'That doesn't translate': The role of evidence-based practice in disempowering speech pathologists in acute aphasia management

Foster, Abby, Worrall, Linda, Rose, Miranda and O'Halloran, Robyn (2015) 'That doesn't translate': The role of evidence-based practice in disempowering speech pathologists in acute aphasia management. International Journal of Language and Communication Disorders, 50 4: 547-563. doi:10.1111/1460-6984.12155


Author Foster, Abby
Worrall, Linda
Rose, Miranda
O'Halloran, Robyn
Title 'That doesn't translate': The role of evidence-based practice in disempowering speech pathologists in acute aphasia management
Journal name International Journal of Language and Communication Disorders   Check publisher's open access policy
ISSN 1368-2822
1460-6984
Publication date 2015-07
Sub-type Article (original research)
DOI 10.1111/1460-6984.12155
Open Access Status Not Open Access
Volume 50
Issue 4
Start page 547
End page 563
Total pages 17
Place of publication Chichester, West Sussex, United Kingdom
Publisher John Wiley and Sons
Collection year 2016
Language eng
Formatted abstract
Background
An evidence–practice gap has been identified in current acute aphasia management practice, with the provision of services to people with aphasia in the acute hospital widely considered in the literature to be inconsistent with best-practice recommendations. The reasons for this evidence–practice gap are unclear; however, speech pathologists practising in this setting have articulated a sense of dissonance regarding their limited service provision to this population. A clearer understanding of why this evidence–practice gap exists is essential in order to support and promote evidence-based approaches to the care of people with aphasia in acute care settings.

Aims
To provide an understanding of speech pathologists’ conceptualization of evidence-based practice for acute post-stroke aphasia, and its implementation.

Methods and Procedures
This study adopted a phenomenological approach, underpinned by a social constructivist paradigm. In-depth interviews were conducted with 14 Australian speech pathologists, recruited using a purposive sampling technique. An inductive thematic analysis of the data was undertaken.

Outcomes and Results
A single, overarching theme emerged from the data. Speech pathologists demonstrated a sense of disempowerment as a result of their relationship with evidence-based practice for acute aphasia management. Three subthemes contributed to this theme. The first described a restricted conceptualization of evidence-based practice. The second revealed speech pathologists’ strained relationships with the research literature. The third elucidated a sense of professional unease over their perceived inability to enact evidence-based clinical recommendations, despite their desire to do so.

Conclusions and Implications
Speech pathologists identified a current knowledge–practice gap in their management of aphasia in acute hospital settings. Speech pathologists place significant emphasis on the research evidence; however, their engagement with the research is limited, in part because it is perceived to lack clinical utility. A sense of professional dissonance arises from the conflict between a desire to provide best practice and the perceived barriers to implementing evidence-based recommendations clinically, resulting in evidence-based practice becoming a disempowering concept for some.
Keyword Acute
Aphasia
Clinical decision-making
Empowerment
Evidence-based practice
Knowledge translation
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Health and Rehabilitation Sciences Publications
 
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