Bowling Green State University, Bowling Green, OH 43403, USA.
Am J Speech Lang Pathol. 2011 Feb;20(1):47-59. doi: 10.1044/1058-0360(2010/09-0106). Epub 2010 Dec 20.
Evidence-based practice (EBP) involves the incorporation of research evidence, clinical expertise, and client values in clinical decision making. One case in which these factors conflict is the use of nonspeech oral motor treatments (NSOMTs) for children with developmental speech sound disorders. Critical reviews of the research evidence suggest that NSOMTs are not valid, yet they are widely used by clinicians based on their expertise/experience. This investigation presents detailed descriptions of clinicians' and researchers' views and opinions on NSOMTs and EBP.
Individual interviews with 11 clinicians who use NSOMTs and 11 researchers in child phonology were conducted. The interviews were transcribed and organized into themes, following a phenomenological research design.
Five themes were identified: (a) NSOMTs are effective, (b) EBP is useful, (c) there is no published research supporting NSOMTs, (d) research evidence may change clinical use of NSOMTs, and (e) researchers and clinicians have separate but shared roles in clinical decision making.
The participants' responses provided detailed and complex insights into each group's decisions regarding NSOMTs. These responses also suggested questions that should be considered when making decisions about approaches that are not fully supported by EBP.
循证实践(EBP)涉及将研究证据、临床专业知识和客户价值观纳入临床决策。在这些因素发生冲突的情况下,有一个案例是使用非言语口腔运动治疗(NSOMTs)来治疗发育性言语声音障碍的儿童。对研究证据的批判性回顾表明,NSOMTs 是无效的,但基于其专业知识/经验,临床医生广泛使用它们。本研究详细介绍了临床医生和研究人员对 NSOMTs 和 EBP 的看法和意见。
对 11 名使用 NSOMTs 的临床医生和 11 名儿童语音学研究人员进行了个人访谈。访谈记录被转录并按照现象学研究设计组织成主题。
确定了五个主题:(a)NSOMTs 是有效的,(b)EBP 是有用的,(c)没有发表的研究支持 NSOMTs,(d)研究证据可能会改变临床对 NSOMTs 的使用,以及(e)研究人员和临床医生在临床决策中有不同但共同的作用。
参与者的回应详细而复杂地了解了每个群体对 NSOMTs 的决策。这些回应还提出了在做出不充分支持 EBP 的方法的决策时应考虑的问题。