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Addressing patients’ communication support needs through speech-language pathologist-nurse information-sharing: Employing ethnography to understand the acute stroke context

Barnard, R. A. ORCID: 0000-0003-4319-9550, Jones, J. & Cruice, M. ORCID: 0000-0001-7344-2262 (2022). Addressing patients’ communication support needs through speech-language pathologist-nurse information-sharing: Employing ethnography to understand the acute stroke context. International Journal of Speech-Language Pathology, 24(5), pp. 504-514. doi: 10.1080/17549507.2022.2034944

Abstract

Purpose: To explore how speech-language pathologists and nurses share information about the communication support needs of stroke patients through structured information-sharing routes and to consider how the two disciplines view their roles and interdependencies in addressing these needs.

Method: Speech-language pathologist and nurse information-sharing was explored in context using ethnography. Ethnography has been used by researchers from other disciplines to understand the context of inpatient care, but the methodology has rarely been adopted within speech-language pathology. Fieldwork (357 hours) was carried out on three stroke wards in England for 40 weeks from 2015-2017. Data included fieldnotes, interviews with 43 members of speech-language pathology and nursing staff, and the patient records of 19 patients.

Result: The findings provide a thematically organised explanation for how information about communication travelled through structured routes on the wards (meetings, the patient record, bedside signs, education, and nursing handover). Limitations were identified that appear underpinned by disciplinary differences in 1) how speech-language pathologists and nurses engaged with the wards in time and space, and 2) perceptions of roles and interdependencies. Speech-language pathologists routinely used meetings and the patient record to share communication information, however these formal structures were not easily accessible during nurses’ caregiving roles. In addition, both SLPs and nurses were ambivalent about the usefulness of signage SLPs sometimes left at the bedside for supporting communication. There was little interdependency between SLP and nursing roles in meeting the communication support needs of patients.

Conclusion: In-depth exploration of the context within which SLPs and nurses share information has revealed limitations in the capacity of structured routes to enhance collective knowledge about patients’ communication support needs.

Publication Type: Article
Additional Information: © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.
Publisher Keywords: speech-language pathologist, nurse, interprofessional, stroke, ethnography
Subjects: B Philosophy. Psychology. Religion > BF Psychology
P Language and Literature > P Philology. Linguistics
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RE Ophthalmology
R Medicine > RT Nursing
Departments: School of Health & Psychological Sciences > Language & Communication Science
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