Barriers and facilitators that affect access to an outpatient speech-language therapy aphasia clinic

Abstract

Background: Many barriers impact on access to services for adults with aphasia. Speech-language therapists need to provide accessible services for people with aphasia, if they hope to inform other service providers to do the same. Previous studies have identified some barriers and facilitators that may influence the participation of individuals with aphasia in outpatient speech-language therapy services, as part of the larger aims of those investigations. However, to date, no investigation has focused specifically on identifying barriers and facilitators that influence access to outpatient speech-language therapy services for adults with aphasia and for their family members. The current study had two aims to address this gap in the literature: 1. To explore the barriers and facilitators that influence the access of adults with aphasia and their family members/friends to an outpatient speech-language therapy aphasia clinic, and; 2. To identify a consensus of the most important barriers and facilitators that influence access to an outpatient speech-language therapy aphasia clinic by adults with aphasia and their family members/friends. Method: A modified Delphi technique was used with two rounds. In the first round, nine participants with aphasia participated in semi-structured interviews involving open-ended questions about perceived barriers and facilitators to accessing an outpatient speech-language therapy aphasia clinic. Nine family member/friend participants and two student speech-language therapy participants also completed qualitative written questionnaires involving the same open-ended questions. The data was analysed using qualitative content analysis and used to develop the questionnaire for the second-round. In the second round, the family member/friend participants and student speech-language therapy participants completed a written questionnaire to identify the most important barriers and facilitators identified in the first round. The researcher administered the same questionnaire face-to-face to the participants with aphasia. The results from round two were analysed to identify the most important barriers and facilitators that reached a consensus. Results: Analysis of the data from round one revealed 23 barriers that fell in eight categories and 37 facilitators that fell in nine categories. In round two, only two of the 23 barriers were identified as being important by all three participant groups, whereas, 36 of the 37 facilitators were considered to be important. Conclusion: The findings can be used to improve the development of more accessible outpatient speech-language therapy and other health services for individuals with aphasia and their families.