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Speech pathologists' experience of involving people with stroke-induced aphasia in clinical decision making during rehabilitation
journal contribution
posted on 2016-01-01, 00:00 authored by K Berg, M B Rise, Susan BalandinSusan Balandin, E Armstrong, T AskimPURPOSE: Although client participation has been part of legislation and clinical guidelines for several years, the evidence of these recommendations being implemented into clinical practice is scarce, especially for people with communication disorders. The aim of this study was to investigate how speech pathologists experienced client participation during the process of goal-setting and clinical decision making for people with aphasia. METHODS: Twenty speech pathologists participated in four focus group interviews. A qualitative analysis using Systematic Text Condensation was undertaken. RESULTS: Analysis revealed three different approaches to client participation: (1) client-oriented, (2) next of kin-oriented and (3) professional-oriented participation. Participants perceived client-oriented participation as the gold standard. The three approaches were described as overlapping, with each having individual characteristics incorporating different facilitators and barriers. CONCLUSIONS: There is a need for greater emphasis on how to involve people with severe aphasia in goal setting and treatment planning, and frameworks made to enhance collaboration could preferably be used. Participants reported use of next of kin as proxies in goal-setting and clinical decision making for people with moderate-to-severe aphasia, indicating the need for awareness towards maintaining the clients' autonomy and addressing the goals of next of kin. IMPLICATIONS FOR REHABILITATION: Speech pathologists, and most likely other professionals, should place greater emphasis on client participation to ensure active involvement of people with severe aphasia. To achieve this, existing tools and techniques made to enhance collaborative goal setting and clinical decision making have to be better incorporated into clinical rehabilitation practice. To ensure the autonomy of the person with aphasia, as well as to respect next of kin's own goals, professionals need to make ethical considerations when next of kin are used as proxies in collaborative goal setting and clinical decision making.
History
Journal
Disability and rehabilitationVolume
38Issue
9Pagination
870 - 878Publisher
Informa HealthcareLocation
Abingdon, Eng.Publisher DOI
eISSN
1464-5165Language
engPublication classification
C Journal article; C1 Refereed article in a scholarly journalCopyright notice
2015, Informa UKUsage metrics
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No categories selectedKeywords
Aphasiaclient participationclinical decision makinggoal-settingstrokeAdultAttitude of Health PersonnelClinical Decision-MakingDecision MakingFemaleHumansNorwayPatient CompliancePatient ParticipationProfessional-Patient RelationsQualitative ResearchRehabilitation ResearchSpeech-Language PathologyStandard of CareScience & TechnologyLife Sciences & BiomedicineRehabilitationPATIENT-CENTEREDNESSGOALCLIENTSWELL
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