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An in-depth exploration of an aphasia care pathway

Student thesis: Doctoral Thesis

Introduction: Clinical or care pathways are increasingly being employed in health care settings, as a structured plan of care, to share with clients and their families and to implement clinical guidelines. Studies have explored the value of generic care pathways, yet there is limited evidence for the use of an aphasia care pathway. This research aimed to review and contribute to the theory and evidence-base for an aphasia care pathway, from a range of the key stakeholders including people with aphasia (PWA) carers and health care professionals (HCPs) including Speech and Language Therapists (SLTs). The aim was to illuminate their experiences and to measure the extent to which practising SLTs referred to an aphasia care pathway in their clinical practice, in order to address the research “Is there a need for an aphasia specific care pathway”?
Methods and procedures: Qualitative research techniques were used initially, PWA participated in focus groups and carers and HCPs in interviews, all were purposively selected. Focus groups and interviews were transcribed verbatim and the data analysed using the thematic based framework. A survey was distributed to SLTs working with PWA, to collect quantitative data. A sequential mixed methods analysis identified similarities and differences in the data sets which were then synthesised.
Outcomes and results: Thematic framework analysis illuminated four themes: experiences of care pathways within the NHS, characteristics and value of an aphasia care pathway, provision of aphasia related information and psychosocial factors that influence response to an aphasia care pathway. Descriptive statistics identified 42% of SLTs used an aphasia care pathway. 88% of all respondents agreed that an accessible version of an aphasia care pathway should be developed.
Conclusions and implications: This study highlights that, whilst the key stakeholders had awareness of an aphasia care pathway, modifications are required, including a description of the core elements of an aphasia care pathway, clear timescales for interventions, the provision of information in a timelier manner. In addition, the need for the key stages of a care pathway to be provided by a registered SLT and for an accessible representation of an aphasia care pathway to be available, were identified as priorities.
Original languageEnglish
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Award dateFeb 2018
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