Factors Associated With Adherence to Self-Managed Aphasia Therapy Practice on a Computer—A Mixed Methods Study Alongside a Randomized Controlled Trial

Harrison, Madeleine; Palmer, Rebecca; Cooper, Cindy

doi:10.3389/fneur.2020.582328

Cited by 14 publications

(13 citation statements)

References 41 publications

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“…Therefore, this finding of reduction in referrals is of concern. One explanation could be that it is simply not safe for SLTs to deliver care to these groups in the COVID-19 context ( 39 ), or these patient groups may be less able to rapidly adapt or adhere to tele-therapy ( 40 ), leading to less engagement in this period. However, the reduction observed in stroke cases from SLTs is in line with other reports showing a concerning reduction in stroke admissions across the UK throughout the lockdown period ( 41 ).…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on the Speech and Language Therapy Profession and Their Patients

2021

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Introduction: The UK's response to the COVID-19 pandemic presented multiple challenges to healthcare services including the suspension of non-urgent care. The impact on neurorehabilitation professions, including speech and language therapy (SLT), has been substantial.Objectives: To review the changes to SLT services triggered by the COVID-19 pandemic with respect to referral rates, service delivery and outcomes, as well as examining the contribution of SLTs to the neurorehabilitation of COVID-19 patients.Methods: Two surveys were distributed to Royal College of Speech and Language Therapists (RCSLT) members exploring experiences of service provision at 6 weeks and 22 weeks after the pandemic was declared in the UK. Responses to closed-ended questions, including questions regarding referral numbers were analyzed descriptively and compared at the two time-points. A database comprising routine clinical data from SLT services across the UK was used to compare information on patients receiving services prior to and during the pandemic. Data on COVID-19 patients was extracted, and findings are provided descriptively.Results: Referrals to SLT services during the acute COVID-19 period in the UK were substantially less than in the same period in 2019. A number of service changes were common including adopting more flexible approaches to provision (such as tele-therapy) and being unable to provide services to some patients. Database analysis suggests fewer patients have accessed SLT since the pandemic began, including a reduction in neurorehabilitation patients. For those who received SLT, the outcomes did not change. SLTs supported a range of needs of COVID-19 patients. Treatment outcomes for COVID-19 patients with dysphagia were positive.Discussion: The pandemic has affected neurorehabilitation and SLT services broadly: referral patterns are different, usual care has been disrupted and interventions have been modified affecting the impact on patient outcomes both positively and negatively. Some patients with COVID-19 require and benefit from SLT intervention.

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Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on the Speech and Language Therapy Profession and Their Patients

2021

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“…There is evidence that PWA disengage from treatment sessions due to perceived disengagement of SLPs during the rehabilitation process (Bright et al, 2017). In addition, PWA engage more with remote self-managed computerized therapy when they are frequently checked upon by SLPs (Harrison et al, 2020). These studies (Bright et al, 2017;Harrison et al, 2020) support SRL emphasis on PWA's and SLPs' collaboration during the treatment and strategy selection.…”

