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What are the factors that may influence the implementation of self-managed computer therapy for people with long term aphasia following stroke? A qualitative study of speech and language therapists' experiences in the Big CACTUS trial.
- Source :
- Disability & Rehabilitation; Jul2022, Vol. 44 Issue 14, p3577-3589, 13p
- Publication Year :
- 2022
-
Abstract
- To explore speech and language therapists' (SLT) experiences of delivering therapy using a computerised self-management approach within a pragmatic trial, in order to identify and understand key factors that may influence the implementation of computerised approaches to rehabilitation for aphasia in routine practice. Qualitative semi-structured telephone interviews were conducted with eleven SLTs delivering computer therapy in the multisite Big CACTUS trial. The interviews were recorded, transcribed verbatim and analysed using thematic analysis in NVivo11. Five themes with implications for implementation emerged: 1) characteristics of the intervention: complexity and adaptability 2) knowledge and beliefs about the intervention: familiarity with computers and the benefits of training; 3) patient needs and the service resource dilemma: "is there anything I can be doing on my computer at home?"; 4) networks and communications; 5) reflecting and evaluating: adaptations for sustainability. Personalisation, feedback and volunteer/assistant support were viewed as benefits of this complex intervention. However, the same benefits required resources including therapist time in learning to use software, procuring it, personalising it, working with volunteers/assistants, and building relationships with IT departments which formed barriers to implementation. The discussion highlights the need to consider integration of computer and face-to-face therapy to support implementation and potentially optimise patient outcomes. Benefits of the self-managed computer approach to word finding therapy evaluated in the Big CACTUS trial included the ability to personalise content, to provide feedback, and provide support with volunteers or assistants depending on availability in different clinical contexts to enable repetitive self-managed practice of word finding. Whilst use of computer therapy approaches can facilitate self-management of practice and increased therapy hours in an efficient manner, services need to consider the resources required to implement and support the approach: costs of software and hardware SLT time required to learn to use the software, tailor and personalise it and manage volunteers/assistants. Readiness for successful adoption of computer approaches requires building of relationships and mutual understanding of requirements between SLT and IT departments within an organisation. For time efficiency, it is recommended that SLTs providing self-managed computer therapy approaches pilot the approach with each individual to check patient ability and engagement before fully investing SLT time in personalisation and tailoring of software. [ABSTRACT FROM AUTHOR]
- Subjects :
- THERAPEUTICS
COMPUTERS in medicine
STROKE
SELF-management (Psychology)
ATTITUDES of medical personnel
WORK
RESEARCH methodology
TELEPHONES
INTERVIEWING
HUMAN services programs
QUALITATIVE research
REHABILITATION of aphasic persons
PSYCHOSOCIAL factors
EXPERIENTIAL learning
SOUND recordings
RESEARCH funding
THEMATIC analysis
DATA analysis software
SPEECH therapists
DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 09638288
- Volume :
- 44
- Issue :
- 14
- Database :
- Complementary Index
- Journal :
- Disability & Rehabilitation
- Publication Type :
- Academic Journal
- Accession number :
- 157982828
- Full Text :
- https://doi.org/10.1080/09638288.2020.1871519