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      Qualitative Exploration of Speech Pathologists' Experiences and Priorities for Aphasia Service Design: Initial Stage of an Experience‐Based Co‐Design Project to Improve Aphasia Services

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          ABSTRACT

          Introduction and Aims

          Stroke survivors with aphasia (impaired language/communication) have poor outcomes and gaps in the clinical implementation of best practice contribute to this. Little is known, however, about speech pathologist perspectives on the touchpoints (key moments shaping experiences) in the clinical care pathway that have the greatest impact on service delivery nor how this varies by geographical location. We explored the experiences of speech pathologists who provide aphasia services to establish priorities for improvement and design.

          Methods and Analysis

          This is the initial experience gathering and priority identification stage of an experience‐based co‐design (EBCD) project. Speech pathologists were recruited from 21 geographically diverse Hospital and Health Services in Queensland, Australia. Speech pathologists working in acute, rehabilitation and community services shared positive and negative experiences of delivering aphasia care in interviews and focus groups. Experiential data were analysed using qualitative thematic analysis to determine touchpoints. Priorities for service design were identified using an adapted nominal group technique.

          Results

          Speech pathologists ( n = 62) participated in 16 focus groups and nine interviews and shared 132 experiences of delivering aphasia care. Providing care in teams with poor awareness of the impacts of aphasia was identified as a key challenge, as poor patient‐provider communication was perceived to increase risk of adverse outcomes for patients. Speech pathologists identified areas for improvement related to their own professional needs (e.g., greater access to clinical supervision); collaborative health care (e.g., better coordination and interdisciplinary care to increase therapy time); and the service context and environment (e.g., psychological services able to support diverse communication needs).

          Conclusions

          Speech pathologist delivery of aphasia services could be improved through increased access to clinical supervision, opportunities for peer debriefing and interdisciplinary care. Priorities for service design varied by geographical location and included: education to support care transitions (remote areas), improved referral pathways and service linkage (regional areas) and dedicated aphasia staffing (metropolitan areas).

          Patient or Public Contribution

          A consumer advisory committee comprising people with aphasia ( n = 3, authors K.M., K.D. and B.A.), their significant others ( n = 2, authors J.D. and P.M.), and a Cultural Capability Officer (author G.B.) guided this research. The team: (1) reviewed participant information; (2) co‐designed surveys and workshop resources; (3) copresented research outcomes and contributed to publications. Research questions and study design (e.g., analysis methods and assessment measures) were developed by the research team (authors L.A., V.J.P., D.A.C. and S.J.W.).

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          Most cited references44

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          Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

          Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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            Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness.

            Qualitative content analysis as described in published literature shows conflicting opinions and unsolved issues regarding meaning and use of concepts, procedures and interpretation. This paper provides an overview of important concepts (manifest and latent content, unit of analysis, meaning unit, condensation, abstraction, content area, code, category and theme) related to qualitative content analysis; illustrates the use of concepts related to the research procedure; and proposes measures to achieve trustworthiness (credibility, dependability and transferability) throughout the steps of the research procedure. Interpretation in qualitative content analysis is discussed in light of Watzlawick et al.'s [Pragmatics of Human Communication. A Study of Interactional Patterns, Pathologies and Paradoxes. W.W. Norton & Company, New York, London] theory of communication.
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              Whatever happened to qualitative description?

              The general view of descriptive research as a lower level form of inquiry has influenced some researchers conducting qualitative research to claim methods they are really not using and not to claim the method they are using: namely, qualitative description. Qualitative descriptive studies have as their goal a comprehensive summary of events in the everyday terms of those events. Researchers conducting qualitative descriptive studies stay close to their data and to the surface of words and events. Qualitative descriptive designs typically are an eclectic but reasonable combination of sampling, and data collection, analysis, and re-presentation techniques. Qualitative descriptive study is the method of choice when straight descriptions of phenomena are desired. Copyright 2000 John Wiley & Sons,
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                Author and article information

                Contributors
                l.anemaat@uq.edu.au
                Journal
                Health Expect
                Health Expect
                10.1111/(ISSN)1369-7625
                HEX
                Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
                John Wiley and Sons Inc. (Hoboken )
                1369-6513
                1369-7625
                16 June 2024
                June 2024
                : 27
                : 3 ( doiID: 10.1111/hex.v27.3 )
                : e14105
                Affiliations
                [ 1 ] School of Health and Rehabilitation Sciences, Queensland Aphasia Research Centre The University of Queensland Herston Australia
                [ 2 ] Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance The University of Queensland and Metro North Health Australia
                [ 3 ] The ALIVE National Centre for Mental Health Research Translation The University of Melbourne Melbourne Australia
                Author notes
                [*] [* ] Correspondence: Lisa Anemaat ( l.anemaat@ 123456uq.edu.au )

                Author information
                http://orcid.org/0000-0001-7410-4652
                http://orcid.org/0000-0001-7212-932X
                http://orcid.org/0000-0002-2257-4270
                http://orcid.org/0009-0005-3652-5698
                http://orcid.org/0009-0005-0714-1505
                http://orcid.org/0009-0002-6594-5307
                http://orcid.org/0009-0008-6532-5443
                http://orcid.org/0009-0006-9081-0649
                http://orcid.org/0009-0004-2642-735X
                http://orcid.org/0000-0002-0600-9343
                Article
                HEX14105
                10.1111/hex.14105
                11180296
                38879788
                aa30b8c8-2aba-455c-855f-6fb83856046a
                © 2024 The Author(s). Health Expectations published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 13 March 2024
                : 11 January 2024
                : 26 May 2024
                Page count
                Figures: 5, Tables: 2, Pages: 13, Words: 7239
                Funding
                Funded by: This work is supported by The University of Queensland Aphasia Rehabilitation Research Fund (2018–2023) and a New Researcher grant awarded by Speech Pathology Australia (2020). S.W. is supported by a National Health and Medical Research Council (NHMRC) Emerging Leadership Investigator Grant (APP1175821) and L.A. is supported by The University of Queensland—Research Training Program Scholarship (QARC)
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                June 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.4.4 mode:remove_FC converted:16.06.2024

                Health & Social care
                aphasia,co‐design,coproduction,patient‐centred care,qualitative,stroke
                Health & Social care
                aphasia, co‐design, coproduction, patient‐centred care, qualitative, stroke

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