Section: Treatment and Strategy Selection In Aphasia Rehabilitationmentioning

confidence: 73%

Toward Self-Regulated Learning in Aphasia Rehabilitation

Imaezue¹,

Goral²

2022

Preprint

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Active collaboration between speech-language pathologists (SLPs) and persons with aphasia (PWA) is essential for personalizing aphasia treatment and optimizing clinical outcomes during aphasia rehabilitation. Studies have demonstrated the feasibility and effectiveness of collaboration between SLPs and PWA during the goal setting phase of the intervention process in aphasia rehabilitation. However, it remains unclear whether this collaboration as well as PWA’s feedback can be applied and be beneficial to all phases of aphasia rehabilitation. Here we introduce a theoretical framework of self-regulated learning (SRL) for aphasia rehabilitation that spotlights the role of PWA’s feedback in all phases of the rehabilitation process. We review studies on models of SRL in educational psychology and evidence from clinical aphasiology and neurolinguistics. Based on the evidence, we argue that PWA’s feedback is beneficial for optimizing all phases of the intervention process in aphasia rehabilitation. To make this work, communicative barriers to collaborative, patient-centered goal setting must be minimized or eliminated to facilitate alternative channels for receiving PWA’s feedback which will promote their engagement in aphasia rehabilitation. Also, insights from PWA’s feedback can help SLPs to select tasks and treatments that promote PWA’s engagement in the intervention process, which, in turn, can maximize aphasia recovery. PWA can be active participants in the whole intervention process and SLPs can use information from PWA’s feedback to improve the personalization of the whole intervention process to maximize clinical outcomes.

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“…Twelve papers from the initial search were finally included in this review (see Figure 1). The updated search conducted in May 2021 located two additional relevant papers [31,32], which supported what had been identified already as themes (from papers from the initial search) but did not change these; therefore, they were not added to the overall review.…”

Section: Resultsmentioning

confidence: 96%

Understanding the facilitators and barriers of stroke survivors’ adherence to recovery-oriented self-practice: a thematic synthesis

Vadas

Prest

Turk

et al. 2021

Disability and Rehabilitation

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Purpose: Stroke survivors receive considerable rehabilitation efforts as inpatients, but one-on-one therapy decreases after discharge. The gap between the amount of required therapy and the lack of its availability in this phase of care may be partly overcome by self-practice. However, patient's adherence to prescribed programs is often low. While single studies have examined factors affecting adherence in this specific case, they have not been reviewed and synthesised previously. Methods: A thematic synthesis of qualitative studies explored factors affecting stroke survivors' adherence to prescribed, recovery-oriented self-practice. Five databases were systematically searched for references: Medline, Psycinfo, CINAHL, Embase, and ASSIA. Quality assessment was undertaken using the CASP tool. Results: From 1308 references, 68 potential papers were read in full, and 12 were included in the review. An overarching theme was identified as: "Tailoring and personalization rather than standardization." It was informed by the following three analytical themes: "The meaning of 'self' in self-practice," "Identifying self-practice as a team effort," and "Self-practice that is grounded in one's reality." Conclusion: To have a positive effect on adherence to self-practice, clinicians are advised to spend time learning about each individual's life circumstances, so they can tailor proposed exercise programs to patients' personal situations, preferences, and needs. ä IMPLICATIONS FOR REHABILITATIONThe topic of patient's adherence to self-practice of prescribed exercise is a common concern, often voiced by frustrated rehabilitation health professionals. Bridging the gap between the patient's needs for post-discharge intensive therapy and the inability of healthcare systems to provide it could be filled partly by self-practice. Adherence to self-practice has become even more essential since the COVID 19 pandemic and the decrease in face-to-face delivery of rehabilitation due to social distancing requirements. Adherence to exercise is a broad topic. Reasons for poor adherence differ between patient populations and the exercises they are prescribed. This study focuses on post-discharge stroke survivors' adherence to recovery targeted exercise that could be described as repetitive and less physically demanding movements and functions. Reviewed studies were qualitative and usually included a relatively small number of participants within a specific context. Using thematic synthesis, we combined these small pieces of the puzzle into a larger picture, to produce recommendations that could be drawn on by clinicians to improve self-practice adherence.

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Factors Associated With Adherence to Self-Managed Aphasia Therapy Practice on a Computer—A Mixed Methods Study Alongside a Randomized Controlled Trial

Cited by 14 publications

References 41 publications

Impact of COVID-19 on the Speech and Language Therapy Profession and Their Patients

Impact of COVID-19 on the Speech and Language Therapy Profession and Their Patients

Toward Self-Regulated Learning in Aphasia Rehabilitation

Understanding the facilitators and barriers of stroke survivors’ adherence to recovery-oriented self-practice: a thematic synthesis

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