Speech-language pathologists in paediatric palliative care: a Delphi study protocol

2018 ◽  
Vol 10 (4) ◽  
pp. e43-e43 ◽  
Author(s):  
Lillian Krikheli ◽  
Lindsay B Carey ◽  
Bernice A Mathisen ◽  
Shane Erickson ◽  
Christa L Carey-Sargeant
Keyword(s):  
Palliative Care ◽  
Clinical Practice ◽  
Delphi Study ◽  
Online Survey ◽  
Delphi Process ◽  
Scope Of Practice ◽  
Delphi Panel ◽  
Speech Language Pathologists ◽  
Paediatric Palliative Care ◽  
Palliative Care Teams

BackgroundGiven the dearth of literature and no clinical practice guidelines written for speech-language pathologists (SLPs) working in paediatric palliative care (PPC), a need has been identified to explore the scope of clinical practice and strategies used by SLPs.ObjectiveThis study aims to undertake an international investigation into the role and scope of practice of SLPs working in PPC to develop consensus-driven ‘Recommendations for Speech-Language Pathologists in Paediatric Palliative Care Teams’ (ReSP3CT).MethodsA modified Delphi process will be used to synthesise consensus-based statements from SLPs in six different countries about their role and practice working in PPC. Initially, preliminary survey data will be collected from SLPs to obtain demographic and caseload information. Respondents will then be invited to participate in an in-depth interview to explore common and unique themes that emerge from the online survey. Participants from the interview will then ‘opt-in’ to become Delphi panel members and receive questionnaires comprising statements for agreement over multiple rounds. Statements will be based on common themes that arise from the literature review, survey and interview data. The Delphi process for each statement will stop if statements achieve ≥ 70 % agreement and an IQR of ≤ 1 (maximum of five rounds).ConclusionThis is the first study to investigate the role and practice of SLPs in PPC across internationally accepted scope of practice areas. The study will use existing frameworks for statistical analysis and a mixed-methods approach to aid in the synthesis of statements/recommendations for international consensus.

scholarly journals Guide for recommendations on specific drug-related off-label treatment in palliative care: A Group Delphi process

2019 ◽  
Author(s):  
Constanze Remi ◽  
Kathrin Weingärtner ◽  
Vera Hagemann ◽  
Claudia Bausewein ◽  
Farina Hodiamont
Keyword(s):  
Palliative Care ◽  
Patient Safety ◽  
Delphi Study ◽  
Online Survey ◽  
Delphi Process ◽  
Treatment Quality ◽  
Direct Patient Care ◽  
Off Label Use ◽  
Off Label ◽  
Label Use

Abstract Background The use of drugs beyond their authorisation label, i.e. off-label-use, is common practice in palliative care with over 70% of off-label-use having little or no scientific support. Recommendations for off-label-use are essential to increase the safety of drug therapy and thus patient safety. The aim was to develop a guide for preparing and consenting drug-specific recommendations for off-label-use in palliative medicine.Methods Group Delphi Study with three rounds and a prior online survey. Participants represented professional groups working in palliative care involved in direct patient care and/or drug management (doctors, pharmacists, nurses) and various care settings (inpatient/community, university/non-university). Furthermore, representatives of relevant professional associations, experts with academic, non-clinical background and experts with international expertise were invited.Results For the preliminary online-survey 18/20 invited participants returned 18 questionnaires. Six domains, including identification of drugs, drug uses, assessment of evidence, formulation, consensus and updating of recommendations were generated and eventually 22 statements were included in the Group Delphi process. 15 experts participated in this consensus process. In combination with the survey results, consensus was achieved over a 28 statements after 3 Delphi rounds.Conclusions The resulted systematic approach for preparing and consenting drug-specific recommendations for off-label-use will allow to develop such recommendations with transparent and reproducible monographs. This will help to increase treatment quality and patient safety as well as security of decision-making in palliative care. The developed guide is part of a larger project aiming to provide therapy recommendations for areas that have little or no scientific evidence to date.

