A Multinational Comparison Of Aphasia Management Practices

Abstract

The effect of restructuring of healthcare on the quality, quantity, and nature of aphasia management is largely unknown. The current study is the first to examine access, diagnostic, treatment, and discharge patterns of patients with aphasia in Australia, Canada, the UK, the US private sector (US-Private), and the US Veterans Health Administration in the Department of Veterans Affairs (US-VA). The authors developed a 37-item survey to be completed by clinicians working with aphasic patients. The survey focused on eight areas: access to care, evaluation procedures, group treatment, number and duration of treatment sessions, limitations of the number of sessions, termination of treatment, follow-up practices, and resumption of treatment. 394 surveys were distributed and 175 were returned completed (44% return rate). Respondents represented a range of ages, work experiences, and work settings. There was considerable consistency among respondents from our five healthcare systems. Results suggest that patients may be routinely denied treatment in direct contradiction to the research literature. Just as we carefully monitor the progress of patients receiving our treatment, we are obliged to monitor the effects of managed care on our patients, fellow clinicians, and our profession.

Speech pathology services for people with aphasia: what is the current practice in Singapore?

“…While there were some similarities with previous research in the discharge criteria used by respondents in the survey such as a plateau in progress or achievement of therapy goals [7,53], clients or families declining aphasia intervention was the most cited reason for discharge in this study. This seems in stark contrast to reports of people with aphasia wanting more rehabilitation than they actually receive [66] and that discharge is difficult to negotiate [28,67].…”

“…Despite the seemingly widespread use of functional or social approaches to aphasia intervention, functional aphasia assessment tools such as those measuring communication partner ratings, quality of life or client satisfaction were rarely used by the participants. The most frequently reported assessment tools were those measuring linguistic impairment such as informal language assessments, PALPA [40] and BDAE [35], which is comparable to previous Australian and multinational findings [7,53]. This has been suggested to be due to the lack of measures assessing communication at the activity and participation levels [54], which is lacking particularly for the Singapore context.…”

Current Clinical Practices in Aphasia Therapy in Finland: Challenges in Moving towards National Best Practice

“…Therefore, our understanding is that the surveys’ response rates provided rather good coverage of the population. The response rates (46 and 66%) were regarded as comparable or even slightly better than the response rates of similar surveys presented in the literature [3,4,5,6]. …”

“…It is also known that there is widespread variability in service provision in different countries [6]. The demands of equitable and good quality service provision as well as the demands of evidence-based practice have brought new challenges for the management of different clinical speech and language disorder groups.…”

Current Clinical Practice of Speech-Language Pathologists who Treat Individuals with Aphasia

“…One multi-national study compared aphasia management techniques among five different English-speaking healthcare systems (Katz et al 2000). Findings revealed the most widely used assessment tool for acute aphasia was the BNT, while the BDAE was used most commonly to assess language performance of individuals who had chronic aphasia.…”