Large variations in intensive speech– language rehabilitation post-stroke

Abstract

Background: Intensive rehabilitation of aphasia is recommended in the national guidelines for stroke care, but is far from implemented in Swedish healthcare. Aim: To explore current practice and detect barriers and enablers for intensive aphasia rehabilitation among Speech Language Pathologists (SLPs) before they were enrolled in a national intervention study.Method: Thirty-six SLPs in 26 clinics answered a web-based questionnaire. Responses were processed using descriptive statistics and thematic analysis.Result: Treatment intensity, duration and delivery format varied widely, and two-thirds offered intensive rehabilitation rarely or never. Thematic analysis generated the following five barriers: understaffing, patient factors, teamwork/scheduling, prioritization, and accessibility, and three enablers: increased staffing, planned intervention programmes, and comprehensive delivery formats.Conclusions: Compliance with Swedish stroke guidelines for intensive aphasia rehabilitation is low, and the current practice varies widely between different clinics. Increasing SLPs in primary care and restructuring care by using planned and comprehensive intervention approaches are suggested to stimulate implementation.