Outcome Measures Following Traumatic Brain Injury: A Synthesis of Speech-Language Pathologist’s Perspectives
2022-05
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Outcome Measures Following Traumatic Brain Injury: A Synthesis of Speech-Language Pathologist’s Perspectives
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2022-05
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Abstract
AbstractPurpose. Traumatic brain injury (TBI) is a major public health concern and impacts
several different cognitive domains, often simultaneously. Outcome measures are used to
evaluate progress in the clinic, and treatment efficacy in research. However, there can be
mismatches between the cognitive impairments that commonly-used outcome measures
assess and how these impairments impact the individual in real life. Historically, TBI
research has relied on the opinions of researchers, rather than key stakeholders, to decide
what is most important in assessment, treatment, and outcome measurement in TBI. By
ignoring the opinions of individuals who hold lived experiences with TBI, there is a risk
of treating and measuring domains that have less relevance to the individuals most
closely impacted by TBI. This thesis is part of a larger study that aims to solicit the
opinions of key stakeholders (individuals with TBI, their families, and speech-language
pathologists) to find what matters most during TBI rehabilitation, in order to inform the
selection of outcome measures for treatment efficacy research as well as the development
of new outcome measures for domains not currently assessed in clinical and research
settings. Here, we consider the perspectives of speech-language pathologists.
Method. 41 speech-language pathologists (SLPs) across the United States completed an
online survey. The two-part survey included: a clinical experience section and an open-ended
response section including questions designed to elicit measurable outcome
domains in TBI rehabilitation. The clinical experience section was analyzed using
descriptive statistics. Open-ended responses were analyzed using qualitative thematic
analysis. Data-driven thematic analyses included creating and refining a codebook,
coding the data set, and organizing codes into themes for interpretation.
Results. Results from the clinical experience section revealed the respondents had
experience as SLPs averaging 14 years with CCCs (Certificate of Clinical Competence),
and an average of 9.5 years of experience with TBI. Respondents worked in varied
practice settings ranging from acute care to outpatient. The inductive qualitative analysis
of the open-ended responses resulted in three themes that are of value to speech-language
pathologists in TBI rehabilitation: Primary Impairments Following TBI (with 41 [100%]
of 41 participants contributing to this theme), Changes to Activities and Participation (41
[100%]), and Process Factors in TBI Rehabilitation (40 [96%]). Conclusion. Many of the frequently cited domains reported by SLPs (e.g. memory, attention, executive function) are captured currently used outcome measures for TBI;
however, some of the domains cited by SLPs are rarely or never measured in current
outcome measures for TBI rehabilitation (e.g. acceptance, ease-effort, use of
compensatory strategies). Future work should synthesize findings from the current study
with perspectives of other key stakeholder groups (e.g. individuals with TBI and their
families) to inform the development of new outcome measures. Limitations of the current
study and opportunities for future research are discussed.
Description
University of Minnesota M.A. thesis. 2022. Major: Speech-Language-Hearing Sciences. Advisor: Natalie Covington. 1 computer file (PDF); 64 pages.
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Grabowski, Annelise. (2022). Outcome Measures Following Traumatic Brain Injury: A Synthesis of Speech-Language Pathologist’s Perspectives. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/241265.
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