The Belgian euthanasia law and its impact on the practises of Belgian paediatric palliative care teams

2018 ◽  
Vol 24 (7) ◽  
pp. 333-337
Author(s):  
Marie Friedel ◽  
Brigitte de Terwangne ◽  
Bénédicte Brichard ◽  
Ilse Ruysseveldt ◽  
Marleen Renard
Keyword(s):  
Palliative Care ◽  
Paediatric Palliative Care ◽  
Palliative Care Teams

Specialized outpatient palliative care: Results from a representative survey among physicians in Germany.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 143-143
Author(s):  
Jens Hermann Papke ◽  
Eberhard A Lux ◽  
Kerstin Marggraf ◽  
Ruth Fricker
Keyword(s):  
Palliative Care ◽  
Online Survey ◽  
Pain Therapy ◽  
Interdisciplinary Cooperation ◽  
Status Quo ◽  
Highly Qualified ◽  
Additional Qualification ◽  
Palliative Care Teams ◽  
The Status ◽  
Health Insurance Provider

143 Background: Specialized ambulatory palliative care (SAPV) allows patients with incurable diseases and limited life expectancy to be cared for until death in their familiar surroundings. In Germany, these services must be prescribed by a physician. Little is known about structure, organization and work pattern within the SAPV teams. Methods: An online survey was carried out between Sept. 2013 and March 2014 with 124 physicians in Germany with regard to aspects related to physicians’ qualification, networks and palliative care teams. Aim of this survey was to evaluate status quo of SAPV from physicians´ viewpoint. Results: All 124 respondents were enrolled in SAPV; 18.3% of them (n=22) were on a direct contract with a health insurance provider. An additional qualification for palliative medicine and for pain therapy was reported by 96.7% and 21.5% of the physicians, respectively. In average, 11.6 physicians are organized in a SAPV-network. The networks comprise general practitioners (in 88.6% of the networks) anesthesiologists (in 62.3%), hematologists/oncologists (in 57.9%) and internists (in 43.9% of the networks) as well as a large proportion of non-medical professions such as pastors, pharmacists, social workers, psychologists and nurses. In most cases, SAPV networks are linked to one or more medical practices, hospitals or welfare institutions. 96% of the respondents assessed the cooperation within the network as “very good”/“good”. Patients admitted to SAPV were mostly suffering from cancer, but also from cardiovascular, neurological and respiratory diseases. The mean duration of care was 26.6 days; 81.4% of them could die in familiar domestic surroundings. On average, one physician is treating 9.7 SAPV-patients at the same time. Documentation requires 25.9% of time spent for medical care. Problems concerning reimbursement were reported by 75.8% of respondents. Conclusions: This survey provides the status quo of the German SAPV concept. Physicians enrolled in SAPV are highly qualified for palliative care and pain therapy. SAPV is a domain of outpatient care sector. While interdisciplinary cooperation within the SAPV networks is good, documentation and reimbursement remains a problem.

Speech-Language Pathologists' Use of Intelligibility Measures in Adults With Dysarthria

2017 ◽  
Vol 26 (3) ◽  
pp. 873-892 ◽  
Author(s):  
Naomi Gurevich ◽  
Sydney L. Scamihorn
Keyword(s):  
Clinical Practice ◽  
Speech Intelligibility ◽  
Online Survey ◽  
Cranial Nerves ◽  
Veterans Affairs ◽  
Standardized Assessments ◽  
Speech Language Pathologists ◽  
Work Settings ◽  
Veterans Affairs Hospitals ◽  
Physical Examinations

Purpose Speech-language pathologists (SLPs) who work with adults with dysarthria were surveyed to investigate trends of clinical practice for assessing speech intelligibility. Method Two hundred ninety-six SLPs responded to an online survey October 22–November 30, 2015. Results Findings showed that 35% of SLPs lacked access to any standardized assessments of intelligibility, with 66% of these implicating cost as the main reason. Work settings played a role, as all SLPs working in Veterans Affairs hospitals and 97% of SLPs working in university or research clinics reported access to at least one formal assessment. Even with access to formal tools to measure intelligibility, most SLPs preferred less formal measures. It is surprising to note that many SLPs reported using physical examinations (e.g., of cranial nerves and oral mechanisms) to measure speech intelligibility. Conclusions Results indicate the need to increase SLP familiarity with, and access to, currently available standardized assessments, as well as to improve education regarding the fundamental need to rate speech to assess intelligibility. Clinicians may also benefit from new standardized methods to objectively assess intelligibility that are accessible, practical, and efficient.

scholarly journals Trends in Pediatric Palliative Care Research (TPPCR) 2019; Issue #5: Commentary on Ekberg et al.

