacher Education , Charles Sturt University , Bathurst , Australia
- b School of Language, Arts, & Media, University of the South Pacific, Suva , Fiji , and
| | - Sharynne McLeod
- a School of Teacher Education , Charles Sturt University , Bathurst , Australia
| | - Sarah H McDonagh
- a School of Teacher Education , Charles Sturt University , Bathurst , Australia
| | - Cen Wang
- a School of Teacher Education , Charles Sturt University , Bathurst , Australia
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Wylie K, McAllister L, Davidson B, Marshall J, Amponsah C, Bampoe JO. Self-help and help-seeking for communication disability in Ghana: implications for the development of communication disability rehabilitation services. Global Health 2017; 13:92. [PMID: 29284504 PMCID: PMC5747098 DOI: 10.1186/s12992-017-0317-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 12/08/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In low and middle-income countries, such as Ghana, communication disability is poorly recognised and rehabilitation services for people with communication disability are limited. As rehabilitation services for communication disability develop, and the profession of speech-language pathology grows, it is important to consider how services can most appropriately respond to the needs and preferences of the community. Understanding the ways in which people currently self-help and seek help for communication disability is central to developing services that build on existing local practices and are relevant to the community. METHODS A qualitative descriptive survey was used to explore likely self-help and help-seeking behaviours for communication disability, in Accra, Ghana. The survey required participants to describe responses to hypothetical scenarios related to communication disability. A mix of theoretical sampling and convenience sampling was used. Qualitative content analysis was used to analyse data and develop categories and subcategories of reported self-help behaviours and sources of help and advice for communication disability. RESULTS One hundred and thirty-six participants completed the survey. Results indicated that community members would be likely to engage in a variety self-help strategies in response to communication disability. These included working directly with a person with a communication disability to attempt to remediate a communication impairment, altering physical and communication environments, changing attitudes or care practices, educating themselves about the communication disability, providing resources, and responding in spiritual ways. Participants indicated that they would seek help for communication disability across a range of sectors - including the Western healthcare, religious, and traditional sectors. CONCLUSIONS Understanding existing community actions to self-help and help-seek may allow emerging communication rehabilitation services, including the profession of speech-language pathology, to build on existing community practices in resource-limited contexts such as Ghana.
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Affiliation(s)
- Karen Wylie
- Korle Bu Teaching Hospital, ENT Department, PO Box 77, Korle Bu, Accra, Ghana
- Faculty of Health Sciences, University of Sydney, 75 East Street, Lidcombe, NSW 2141 Australia
- Department of Audiology, Speech and Language Therapy, School of Biomedical and Allied Health Sciences, University of Ghana, PO Box 143, Korle Bu, Accra, Ghana
| | - Lindy McAllister
- Faculty of Health Sciences, University of Sydney, 75 East Street, Lidcombe, NSW 2141 Australia
| | - Bronwyn Davidson
- Department of Audiology & Speech Pathology, The University of Melbourne, 550 Swanston Street, Melbourne, VIC 3010 Australia
| | - Julie Marshall
- Health Professions Department, Manchester Metropolitan University, 53 Bonsall Street, Manchester, M15 6GX UK
| | - Clement Amponsah
- Department of Audiology, Speech and Language Therapy, School of Biomedical and Allied Health Sciences, University of Ghana, PO Box 143, Korle Bu, Accra, Ghana
| | - Josephine Ohenewa Bampoe
- Department of Audiology, Speech and Language Therapy, School of Biomedical and Allied Health Sciences, University of Ghana, PO Box 143, Korle Bu, Accra, Ghana
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10
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Palad YY, Barquia RB, Domingo HC, Flores CK, Padilla LI, Ramel JMD. Scoping review of instruments measuring attitudes toward disability. Disabil Health J 2016; 9:354-74. [PMID: 26962020 DOI: 10.1016/j.dhjo.2016.01.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 01/18/2016] [Accepted: 01/23/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Negative attitudes toward disability cause difficulties in integrating persons with disabilities (PWDs) into society and limit their access to health care, education, employment, and leisure. Being aware of societal attitudes toward disability may help explain discrimination against PWDs and draw attention to the solutions needed to address these. Good measures of attitudes are vital for this purpose. OBJECTIVE The aim is to synthesize published information, including evidences on psychometric properties and overall utility on instruments that measure attitudes toward disability. METHODS A two-tiered search process was performed to identify instruments that measure attitudes toward disability and retrieve articles that describe their development and/or validation. The CanChild Outcome Measures Rating Form was utilized to determine the overall utility of the instruments. Results were synthesized using a self-constructed data extraction form. RESULTS Thirty-one instruments were included in the study. Five measured attitudes toward communication disability, 7 toward intellectual disability, 4 toward mental illness, and 15 toward disability in general. Target respondents ranged from children to adults, and included respondents from different occupations and cultural backgrounds. Twenty-three were found to have adequate overall utility, while 8 have poor overall utility. CONCLUSION Several instruments are available in literature and all may be used for their intended purposes as long as their limitations are considered. Many still require further validation to ascertain their validity and responsiveness to change.
