Developing goals for aphasia in the acute care hospital setting: a survey

Purpose This study was conducted as part of an implementation project in which researchers and clinicians partnered to clarify a goal-setting model for communication-focused intervention methods across the continuum of care. We surveyed speech-language pathologists (SLPs) to understand how they allocate time for aphasia management in acute care hospital settings, how they approach goal setting, and the extent to which the goals they use address communication access and knowledge about aphasia.Methods The survey was designed with a mixture of choice and free response questions and then shared on a website about goal setting for aphasia. SLPs evaluating and treating adult patients in acute care hospital settings were invited to respond. Quantitative analyses in the form of descriptive statistics were completed for demographic information and choice questions, while conventional qualitative content analysis was conducted for free response questions. Results were compared to sample goals that respondents were also asked to share.Results Eighty-two SLPs completed the survey. Most reported spending at least 20 minutes per day with each person with aphasia but shared that this time included attention to coexisting disorders, especially dysphagia. We identified 12 content categories, organized into five overarching themes. The most frequently reported goal-setting approach was to assess and treat speech and language impairments, with 68.2% of submitted goal samples reflecting this approach. Although respondents identified real life communication and aphasia knowledge as important aspects of care, these areas were infrequently represented as intervention goals.Conclusions This study identified barriers and facilitators to communication-focused goal setting in acute care hospital settings. Findings support the need for a structured model that simplifies treatment planning and legitimizes focus on meaningful communication and information counseling during the first week of stroke recovery.