Department of Communication Sciences and Disorders, University of Mississippi, Oxford, MS 38677, USA.
Department of Social Work, University of Mississippi, Oxford, MS 38677, USA.
Int J Environ Res Public Health. 2021 Nov 20;18(22):12197. doi: 10.3390/ijerph182212197.
The study investigated how pediatric speech-language pathologists (SLPs) applied telepractice to compensate for the loss of in-person services and the dynamics of telepractice use during the COVID-19 pandemic in a rural state. We conducted interviews with 10 SLPs and then a statewide survey in which 51 SLPs participated. The qualitative interviews revealed themes including changes in service environment due to the pandemic (e.g., transition to telepractice, losing clients), challenges in the transition to telepractice (e.g., limited training, difficulty engaging clients), worsening wellbeing of clinicians and clients, and SLPs' perspectives and suggestions towards telepractice in the future. Survey results showed service disruptions and transition dynamics during the pandemic. SLPs' weekly caseloads reduced from an average of 42.3 clients prior to the pandemic to 25.9 and 23.4 from March to May and from June to September 2020, respectively, and then recovered to 37.2 clients from October to December 2020. In contrast, the number of telepractice caseloads sharply increased from 0.2 clients per week prior to the pandemic to 14.8 from March to May 2020. The weekly telepractice caseloads then declined to 5.5 clients from June to September and 7.9 clients from October to December 2020. In the months right after the pandemic outbreak (i.e., March to May), client children struggled with treatment gains and behavioral wellbeing. However, their outcomes gradually improved by October to December and approached pre-pandemic levels. About one-third of the SLPs reported that they would be more likely or much more likely to use telepractice in the future regardless of the pandemic. However, only about a quarter perceived telepractice as comparable to in-person services. We concluded that the transition from in-person services to telepractice substantially mitigated service disruptions right after the pandemic outbreak and that telepractice's substitute role evolved over time.
本研究调查了在农村州，儿童言语语言病理学家 (SLP) 如何应用远程实践来弥补因新冠疫情而导致的面对面服务的丧失，以及远程实践在疫情期间的使用动态。我们对 10 名 SLP 进行了访谈，然后对 51 名 SLP 进行了全州范围的调查。定性访谈揭示了一些主题，包括大流行导致服务环境的变化（例如，转向远程实践，失去客户）、向远程实践过渡的挑战（例如，培训有限，难以吸引客户）、临床医生和客户的健康状况恶化，以及 SLP 对未来远程实践的看法和建议。调查结果显示，大流行期间服务中断和过渡动态。SLP 的每周病例量从疫情前的平均 42.3 名患者减少到 2020 年 3 月至 5 月的 25.9 名和 23.4 名，然后从 2020 年 6 月至 9 月恢复到 37.2 名，而从 2020 年 10 月至 12 月，远程实践的病例量从每周 0.2 例急剧增加到 14.8 例。然后，从 2020 年 6 月至 9 月，每周远程实践的病例量下降到 5.5 例，从 2020 年 10 月至 12 月下降到 7.9 例。在大流行爆发后的几个月（即 3 月至 5 月），客户的孩子在治疗效果和行为健康方面遇到困难。然而，到 2020 年 10 月至 12 月，他们的结果逐渐改善，接近大流行前的水平。约三分之一的 SLP 表示，无论是否发生大流行，他们将来更有可能或更有可能使用远程实践。然而，只有大约四分之一的人认为远程实践与面对面服务相当。我们的结论是，从面对面服务向远程实践的转变大大减轻了大流行爆发后的服务中断，并且远程实践的替代角色随着时间的推移而演变。
