School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.
Hunter Medical Research Institute, New Lambton Heights, Australia.
Disabil Rehabil. 2022 Nov;44(23):7009-7022. doi: 10.1080/09638288.2021.1977397. Epub 2021 Nov 5.
A lack of social interaction during early stroke recovery can negatively affect neurological recovery and health-related quality of life of patients with aphasia following stroke. A Communication Enhanced Environment (CEE) model was developed to increase patient engagement in language activities early after stroke. This study aimed to examine staff ( = 20) and volunteer ( = 2) perceptions of a CEE model and factors influencing the implementation and use of the model. This study formed part of a broader study that developed and embedded a CEE model on two hospital wards.
Six focus groups and one interview with hospital staff were conducted and analysed using a qualitative description approach. Feedback emailed by volunteers was included in the data set.
Staff and volunteers perceived the CEE model benefitted themselves, the hospital system and patients. Staff identified a range of factors that influenced the implementation and use of the CEE model including individual staff, volunteer and patient factors, hospital features, the ease with which the CEE model could be used, and the implementation approach.
This study provides valuable insights into staff perceptions which may inform the implementation of interventions and future iterations of a CEE model.Implications for RehabilitationA CEE model may promote efficiency and increased patient engagement in stroke rehabilitation.The CEE model information session and aphasia communication partner training, and the provision of resources, may be useful strategies to increase staff confidence in using communication supporting strategies with patients with aphasia.Behaviour change and implementation science strategies may provide a framework to address barriers and promote facilitators to embed hospital-based interventions that require individual, ward, cultural and systems level change to reduce the evidence-based gap in clinical practice.
在中风后言语障碍患者的早期康复阶段，如果缺乏社交互动，可能会对其神经康复和健康相关生活质量产生负面影响。沟通增强环境（CEE）模型旨在增加患者在中风后早期参与语言活动的积极性。本研究旨在调查工作人员（n=20）和志愿者（n=2）对 CEE 模型的看法，以及影响模型实施和使用的因素。本研究是更广泛研究的一部分，该研究在两个医院病房中开发并嵌入了 CEE 模型。
对医院工作人员进行了六次焦点小组讨论和一次访谈，并使用定性描述方法进行了分析。志愿者通过电子邮件反馈的信息也包含在数据集内。
工作人员和志愿者认为 CEE 模型使他们自己、医院系统和患者受益。工作人员确定了一系列影响 CEE 模型实施和使用的因素，包括个人工作人员、志愿者和患者因素、医院特征、CEE 模型的易用性以及实施方法。
本研究提供了有关工作人员看法的宝贵见解，这可能为干预措施的实施和 CEE 模型的未来迭代提供信息。
CEE 模型可能会提高中风康复的效率和患者的参与度。CEE 模型信息会议和失语症沟通伙伴培训，以及提供资源，可能是提高工作人员对使用沟通支持策略与失语症患者的信心的有用策略。行为改变和实施科学策略可能为解决障碍和促进促进者提供框架，以促进需要个人、病房、文化和系统层面改变的基于医院的干预措施的实施，从而减少临床实践中的循证差距。
