Acute post‐stroke aphasia management: An implementation science study protocol using a behavioural approach to support practice change.

Background: Evidence should guide decisions in aphasia practice across the continuum of stroke care; however, evidence–practice gaps persist. This is particularly pertinent in the acute setting where 30% of people with stroke will have aphasia, and speech pathologists experience many challenges impl...

Descripción completa

Detalles Bibliográficos
Publicado en:International Journal of Language & Communication Disorders (John Wiley & Sons, Inc.) Vol. 58; no. 3; pp. 968 - 977
Autores principales: Clapham, Renee P., McKinley, Kathryn, Stone, Marissa, Candy, Mary‐Anne, Candy, Phil, Carragher, Marcella, O'Halloran, Robyn
Formato: protocol tables/charts Journal Article
Publicado: John Wiley & Sons, Inc. May2023
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=163160847&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 163160847
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        14606984
        NRNM
      jtl: International Journal of Language & Communication Disorders (John Wiley & Sons, Inc.)
      issn: 14606984
      maglogo: N
    pubinfo:
      dt: May2023
      vid: 58
      iid: 3
      pid: 52269
      pub: John Wiley & Sons, Inc.
    artinfo:
      ui:
        163160847
        163160847
        163160847
        10.1111/1460-6984.12816
        163160847
      ppf: 968
      ppct: 9
      formats:
      tig:
        atl: Acute post‐stroke aphasia management: An implementation science study protocol using a behavioural approach to support practice change.
      aug:
        au:
          Clapham, Renee P.
          McKinley, Kathryn
          Stone, Marissa
          Candy, Mary‐Anne
          Candy, Phil
          Carragher, Marcella
          O'Halloran, Robyn
        affil: Department of Speech Pathology, St. Vincent's Hospital, Melbourne, VIC, Australia
      sug:
        subj:
          Aphasia Therapy
          Stroke Complications
          Implementation Science
          Behavior Therapy
          Acute Care
          Multimethod Studies
          Stroke Patients
          Survivors
          Collaboration
          Translations
          Pathologists
          Audit
          Knowledge
          Seminars and Workshops
          Outcome Assessment
      ab: Background: Evidence should guide decisions in aphasia practice across the continuum of stroke care; however, evidence–practice gaps persist. This is particularly pertinent in the acute setting where 30% of people with stroke will have aphasia, and speech pathologists experience many challenges implementing evidence‐based practice. This has important consequences for people with aphasia and their close others, as well as speech pathologists working in acute settings. Aims: This study protocol details how we will target practice change using a behavioural approach, with the aim of promoting the uptake of synthesized evidence in aphasia management post‐stroke in the acute hospital setting. Methods & Procedures: We will conduct a mixed‐methods before‐and‐after study following the Knowledge‐to‐Action (KTA) framework. Researchers, speech pathologists and people with lived experience of aphasia will collaborate to identify and prioritize practice gaps, and develop and implement changes to clinical practice based on the Theoretical Domains Framework and Behaviour Change Wheel. Discussion: This study may provide a template for acute stroke services in how to use an implementation science approach to promote the application of synthesized evidence into routine clinical practice to ensure people with aphasia receive high‐quality services. Collaboration among researchers, healthcare providers, people with aphasia and their close others ensures that the identification and targeting of practice gaps are driven by theory, lived experience and the local context. WHAT THIS PAPER ADDS: What is already known on this subject: Synthesized evidence, such as clinical guidelines and consensus statements, provides the highest level of evidence to inform clinical practice, yet discrepancies between delivered care and evidence remain. This discrepancy is of note in the acute setting where clinicians report many challenges implementing the best available evidence, combined with a high proportion of people with stroke who will have aphasia (30%). There are many reasons why evidence is not put into practice, and efforts to change clinical practice need to consider these barriers when developing interventions. What this paper adds to existing knowledge: This study protocol details an implementation science approach to affect clinical practice change, informed by a collaboration of key stakeholders (researchers, speech pathologists, and people with aphasia and their close others). Protocol papers that focus on bridging the gap between evidence and practice are uncommon in communication disorders; moreover, explicit prioritization of practice gaps is a critical but often overlooked aspect of promoting evidence‐based practice. What are the potential or actual clinical implications of this work?: This protocol provides insights into how one study site identified and prioritized evidence–practice gaps using a participatory approach. We provide insights into how clinical practice change may occur by describing how we plan to identify priority evidence–practice gaps and develop an intervention to improve the use of aphasia evidence in routine practice. This protocol aims to share an implementation science approach to service improvement that may be replicated across other services.
      pubtype: Academic Journal
      doctype:
        protocol
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N