2021 ◽  
Author(s):  
Fariel Rahman ◽  
TPPCR
Keyword(s):  
Palliative Care ◽  
Delphi Study ◽  
Palliative Medicine ◽  
Pediatric Palliative Care ◽  
Care Research ◽  
Paediatric Palliative Care

This TPPCR commentary discusses the 2020 paper by Ekberg et al., “Finding a way with words: Delphi study to develop a discussion prompt list for paediatric palliative care” published in Palliative Medicine.

scholarly journals A Multidisciplinary Delphi Consensus Study of Communicative Participation in Young Children With Language Disorders

2020 ◽  
Vol 63 (6) ◽  
pp. 1793-1806
Author(s):  
Ingrid Singer ◽  
Inge S. Klatte ◽  
Marlies Welbie ◽  
Ingrid C. Cnossen ◽  
Ellen Gerrits
Keyword(s):  
Young Children ◽  
Delphi Study ◽  
Language Disorders ◽  
Likert Scale ◽  
Delphi Panel ◽  
Delphi Consensus ◽  
Speech Language Pathologists ◽  
Communication Problems ◽  
Communicative Participation ◽  
Definition Of

Purpose Our aim was to develop consensus on the definition and operationalization of communicative participation (CP) in 2- to 8-year-old children with language disorders (LDs). A clear definition and operationalization can facilitate the discussion about children's communication problems in daily life between parents and professionals. Method In an online Delphi study, anonymized thoughts and opinions were collected on the definition and operationalization of CP in young children with LD. The 47 Delphi panel members were Dutch parents, young adults with LDs, teachers and assistants, speech-language pathologists, clinical linguists, and clinical researchers. Thematic content analysis was used to develop a concept definition and items operationalizing CP. The Delphi panel rated the suitability of concept definitions using a 7-point Likert scale. Concept definitions were revised with feedback from the Delphi panel until consensus was achieved. The Delphi panel rated items on how well they operationalize CP, using the same Likert scale. Results The majority (79%) of the Delphi panel indicated that the essence of CP was captured by the definition: “CP is understanding and being understood in a social context, by applying verbal and non-verbal communication skills.” In addition, 33 behavioral items were developed. Conclusion This study resulted in strong consensus on the definition of CP between Dutch parents and professionals. Items were developed that can inform speech-language pathologists on the type of questions to ask a child's parents or teacher when discussing CP. Further research is needed on how the items can best be used in clinical practice.

Aphasia and Friendship: The Role and Perspectives of Speech-Language Pathologists

2021 ◽  
pp. 1-13
Author(s):  
Michelle C. S. Therrien ◽  
Elizabeth B. Madden ◽  
Lauren Bislick ◽  
Sarah E. Wallace
Keyword(s):  
Clinical Practice ◽  
Online Survey ◽  
Treatment Plan ◽  
Well Being ◽  
The United States ◽  
Communicative Interaction ◽  
Language Therapy ◽  
Speech Language Pathologists ◽  
Treatment Practices ◽  
Friendship Development

