Research Capacity and Culture (RCC) is important for research engagement. Little is known of what speech and language therapy staff perceives to be the barriers or enablers to this at individual, team and organisational levels.
To identify the barriers and enablers to RCC among speech and language therapy staff, using behaviour change theory as a framework, and to explore their self-reported level of research engagement.
Participants completed an online survey through purposive sampling. The survey and results were analysed following the Theoretical Domains Framework (TDF) and Capability, Opportunity and Motivation (COM-B) model, informed by the RCC Tool. Quantitative data were analysed using descriptive statistics. Percentage responses for ‘Yes’, ‘No’ and ‘Don't Know’ were categorised as barriers, enablers and don't know. Total percentage scores were classified as weak (0%–33.33%), moderate (33.34%–66.66%) or strong (66.67%–100%). Free text responses were analysed using NVivo (v12.0) and a structured categorisation matrix of barrier and enabler. Labelled emotions were the unit of analysis. Finally, participants selected a category reflecting their level of research engagement.
Fifty-seven (response rate 73.08%) speech and language therapy staff members from an NHS Trust participated. Barriers and enablers were represented across eight domains of the TDF. At the individual level, knowledge and skill for activities linked to research-related professional standards from the HCPC were strong or moderate enablers, except one. More advanced research activities were rated as strong or moderate level barriers. For motivation, participants' beliefs about the benefit to clinical practice and desire to engage in more research activity (91.23% and 71.93%) were strong enablers. At the team and organisational level, time was a moderate strength barrier. Overall, there was poor knowledge of the availability of support and supervision. For environmental context and resources, library access was a strong enabler (98.25%); all other factors were weak enablers. For the level of research engagement, 52.63% were ‘Research Conscious’, 24.56% ‘Research Participative’, 21.05% ‘Research Active’ and 1.75% unknown.
Barriers
The influence of the listening environment in which communication occurs has been of longstanding interest related to communication disorders. It also has been posited that specific listening scenarios may differentially effect listener judgements of a speaker. In the case of those who have lost their larynx and normal voice due to cancer, a listener's assessment may carry a substantial penalty. This study was designed to determine if situationally-bound communication ‘scenario’ influences a listener's auditory-perceptual judgement of level of comfort for three modes of postlaryngectomy alaryngeal speech: oesophageal (ES), tracheo-oesophageal (TE) and electrolaryngeal (EL) speech. Additionally, a modified oesophageal speech (MES) group where air insufflation pauses were excluded digitally, was also included; this modification was employed to reduce the potential impact of unusual, non-junctural pauses that may occur in some oesophageal speakers.
Forty-eight speaker samples (12 speakers per alaryngeal group) were evaluated by 22 naïve adult listeners for a dimension termed listener comfort (LC). Judgements assessed all speaker samples based on two implied listening scenarios: (1) a social conversation interaction (LC-Soc) and (2) a telephone conversation (LC-Tel). Both scenarios were rated by listeners using a visual analogue scaling procedure. Ratings were provided in a counterbalanced manner across two sessions separated by 7–10 days.
Listener ratings were not found to differ significantly by listening scenario (social vs. telephone) for any given speech mode. However, significant differences were observed in listener judgements of TE speakers when compared to EL, ES and MES speaker samples for both LC-Soc and LC-Tel listening scenarios. Further, a significant correlation was found between judgements of LC-Soc and LC-Tel, indicating a strong relationship between the two.
Listeners indicated that they were more comfortable listening to TE speakers when compared to the other postlaryngectomy speech modes that were evaluated. This suggests that in general, a listener's perceived LC may be more favourable to TE speech. Thus, these comparative findings provide objective data on how a listener may respond to postlaryngectomy communication methods and, consequently, may offer valuable insights into the relative merits of these postlaryngectomy communication rehabilitation methods. Collectively, the findings of thi
This paper examines assessment report-writing from a critical perspective, a relatively unexplored aspect of speech and language therapy (SLT) clinical practice. To date, there has been little discussion of the relationship between discourse formats, objectives of assessment reports, and the effects of these objectives on how clients and speech and language therapists (SLTs) are portrayed. Furthermore, there has been little exploration of the concepts of objectivity and scientific writing in relation to report-writing in SLT. An emphasis on a scientific, objectifying system has long been in operation in the profession: the establishment of diagnostic categories and the relegation of the personal, subjective experiences of client and SLT to secondary, non-scientific status. However, person-centred care (PCC) is now a focus in SLT in an attempt to rehumanise care by considering clients as unique individuals with important knowledge to contribute.
To examine representations of clients and SLTs in assessment report-writing drawing on systemic functional linguistics (SFL) and critical discourse analysis.
A total of 28 assessment reports were collected: 18 assessment report-writing exemplars from published texts aimed at modelling professional report-writing and 10 assessment reports from clinical practice. The global structure of the reports was identified, and the reports were also analysed using transitivity analysis as defined in SFL. Doing, saying, sensing, and being processes, and passives were identified.
Without exception, all reports followed a similar global structure for organising the content, with an overall focus on presenting the speech, language, communication, and swallowing/feeding impairments under consideration while omitting the perspectives of the clients and families. The global structure was characterised by a problem focus. The use of passive verbs masked the SLT as an agent of clinical actions and positioned the clients as recipients of the actions of unidentified professionals while also under-emphasising their individual perspectives, experiences, and goals. SLTs used categorical assertions (i.e., declarative statements with no modality) to make claims appear scientific, while the relatively less-frequent contributions of clients and family members were introduced using saying processes, highlighting their subjectivity. In the paediatric reports, no child's perspective was included.<
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