Abstract
BackgroundCommunication and swallowing disorders are a common consequence of stroke. Clinical practice guidelines (CPGs) have been created to assist health professionals to put research evidence into clinical practice and can improve stroke care outcomes. However, CPGs are often not successfully implemented in clinical practice and research is needed to explore the factors that influence speech pathologists’ implementation of stroke CPGs. This study aimed to describe speech pathologists’ experiences and current use of guidelines, and to identify what factors influence speech pathologists’ implementation of stroke CPGs.MethodsSpeech pathologists working in stroke rehabilitation who had used a stroke CPG were invited to complete a 39-item online survey. Content analysis and descriptive and inferential statistics were used to analyse the data.Results320 participants from all states and territories of Australia were surveyed. Almost all speech pathologists had used a stroke CPG and had found the guideline “somewhat useful” or “very useful”. Factors that speech pathologists perceived influenced CPG implementation included the: (a) guideline itself, (b) work environment, (c) aspects related to the speech pathologist themselves, (d) patient characteristics, and (e) types of implementation strategies provided.ConclusionsThere are many different factors that can influence speech pathologists’ implementation of CPGs. The factors that influenced the implementation of CPGs can be understood in terms of knowledge creation and implementation frameworks. Speech pathologists should continue to adapt the stroke CPG to their local work environment and evaluate their use. To enhance guideline implementation, they may benefit from a combination of educational meetings and resources, outreach visits, support from senior colleagues, and audit and feedback strategies.
Highlights
Communication and swallowing disorders are a common consequence of stroke
As this study aimed to describe the experiences and use of stroke Clinical practice guidelines (CPGs) across a broad cross section of speech pathologists, a survey method was used
Speech pathologists and stroke clinical practice guidelines (n = 254) The following results describe the responses of the 254 respondents who completed the remainder of the survey. These results report on (a) speech pathologists’ initial experiences and current use of stroke CPGs and (b)
Summary
Communication and swallowing disorders are a common consequence of stroke. One third of these people acquire permanent disability [1]. Many people experience the sudden onset of a communication disability following a stroke. It is estimated that 35% of people acquire aphasia [2], 58% of people present with dysarthria [3], and approximately 25-77% of individuals have a cognitive impairment that may impact on communication [4] post stroke. Between 64%78% of people experience a swallowing disability [5] after a stroke. These disabilities can have a devastating impact on a person’s life [6,7]
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