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前线思考:加拿大在学前言语语言病理学中采用和实施推荐临床标签的观点。

Thoughts From the Front Lines: Canadian Perspectives in Adopting and Implementing Recommended Clinical Labels in Preschool Speech-Language Pathology.

作者信息

Csercsics Alison Lynn, Denusik Lauren, Cunningham Barbara Jane

机构信息

School of Communication Sciences and Disorders, The University of Western Ontario, London, Canada.

CanChild, Institute of Applied Health Sciences, McMaster University, Hamilton, Ontario, Canada.

出版信息

Am J Speech Lang Pathol. 2025 Jan 7;34(1):139-154. doi: 10.1044/2024_AJSLP-24-00272. Epub 2024 Nov 4.

Abstract

PURPOSE

Previous literature has proposed barriers to speech-language pathologists (SLPs) using standard clinical labels; however, the perspectives of SLPs have been studied to a lesser extent. This quality improvement project reports on SLPs' perceived barriers and facilitators to using currently recommended clinical labels for preschool communication disorders and identifies next steps to support implementation in one preschool communicative health system.

METHOD

This project aimed to establish the consistent use of clinical labels in one large Canadian preschool speech and language program. After completing a web-based training and a 3-month trial period, 387 SLPs completed an exit survey to share their perceived barriers and facilitators to label use. Qualitative survey data were analyzed using a hybrid codebook inductive/deductive thematic analysis approach.

RESULTS

Six themes were identified, which aligned with the diffusion of innovations theory. SLPs identified several facilitators and barriers to using the recommended clinical labels within each theme. Major facilitators included improved communication, better caregiver understanding of children's communication, positive feedback from caregivers, SLPs' increased confidence in sharing labels, and improved access to services for children. Major barriers related to additional time required to share labels, SLPs' perceptions of caregivers' values, SLPs' views surrounding the recommended labels, lack of comfort using some labels, and limited opportunity to practice label use or observe successful label use by others.

CONCLUSIONS

Contextual barriers continue to impact SLPs' use of the recommended clinical labels. Ongoing collaboration with SLPs and caregivers will be critical for supporting implementation. Further research examining SLPs' perspectives across other clinical settings and geographic areas is needed.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.27296970.

摘要

目的

以往文献提出了言语语言病理学家(SLP)使用标准临床标签的障碍;然而,对SLP观点的研究程度较低。本质量改进项目报告了SLP在使用当前推荐的学前交流障碍临床标签时所感知到的障碍和促进因素,并确定了在一个学前交流健康系统中支持实施的后续步骤。

方法

本项目旨在在加拿大一个大型学前言语和语言项目中建立临床标签的一致使用。在完成基于网络的培训和3个月的试用期后,387名SLP完成了一项离职调查,以分享他们在标签使用方面所感知到的障碍和促进因素。使用混合编码本归纳/演绎主题分析方法对定性调查数据进行了分析。

结果

确定了六个主题,这些主题与创新扩散理论一致。SLP在每个主题中都确定了使用推荐临床标签的几个促进因素和障碍。主要促进因素包括沟通改善、照顾者对儿童沟通的更好理解、照顾者的积极反馈、SLP在分享标签方面信心增强以及儿童获得服务的机会增加。主要障碍与分享标签所需的额外时间、SLP对照顾者价值观 的看法、SLP对推荐标签的看法、使用某些标签时缺乏舒适度以及练习标签使用或观察他人成功使用标签的机会有限有关。

结论

情境障碍继续影响SLP对推荐临床标签的使用。与SLP和照顾者的持续合作对于支持实施至关重要。需要进一步研究考察SLP在其他临床环境和地理区域的观点。

补充材料

https://doi.org/10.23641/asha.27296970

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