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Affiliation(s)
- Yves Y Palad
- Department of Physical Therapy, College of Allied Medical Professions, University of the Philippines Manila, UP-PGH Compound, Pedro Gil Street, Malate, Manila 1004, Philippines.
| | - Rensyl B Barquia
- Department of Physical Therapy, College of Allied Medical Professions, University of the Philippines Manila, UP-PGH Compound, Pedro Gil Street, Malate, Manila 1004, Philippines
| | - Harvey C Domingo
- Department of Physical Therapy, College of Allied Medical Professions, University of the Philippines Manila, UP-PGH Compound, Pedro Gil Street, Malate, Manila 1004, Philippines
| | - Clinton K Flores
- Department of Physical Therapy, College of Allied Medical Professions, University of the Philippines Manila, UP-PGH Compound, Pedro Gil Street, Malate, Manila 1004, Philippines
| | - Levin I Padilla
- Department of Physical Therapy, College of Allied Medical Professions, University of the Philippines Manila, UP-PGH Compound, Pedro Gil Street, Malate, Manila 1004, Philippines
| | - Jonas Mikko D Ramel
- Department of Physical Therapy, College of Allied Medical Professions, University of the Philippines Manila, UP-PGH Compound, Pedro Gil Street, Malate, Manila 1004, Philippines
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Morris MA, Meier SK, Griffin JM, Branda ME, Phelan SM. Prevalence and etiologies of adult communication disabilities in the United States: Results from the 2012 National Health Interview Survey. Disabil Health J 2015; 9:140-4. [PMID: 26303018 DOI: 10.1016/j.dhjo.2015.07.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Revised: 06/09/2015] [Accepted: 07/03/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND Communication disabilities, including speech, language and voice disabilities, can significantly impact a person's quality of life, employment and health status. Despite this, little is known about the prevalence and etiology of communication disabilities in the general adult population. OBJECTIVES To assess the prevalence and etiology of communication disabilities in a nationally representative adult sample. METHODS We conducted a cross-sectional study and analyzed the responses of non-institutionalized adults to the Sample Adult Core questionnaire within the 2012 National Health Interview Survey. We used respondents' self-report of having a speech, language or voice disability within the past year and receiving a diagnosis for one of these communication disabilities, as well as the etiology of their communication disability. We additionally examined the responses by subgroups, including sex, age, race and ethnicity, and geographical area. RESULTS In 2012 approximately 10% of the US adult population reported a communication disability, while only 2% of adults reported receiving a diagnosis. The rates of speech, language and voice disabilities and diagnoses varied across gender, race/ethnicity and geographic groups. The most common response for the etiology of a communication disability was "something else." CONCLUSIONS Improved understanding of population prevalence and etiologies of communication disabilities will assist in appropriately directing rehabilitation and medical services; potentially reducing the burden of communication disabilities.
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Affiliation(s)
- Megan A Morris
- Mayo Clinic, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA; Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
| | - Sarah K Meier
- Mayo Clinic, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA; Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Joan M Griffin
- Mayo Clinic, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA; Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Megan E Branda
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Sean M Phelan
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
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12
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Hemsley B, Dann S, Palmer S, Allan M, Balandin S. "We definitely need an audience": experiences of Twitter, Twitter networks and tweet content in adults with severe communication disabilities who use augmentative and alternative communication (AAC). Disabil Rehabil 2015; 37:1531-42. [PMID: 26030339 PMCID: PMC4699409 DOI: 10.3109/09638288.2015.1045990] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Purpose: The aim of this study was to investigate the Twitter experiences of adults with severe communication disabilities who use augmentative and alternative communication (AAC) to inform Twitter training and further research on the use of Twitter in populations with communication disabilities. Method: This mixed methods research included five adults with severe communication disabilities who use AAC. It combined (a) quantitative analysis of Twitter networks and (b) manual coding of tweets with (c) narrative interviews with participants on their Twitter experiences and results. Results: The five participants who used AAC and Twitter were diverse in their patterns and experiences of using Twitter. Twitter networks reflected interaction with a close-knit network of people rather than with the broader publics on Twitter. Conversational, Broadcast and Pass Along tweets featured most prominently, with limited use of News or Social Presence tweets. Tweets appeared mostly within each participant's micro- or meso-structural layers of Twitter. Conclusions: People who use AAC report positive experiences in using Twitter. Obtaining help in Twitter, and engaging in hashtag communities facilitated higher frequency of tweets and establishment of Twitter networks. Results reflected an inter-connection of participant Twitter networks that might form part of a larger as yet unexplored emergent community of people who use AAC in Twitter.Implications for Rehabilitation Twitter can be used as an important vehicle for conversation and a forum for people with communication disabilities to exchange information and participate socially in online communities. It is important that information and resources relating to the effective use of Twitter for a range of purposes are made available to people with communication disabilities who wish to take up or maintain use of Twitter. People with communication disabilities might benefit from support in using Twitter to meet their goals relating to participation in online forums and information exchange. Practitioners need to consider how their own social media skills might impact on service delivery and supporting these goals.
