Exploring the evidence-practice gap in post-stroke aphasia in Aotearoa New Zealand

Abstract

Background: The significant gap between health research and clinical implementation is well established. There has been growing research around the evidence-service gap in aphasia, and how to change this situation for the benefit of people with aphasia and for speech-language therapists. However no research had explored this area in Aotearoa New Zealand. Aims: To explore the evidence-practice gap through investigating the experiences of SLTs and people with aphasia receiving aphasia therapy in Aotearoa New Zealand, and to improve the provision of aphasia therapy. Method: This doctoral research was divided into three separate studies: A questionnaire distributed to SLTs, semi-structured interviews with 16 people with aphasia, and a co-designed workshop for SLTs. Results: In study one, we established the existence of an evidence-practice gap in aphasia in Aotearoa New Zealand. Respondents described what they did in aphasia therapy, the barriers they experienced to providing aphasia therapy that they wanted to do, and how they felt about different aspects of aphasia therapy. In study two, themes generated from interviewing people with aphasia included the importance of the therapeutic relationship with the person with aphasia and their whānau, the relevance of the therapy, the awareness and availability of aphasia therapy, and the access to that therapy. In study three, a co-designed workshop was overall effective in improving SLTs’ self-rated provision of aphasia therapy. The evaluation results were split into two categories: implementation questions and skill level/confidence questions. There was less change across the implementation questions which was likely to have been affected by pandemic-related service changes at that time. However, there was consistent improvement noted with responses to the skill/confidence levels with the greatest gain being in SLTs’ skill in tailoring their interventions for people with aphasia. Discussion and conclusions: This doctoral research added important information to our understanding of the experiences of SLTs and people with aphasia receiving aphasia therapy and how to improve the provision of aphasia therapy. This research is a step on the journey to ensure that all those with aphasia in Aotearoa New Zealand receive best practice aphasia therapy.