The core components of clinical planning for Comprehensive, High‐dose Aphasia Treatment (CHAT): A task analysis
International Journal of Language & Communication Disorders,
Journal Year:
2025,
Volume and Issue:
60(2)
Published: March 1, 2025
Abstract
Background
Intensive
comprehensive
aphasia
programmes
(ICAPs)
deliver
intensive
rehabilitation
via
a
cohort
approach,
aligning
with
the
World
Health
Organization's
(WHO)
International
Classification
for
Functioning,
Disability
and
(ICF).
ICAPs
are
an
effective
treatment
approach
rehabilitation,
their
implementation
within
healthcare
settings
is
currently
being
investigated.
However,
there
challenges
associated
selecting
tailoring
evidence‐based
treatments
delivery
supportive
processes
therapy
required.
To
address
this
challenge,
structured
collaborative
clinical
planning
has
been
incorporated
as
key
element
of
one
modified
ICAP
(mICAP),
Comprehensive,
High‐dose
Aphasia
Treatment
(CHAT)
programme.
CHAT
provides
50
h
personalized,
goal‐directed
language
impairment
function
across
8
weeks.
Our
current
understanding
how
conducted
programme
limited.
Aims
(1)
identify
define
individual
tasks
performed
part
structured,
process
its
telerehabilitation
counterpart
TeleCHAT;
(2)
to
understand
speech
pathologists’
perspectives
components,
roles
resources
planning.
Methods
A
mixed
methods
hierarchical
task
analysis
(HTA)
was
utilized
analyse
observations
10
goal‐setting
sessions
discussions
13
patients
two
TeleCHAT
cohorts.
Focus
groups
interviews
seven
pathologists
pathology
leaders
involved
in
delivering
or
supporting
were
also
conducted.
Clinical
tasks,
personnel
used
iteratively
built
into
framework.
Perspectives
on
elements
obtained
analysed
using
deductive
qualitative
content
analysis.
Results
Seven
comprising
25
subtasks,
identified
TeleCHAT:
assessment
analysis,
goal‐setting,
initial
meeting,
scheduling
coordination,
resource
preparation,
midway
throughout
therapy.
One
additional
prepare
technology.
Identifying
appropriate
considered
precursor
Each
perceived
essential
success.
The
involvement
both
research
teams
access
structure
described
elements.
Conclusion/implications
central
component
TeleCHAT,
involving
number
multifaceted
processes.
Understanding
executed
practice
first
step
towards
implementing
mICAPs
such
other
settings.
factors
that
influence
needed
further
inform
translation.
WHAT
THIS
PAPER
ADDS
What
already
known
subject
Speech
experience
therapy,
support
reported
facilitate
ICAPs.
paper
adds
existing
knowledge
This
study
comprehensively
describes
programmes,
Australian‐modified
(mICAPS),
amongst
few
descriptions
mapping
broader
practice.
potential
actual
implications
work?
detailed
description
processes,
addition
may
assist
improving
practices.
It
preliminary
translating
Language: Английский
Using the RE‐AIM and TDF frameworks to evaluate the implementation of a standardized cognitive assessment protocol in outpatient rehabilitation
PM&R,
Journal Year:
2024,
Volume and Issue:
unknown
Published: Aug. 19, 2024
Abstract
Background
Impairments
in
cognition
significantly
affect
patient
functioning
and
rehabilitation
outcomes.
Assessment
is
essential
to
identifying
at‐risk
individuals
guiding
care
plans.
Objective
A
cognitive
assessment
protocol
was
implemented
occupational
therapy
(OT)
speech‐language
pathology
(SLP)
outpatient
practice.
Using
the
Reach,
Effectiveness,
Adoption,
Implementation,
Maintenance
(RE‐AIM)
framework
Theoretical
Domains
Framework
(TDF),
this
study
(1)
measured
reach
adoption
of
(2)
explored
determinants
strategies
that
may
adoption.
Design
Sequential
mixed
methods.
Setting
Two
clinics
(A
B)
within
a
health
network.
Participants
Medical
records
from
220
adult
patients
with
neurologic
diagnosis
15
OT
SLP
clinicians.
Interventions
Cognitive
protocol.
Main
Outcome
Measure(s)
Reach
across
characteristics
clinical
sites
were
quantitatively
via
retrospective
electronic
medical
review.
Qualitative
data
on
effectiveness
implementation
process
collected
clinician
focus
groups.
Results
Protocol
rates
71%
54%
at
B,
respectively.
Site
B
more
likely
be
noncompliant
compared
A,
when
controlling
for
characteristics,
(81%
vs.
16%,
respectively;
odds
ratio
=
11.4,
95%
confidence
interval
[3.36–38.64],
p
≤
.001).
Patient
age
significant
factor
reach;
older
associated
noncompliance
adoption,
<
.05.
Both
employed
targeting
provider
level
(eg,
education/training);
additionally
included
organization‐level
leadership
engagement).
In
absence
strategies,
clinicians
identified
barriers
related
support,
resources,
workflow.
Conclusions
Standardized
practice
protocols
are
feasible
implement
setting,
though
multilevel
needed
promote
Aligning
practices
needs,
values
priorities
organization,
providers,
families
imperative.
Language: Английский