Dr Abby Foster1,2, Professor Linda Worrall2, Associate Professor Miranda Rose1, Dr Robyn O’Halloran1
1La Trobe University, Melbourne, Australia, 2The University of Queensland, Brisbane, Australia
Aim:
To provide an understanding of speech pathologists’ conceptualisation of evidence-based practice for acute post-stroke aphasia, and its implementation.
Method:
An interpretive phenomenological approach was adopted by the research team. Single, semi-structured in-depth interviews were conducted with fourteen purposively sampled speech pathologists working with people with acute post-stroke aphasia. Thematic analysis was undertaken, leading to the generation of key themes across all cases.
Results:
Participants demonstrated a sense of disempowerment in their acute aphasia management as a result of their relationship with evidence-based practice. This formed a single, overarching theme: The disempowering influence of EBP on acute aphasia management. Three sub-themes were identified:
(1) “To me EBP means…”: Speech pathologists’ restricted conceptualisation of evidence-based practice;
(2) “That doesn’t translate”: Speech pathologists’ relationship with the research literature and other streams of evidence; and,
(3) “[EBP] is in the back of your mind but there’s nothing I can do about it”: Conflict between a desire to provide optimal service to people with aphasia and the perceived barriers to implementing evidence-based practice recommendations clinically.
Significance of the findings to allied health:
Speech pathologists place significant emphasis on evidence from the research literature, resulting in a restricted conceptualisation of evidence-based practice. In addition, there is disengagement between clinicians and the research literature. Given the knowledge-practice gap in aphasia management and the increasing emphasis on evidence-based care at an organisational level, evidence-based practice has become a disempowering concept for some speech pathologists. The implications of these findings for speech pathology and other allied health disciplines will be discussed