The impact of PD Check-In on self-management skills for maintenance of speech after intensive treatment

IF 1.5 3区医学 Q2 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY International Journal of Language & Communication Disorders Pub Date : 2024-02-20 DOI:10.1111/1460-6984.13024

Ann Finnimore, Deborah Theodoros, Anna F. Rumbach

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Abstract

Background

Maintenance of speech outcomes following speech-language therapy (SLT) in Parkinson's disease (PD) is an unmet expectation of people with PD (PWPD) and poorly defined in SLT practice. PD Check-In, a model for supported self-managed maintenance of speech following Lee Silverman Voice Treatment (LSVT) LOUD was investigated.

Aims

To investigate the impact of the semi-structured component of PD Check-In on the adoption of self-management concepts and behaviours and the identification of facilitators, barriers and strategies for speech maintenance by PWPD over 24 months post-treatment.

Methods and procedure

Following LSVT LOUD, 16 PWPD participated in individual PD Check-In semi-structured discussions with a SLT at 6 and 12 weeks, and 6, 12 and 24 months post treatment. A two-stage qualitative content analysis was applied: directed content analysis using categories from the theoretical framework of PD Check-In followed by inductive content analysis to identify subcategories.

Outcomes and results

Statements from PWPD indicated adoption of seven concepts of self-management across participants and across time. Six concepts from the theoretical framework of PD Check-In (partnerships, self-reflection, maintenance barriers and facilitators, revision of LSVT LOUD skill, goal setting and maintenance strategies), and one new category, participation, emerged from the analysis. Self-reflection, maintenance facilitators and barriers and participation were most prevalent in discussions. PWPD identified facilitators, barriers and strategies for maintenance across time points.

Conclusions and implications

Statements from PWPD indicated a positive impact of SLT-supported self-management of speech using self-tailored strategies for sustainable maintenance according to their individual circumstances and needs.

WHAT THIS PAPER ADDS

What is already known on this subject

People with Parkinson's disease (PWPD) have expressed their need for speech-language therapy (SLT) services that are accessible for the duration of the condition and responsive to their expectation of maintaining speech following treatment. Outcomes for maintenance of the treatment effect following Lee Silverman Voice Treatment (LSVT) LOUD are variable.

What this paper adds to existing knowledge

This study presents the outcomes of five PD Check-In interventions delivered in semi-structured discussions between PWPD and a SLT over 24 months following LSVT LOUD for the development of self-management skills and behaviours. PWPD adopted self-management positively using self-tailored strategies for sustainable maintenance according to their individual circumstances and needs.

What are the potential or actual clinical implications of this work?

PWPD responded positively to the individual development of self-management skills and behaviours over time. Individuality and flexible responsivity are features of PD Check-In which resonate with PWPD and speak to SLT supported self-managed maintenance of speech as a long-term model for PD.

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PD Check-In 对强化治疗后保持言语能力的自我管理技能的影响。

背景：帕金森病（Parinson's disease，PD）患者在接受言语治疗（SLT）后，其言语能力的维持是他们的期望，但在 SLT 实践中却没有得到很好的定义。目的：调查帕金森病患者在治疗后 24 个月内采用自我管理概念和行为以及识别语言维持的促进因素、障碍和策略的情况：在进行LSVT LOUD治疗后，16名残疾人分别在治疗后6周和12周、6个月、12个月和24个月参加了由一名语言康复师主持的半结构化个人PD Check-In讨论。我们采用了两阶段定性内容分析：利用 "PD Check-In "理论框架中的类别进行定向内容分析，然后进行归纳内容分析，以确定子类别：结果和成果：PWPD 的陈述表明，不同参与者在不同时期采用了七种自我管理概念。通过分析，我们得出了 "PD Check-In "理论框架中的六个概念（伙伴关系、自我反思、维持的障碍和促进因素、LSVT LOUD 技能的修订、目标设定和维持策略）和一个新的类别--参与。在讨论中，自我反思、维持的促进因素和障碍以及参与最为普遍。公共工程专业人员确定了不同时间点的促进因素、障碍和维持策略：PWPD的发言表明，在SLT的支持下，根据个人情况和需求使用自我定制的可持续维护策略进行言语自我管理具有积极影响：帕金森病患者（PWPD）表示，他们需要在患病期间都能获得语言治疗（SLT）服务，并能满足他们在治疗后保持言语能力的期望。李-西尔弗曼嗓音治疗法（LSVT）LOUD治疗后的疗效维持情况各不相同。本文对现有知识的补充本研究介绍了残疾人在接受LSVT LOUD治疗后24个月内，通过与SLT进行半结构化讨论，采取五项PD Check-In干预措施，培养自我管理技能和行为的结果。残疾人根据自己的情况和需要，采用自我定制的策略，积极进行自我管理，以实现可持续的维持。这项工作有哪些潜在或实际的临床影响？随着时间的推移，残疾人对自我管理技能和行为的个人发展做出了积极回应。个性化和灵活响应是 "PD Check-In "的特点，这些特点引起了残疾人的共鸣，也说明了 SLT 支持的自我管理言语维护是治疗 PD 的一种长期模式。

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来源期刊

International Journal of Language & Communication Disorders AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-REHABILITATION

CiteScore

3.30

自引率

12.50%

发文量

116

审稿时长

6-12 weeks

期刊介绍： The International Journal of Language & Communication Disorders (IJLCD) is the official journal of the Royal College of Speech & Language Therapists. The Journal welcomes submissions on all aspects of speech, language, communication disorders and speech and language therapy. It provides a forum for the exchange of information and discussion of issues of clinical or theoretical relevance in the above areas.