Understanding practices of speech-language pathologists in aphasia rehabilitation: a grounded theory study
Notice bibliographique
Résumé
Background: Social participation is the stated ideal end purpose of rehabilitation, however people with aphasia often have limited social participation following rehabilitation. Despite growing evidence regarding the importance of addressing social participation issues in aphasia rehabilitation, it is unknown how much these issues are considered by speech-language pathologists. More importantly, it is unclear what aphasia rehabilitation practice includes.Aim: The aim of this study was to understand speech-language pathology practice in aphasia rehabilitation by means of a theoretical model.Methods & Procedures: Grounded theory was used to structure this research study. Seventeen speech-language pathologists working in different settings of the care continuum of aphasia rehabilitation in Quebec (Canada) were recruited to participate in individual, semi-structured interviews. They were questioned about the ideal end purpose of aphasia rehabilitation and the clinical activities performed in practice. Recorded interviews were transcribed and analysed following an inductive, constructivist-based approach. Categories were identified and a theoretical model was developed.Outcomes & Results: The main characteristic of the participants’ practice was that it included underlying questions. These questions were either related to the purpose of aphasia rehabilitation or to the clinical activities performed to achieve that purpose. Four central clinical activities were described: counselling; assessing needs and abilities; setting therapy goals; and conducting therapy. Two clinical activities were not systematically performed; thus, they were considered peripheral within practice: including relatives in therapy and considering other parties. The focus of practice was either on language impairment or on social participation of the person with aphasia. Participants expressed different perceptions about the ideal end purpose of aphasia rehabilitation and considered their workplace environment as constraining or encouraging professional autonomy, which had an impact on the focus of practice. Underlying questions led participants to express a need for guidance to orient their practice.Conclusions: Results contribute to a better understanding of aphasia rehabilitation practice. When deeply motivated by helping the person resume significant life habits, speech-language pathologists’ practice was more likely to be focused on social participation, but questions regarding clinical activities persisted. A future knowledge transfer strategy could help guide and orient speech-language pathologists.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,039 | 0,026 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,005 | 0,003 |
| Études des sciences et des technologies | 0,010 | 0,016 |
| Communication savante | 0,009 | 0,007 |
| Science ouverte | 0,003 | 0,006 |
| Intégrité de la recherche | 0,003 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».