Clinician Survey on Speech Pathology Services for People with Aphasia in Hong Kong

Abstract

This study aims to investigate aphasia practices by speech-language pathologists working with clients suffering from acquired neurogenic communication disorders through an online survey. Questions pertaining to content and intensity of aphasia management, service adequacy, and barriers to effective service provision to persons with aphasia were asked to understand the current service-provision situation in Hong Kong. A web-based questionnaire containing 38 questions was electronically distributed to speech-language pathologists in Hong Kong. A total of 41 respondents (equivalent to about 5% of the body of clinicians) completed and returned the survey. Compared to recommendations in existing best practice guidelines of aphasia from western countries, the results indicated that intensity and frequency of current aphasia services in Hong Kong fell short of expectations. Major challenges perceived by speech-language pathologists that contributed to dissatisfaction of aphasia service included limited manpower, resources, funding, and accessibility. It was also found that barriers to effective services could be related to clinicians' restricted adoption of intervention approaches, lack of active involvement of related healthcare professionals, and insufficient effort of referring persons with aphasia to support or self-help groups. Finally, factors to consider in order to improve existing aphasia management were discussed.

Behind the therapy door: what is “usual care” aphasia therapy in acute stroke management?

“…Australian therapists reported that a functional approach was most widely used in aphasia therapy (M. Rose et al, 2014;Verna et al, 2009). This has also been reported in international research (Guo et al, 2014;Kong & Tse, 2018). Functional approaches seek to reduce the activity limitation and participation restriction associated with aphasia and have a focus on enhancing communicative ability in everyday life (Patterson & Chapey, 2008).…”

“…When describing usual care therapy, many elements have been considered such as the amount and frequency of therapy provided (Verna et al, 2009), the theoretical approach or nature of the treatment sessions (Guo et al, 2014;Kong & Tse, 2018;Verna et al, 2009), and the way in which outcomes are measured (Verna et al, 2009). These descriptions of usual care constitute a broad look at usual care therapy and aimed to reflect current practice and therapists' clinical decision-making with data collected through surveys reflecting clinicians' perspectives of therapy provided.…”

Supporting people with post‐stroke aphasia to live well: A cross‐sectional survey of Speech & Language Therapists in Ireland

“…This evidence gap is compounded by an evidence‐practice gap including the provision of aphasia‐friendly information, support with depression and SLT of adequate intensity to maximise effectiveness (Code & Petheram, 2011; Foster, Worrall, Rose, & O'Halloran, 2015; Hickey, Shrubsole, Worrall, & Power, 2019; Hilari et al., 2015; Rose, Worrall, McKenna, Hickson, & Hoffmann, 2009; Shrubsole, Worrall, & Power, 2019; Shrubsole, Worrall, Power, & O'Connor, 2018; Thomas et al., 2013; Trebilcock et al., 2019). Surveys of SLTs in Australia and Hong Kong highlighted that PWA received sub‐optimum dosage for effective therapy (Kong, 2011; Kong & Tse, 2018; Rose, Ferguson, Power, Togher, & Worrall, 2014; Verna, Davidson, & Rose, 2009). This echoes earlier surveys in Australia, Canada, the United Kingdom and the United States (Katz et al., 2000; Mackenzie et al., 1993; Verna et al., 2009).…”

“…They noted that access to SLT was variable (a ‘post‐code lottery’), with better access in the first year (Palmer et al., 2018). A lack of aphasia education and training for PWA, caregivers and other healthcare professionals was reported in the Hong Kong survey (Kong & Tse, 2018); and there was a lack of aphasia information for friends in Australia (Rose et al., 2014). A lack of access to group and intensive therapy, limited follow‐up, and a general lack of community support services particularly in rural areas was also reported in the Australian survey (Rose et al., 2014).…”

Development and preliminary psychometric analysis of a quick screening form for referrals of individuals with neurogenic communication disorders to speechlanguage pathologists by laypersons

“…In Hong Kong, speechlanguage pathologists in community settings may receive referrals from any source to provide assessment and treatment to patients though speech-language pathologists in hospitals may only receive referrals from doctors. According to the results of a recent clinician survey study, the intensity and frequency of current speech and language pathology services in Hong Kong for individuals with acquired neurogenic communication disorders fell short of expectations and most "best practice" recommendations set in developed countries [8].…”