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Priorities for closing the evidence-practice gaps in post-stroke aphasia rehabilitation: A scoping review.

Arch Phys Med Rehabil; 2017 Sep 15.
Article in English | MEDLINE | ID: mdl-28923500


OBJECTIVE: To identify implementation priorities for post-stroke aphasia management relevant to the Australian healthcare context. DATA SOURCES: Using systematized searches of databases (CINAHL, Medline), guideline and stroke websites, and other sources, evidence was identified and extracted for seven implementation criteria for 13 topic areas relevant to aphasia management. These seven priority-setting criteria were identified in the implementation literature; strength of the evidence; current evidence-practice gap; clinician preference; client preference; modifiability; measurability; and health impact. STUDY SELECTION: Articles were included if they were in English, related to a specific recommendation requiring implementation, and contained information pertaining to any of the seven prioritisation criteria. DATA EXTRACTION: The scoping review methodology was chosen to address the broad nature of the topic. Evidence was extracted and placed in an evidence matrix. Following this, evidence was summarised, then aphasia rehabilitation topics prioritised using an approach developed by the research team. DATA SYNTHESIS: Evidence from 100 documents was extracted and summarised. Four topic areas were identified as implementation priorities for aphasia: Timing, Amount and Intensity of Therapy; Goal Setting; Information, Education and Aphasia-Friendly Information; and Constraint-Induced Language Therapy. CONCLUSIONS: Closing the evidence-practice gaps in the four priority areas identified may deliver the greatest gains in outcomes for Australian stroke survivors with aphasia. Our approach to developing implementation priorities may be useful for identifying priorities for implementation in other healthcare areas.