Purpose Speech-language pathologists (SLPs) who work with people with aphasia focus on assessment and intervention to support improved communication outcomes for their clients. Friendship, a key component of quality of life, often depends on communicative interaction, and many people with aphasia report having reduced social circles. The purpose of this study was to explore the perceptions of SLPs working with clients with aphasia on their role in supporting friendship development and maintenance. Method An online survey composed of questions addressing SLP perspectives and goal setting, assessment, and treatment practices related to aphasia and friendship was distributed to SLPs across the United States. Survey data were analyzed using both quantitative and qualitative methods. Results Forty-seven SLPs completed the survey. While many SLPs reported that the friendships of their clients with aphasia were impacted by aphasia and that it was within their scope of practice to support friendship development and maintenance, many did not specifically assess or target friendship and friendship outcomes in the treatment plan. SLPs identified barriers and facilitators to focusing on friendship within the context of speech and language therapy. Conclusions Findings suggest the majority of participating SLPs were interested in addressing friendship with clients with aphasia; however, they experienced barriers in practice. Further examination of SLP perspectives and clinical practice regarding friendship and aphasia is warranted. Additionally, research investigating effective assessment and therapeutic methods that target friendship in aphasia is needed to support clinical practice and the well-being of clients with aphasia. Supplemental Material https://doi.org/10.23641/asha.15032217

scholarly journals Future trends in social media use for strategic organisation communication: Results of a Delphi study

2012 ◽  
Vol 2 (2) ◽  
Author(s):  
Anne Linke ◽  
Ansgar Zerfass
Keyword(s):  
Social Media ◽  
Delphi Study ◽  
Online Survey ◽  
Delphi Panel ◽  
Future Trends ◽  
Media Communication ◽  
Non Profit ◽  
The Status ◽  
Research Findings ◽  
Social Media Communication

This article examines current uses of social media for communication by enterprises, political organisations and non-profit organisations (NPOs) and identifies likely future trends. Based on a quantitative online survey among 860 communication professionals in Germany and a follow-up qualitative Delphi study with 32 identified experts from the organisational communication profession and academia, it explores the status quo and aims to identify future directions. While organisations show more advanced structures for social media communication compared to earlier research findings, the empirical data also identifies many shortcomings. The potentials of social media communication are not fully exploited due to missing prerequisites including governance structures, rules and resources. Looking into the future, the Delphi panel suggests that dedicated budgets, social media guidelines and other structural aspects will increase in the near future. However, many organisations will find specific ways to deal with the issue and common strategies are rare. At the same time, according to the qualitative findings, social media evaluation and cooperation across the boundaries of departments and organisational functions are likely to stay underdeveloped.

Off-label drugs in palliative care: a Group Delphi treatment recommendation process

2020 ◽  
pp. bmjspcare-2019-002165
Author(s):  
Constanze Remi ◽  
Kathrin Weingärtner ◽  
Vera Hagemann ◽  
Claudia Bausewein ◽  
Farina Hodiamont
Keyword(s):  
Palliative Care ◽  
Patient Safety ◽  
Online Survey ◽  
Delphi Process ◽  
Treatment Quality ◽  
Direct Patient Care ◽  
Treatment Recommendation ◽  
Off Label Use ◽  
Off Label ◽  
Label Use

ObjectivesThe use of drugs beyond their marketing authorisation, that is, off-label use, is common practice in palliative care with over 70% of off-label use having little or no scientific support. The lack of evidence makes recommendations for off-label use essential, in order to increase the safety of drug therapy and thus patient safety. The aim of this study was to develop a guide for preparing and consenting drug-specific recommendations for off-label use in palliative care.MethodsGroup Delphi Study with three rounds and a prior online survey to identify topics of dissent. Participants represented professional groups working in palliative care involved in direct patient care and/or drug management and various care settings. Furthermore, representatives of relevant professional associations, experts with academic, non-clinical background and experts with international expertise were invited.Results18/20 invited professionals participated in the prior online-survey. 15 experts participated in the Group Delphi process. Six domains, including identification of drugs, drug uses, assessment of evidence, formulation, consensus and updating of recommendations were generated and respective statements were included in the Group Delphi process. The consensus process resulted in 28 statements forming the guide for recommendations.ConclusionsThe resultant systematic approach for preparing and consenting drug-specific recommendations for off-label use will allow the development of recommendations with transparent and reproducible monographs. This will help to increase treatment quality and patient safety as well as security of decision-making in palliative care. The developed guide is part of a larger project aiming to provide therapy recommendations for areas that have little or no scientific evidence.

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