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Affiliation(s)
- Bronwyn Hemsley
- School of Humanities and Social Science, The University of Newcastle , Newcastle , Australia
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13
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O'Halloran R, Lee YS, Rose M, Liamputtong P. Creating communicatively accessible healthcare environments: perceptions of speech-language pathologists. Int J Speech Lang Pathol 2014; 16:603-614. [PMID: 24665913 DOI: 10.3109/17549507.2014.894125] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
There is a growing body of research that indicates that a person with a communication disability communicates and participates more effectively given a communicatively accessible environment. If this research is to be translated into practice then one needs to determine who will take on the role of creating communicatively accessible environments. This research adopted a qualitative methodology to explore the perceptions of speech-language pathologists about working to create communicatively accessible healthcare settings. Fifteen speech-language pathologists in three focus groups participated in this research. The focus group discussions were transcribed and analysed thematically. Thematic analysis indicated that speech-language pathologists believe there are four main benefits in creating communicatively accessible healthcare environments. These are Benefits for all people: Access for all, Benefits for healthcare administrators, Benefits for those wanting to improve communication with patients, and Benefits to the capacity to provide communicatively accessible environments. However, they believe these benefits can only be achieved if; The communication resources are available, Skilled, knowledgeable and supportive healthcare providers are available; and Systems are in place to support a whole-of-hospital approach. This research supports the development of a new role to improve the communicative accessibility of healthcare settings.
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Affiliation(s)
- Robyn O'Halloran
- La Trobe University, Human Communication Sciences , Bundoora, Melbourne , Australia
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14
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Hemsley B, Balandin S. A metasynthesis of patient-provider communication in hospital for patients with severe communication disabilities: informing new translational research. Augment Altern Commun 2014; 30:329-43. [PMID: 25229213 PMCID: PMC4266100 DOI: 10.3109/07434618.2014.955614] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Accepted: 06/06/2014] [Indexed: 11/13/2022] Open
Abstract
Poor patient-provider communication in hospital continues to be cited as a possible causal factor in preventable adverse events for patients with severe communication disabilities. Yet to date there are no reports of empirical interventions that investigate or demonstrate an improvement in communication in hospital for these patients. The aim of this review was to synthesize the findings of research into communication in hospital for people with severe communication disabilities arising from lifelong and acquired stable conditions including cerebral palsy, autism, intellectual disability, aphasia following stroke, but excluding progressive conditions and those solely related to sensory impairments of hearing or vision. Results revealed six core strategies suggested to improve communication in hospital: (a) develop services, systems, and policies that support improved communication, (b) devote enough time to communication, (c) ensure adequate access to communication tools (nurse call systems and communication aids), (d) access personally held written health information, (e) collaborate effectively with carers, spouses, and parents, and (f) increase the communicative competence of hospital staff. Currently there are no reports that trial or validate any of these strategies specifically in hospital settings. Observational and evaluative research is needed to investigate the ecological validity of strategies proposed to improve communication.
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Affiliation(s)
- Bronwyn Hemsley
- School of Humanities and Social Science, Faculty of Education and Arts, The University of Newcastle, New South Wales, Australia
| | - Susan Balandin
- School of Health and Social Development, Faculty of Health, Deakin University, Victoria, Australia
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15
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Morris MA, Clayman ML, Peters KJ, Leppin AL, LeBlanc A. Patient-centered communication strategies for patients with aphasia: discrepancies between what patients want and what physicians do. Disabil Health J 2015; 8:208-15. [PMID: 25458973 DOI: 10.1016/j.dhjo.2014.09.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 08/05/2014] [Accepted: 09/27/2014] [Indexed: 11/22/2022]
Abstract
BACKGROUND Communication during clinical encounters can be challenging with patients with communication disabilities. Physicians have the potential to positively affect the encounter by using communication strategies that engage the patient in patient-centered communication. OBJECTIVE We engaged patients and their physicians in defining their preferences for patient-centered communication strategies, then evaluated the use of the identified strategies during observed clinical encounters. METHODS We video-recorded 25 clinical encounters with persons with aphasia. All encounters were previously scheduled with community physicians and a companion was present. Following each encounter, physicians completed a brief questionnaire and the person with aphasia and his or her companion participated in a video elicitation interview. RESULTS While many of the communication strategies identified and described by physicians, patients and companions were similar, patients and companions identified three additional key communication strategies. These strategies included (1) using visual aids, (2) writing down key words while speaking, and (3) using gestures. In the video recorded clinical encounters, no physicians wrote down key words while speaking and only one used a visual aid during the clinical encounter. The frequency with which physicians used gestures varied greatly, even within the same patient, suggesting the use of gestures was independent of patient or companion characteristics. CONCLUSIONS To maximize patient-centered communication with patients with communication disabilities, physicians should use "disability-specific" communication strategies. Our study suggests that physicians should routinely ask patients and companions about communication preferences and then incorporate identified communication strategies into their communication style.
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