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对失语症康复中言语语言病理学家实践共同体的评估:逻辑分析。

Evaluation of a community of practice for speech-language pathologists in aphasia rehabilitation: a logic analysis.

机构信息

School of Speech-Language Pathology and Audiology, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.

Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada.

出版信息

BMC Health Serv Res. 2019 Jul 29;19(1):530. doi: 10.1186/s12913-019-4338-0.

Abstract

BACKGROUND

Aphasia is a communication disorder affecting participation. Although there are evidence-based practice recommendations about participation and aphasia rehabilitation, it may be challenging for speech-language pathologists to ensure that rehabilitation activities have an impact on the person's participation, in part due to time limitations. Participation remains limited after rehabilitation for persons who have aphasia. Communities of practice (CoPs) are a collaborative knowledge transfer strategy that can be used for evidence-based practice implementation. The aim of this study was to describe the components and evaluate a CoP for speech-language pathologists about participation and aphasia rehabilitation.

METHODS

Logic analysis was used to determine the adequacy between resources, implemented activities, outputs and short-term outcomes of the CoP. Qualitative and quantitative descriptive data were collected through observation and participants' logbooks. Outputs and outcomes of the CoP were revealed through thematic analysis and interpretation of descriptive statistics.

RESULTS

Resources including CoP design and educational aims, human and material resources were combined to create various web-based, online and offline activities. Participants invested more time per week than expected in the CoP, shared and created clinical tools and appreciated the array of suggested activities. Participant engagement allowed them to reflect, interact and collaborate with each other. All 13 participants reported they acquired knowledge about clinical tools and 12 mentioned they reflected on their practice. While the CoP was ongoing, six participants noticed evidence-practice gaps, seven prepared to change their practice, and three changed their practice towards including more participation-based considerations.

CONCLUSIONS

This study showed that speech-language pathologists can include more participation-based approaches in aphasia rehabilitation as a result of participating in a time-bound, web-based CoP.

摘要

背景

失语症是一种影响参与的交流障碍。尽管有关于参与和失语症康复的循证实践建议,但言语治疗师可能难以确保康复活动对患者的参与产生影响,部分原因是时间限制。失语症患者康复后参与度仍然有限。实践社区(CoP)是一种协作知识转移策略,可用于实施循证实践。本研究旨在描述参与和失语症康复的言语治疗师 CoP 的组成部分并对其进行评估。

方法

逻辑分析用于确定 CoP 的资源、实施活动、产出和短期结果之间的充分性。通过观察和参与者的日志收集定性和定量描述性数据。通过主题分析和描述性统计数据的解释揭示 CoP 的产出和结果。

结果

包括 CoP 设计和教育目标在内的资源,以及人力和物力资源,结合起来创建了各种基于网络的、在线和离线活动。参与者每周在 CoP 上投入的时间超过预期,分享和创建临床工具,并欣赏各种建议的活动。参与者的参与使他们能够相互反思、互动和协作。所有 13 名参与者都报告说他们获得了关于临床工具的知识,12 名参与者提到他们反思了自己的实践。在 CoP 进行期间,六名参与者注意到实践证据差距,七名参与者准备改变实践,三名参与者改变实践以纳入更多基于参与的考虑因素。

结论

这项研究表明,由于参与限时的基于网络的 CoP,言语治疗师可以在失语症康复中纳入更多基于参与的方法。

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