- Title
- Investigating the implementation of linguistic discourse analysis for the assessment of aphasia in speech pathology practice
- Creator
- Bryant, Lucy Ellen Gillham
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2018
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Background: Linguistic discourse analysis is an assessment tool used in speech pathology to assess the language of people with aphasia. In research, this assessment tool is frequently applied to examine changes in communication and measure the generalisation of intervention outcomes. However, barriers of time and knowledge reportedly limit the translation of this research to clinical practice. Aims: This doctoral research aimed to examine the Knowledge-to-Action gap affecting the implementation of linguistic discourse analysis in speech pathology for people with aphasia and develop and evaluate a hybrid Knowledge-to-Action intervention to overcome this gap. Method: The Knowledge-to-Action gap was examined in two steps. First, a systematic literature review examined seven electronic databases for peer-reviewed studies that used linguistic discourse analysis to examine the language of people with aphasia. Second, a mixed-methods survey was electronically distributed to speech pathologists working with people with aphasia across five English-speaking countries. The information from the systematic review and survey informed the development of a Knowledge-to-Action intervention. The intervention was implemented in a preliminary trial across four Australian universities, with 29 participants in their final year of study. Participants completed evaluations at three time-points to examine their application of linguistic discourse analysis to a case study person with aphasia, and translation of their learned skills and knowledge. Results: The systematic review identified 165 original research studies that used discourse analysis to examine the language of people with aphasia. Analysis indicated that the methods used to elicit, prepare and analyse discourse varied significantly across studies. Of 123 survey responses, 106 speech pathologists reported using discourse analysis to assess the language of people with aphasia. Most respondents (97.6%) reported completing analysis using their professional knowledge and judgement, compared to the 25.2% who used the detailed analysis methods outlined in the research literature. The varying approaches to analysis identified in the review and survey were categorised into four modes of linguistic discourse analysis to be delivered in the Knowledge-to-Action intervention. Following the intervention, participants demonstrated that they were able to apply linguistic discourse analysis knowledge and skills. Participants identified significantly more discourse-level communicative behaviours in their assessment and management of a case study person with aphasia. They also included the functional use of language in management plans with greater frequency. Knowledge of linguistic discourse analysis was maintained in the period to follow-up, however self-reported implementation of this knowledge to practice was limited due to reported personal and environmental barriers. Discussion: Large variation in the use of linguistic discourse analysis within and between the research literature and practising speech pathologists illustrated the nature and existence of a Knowledge-to-Action gap. The preliminary trial of the Knowledge-to-Action intervention appeared to be effective in providing entry-level speech pathologists with the knowledge and skills they needed to use linguistic discourse analysis to assess the language of people with aphasia. Findings suggested that speech pathologists had interest and intent to use linguistic discourse analysis following education and training, though were still limited by barriers to implementation. Adaptations to the content and strategy used in the implementation intervention could better support clinical use of discourse analysis.
- Subject
- discourse; discourse analysis; aphasia; implementation science; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1388301
- Identifier
- uon:32740
- Rights
- Copyright 2018 Lucy Ellen Gillham Bryant
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 3 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 758 KB | Adobe Acrobat PDF | View Details Download |