Benefits and losses: a qualitative study exploring healthcare staff perceptions of teamworking.

OBJECTIVES: To examine staff perceptions of teamworking practice in the field of stroke care. DESIGN: Qualitative interview study. SETTING: Three teams providing care to patients with stroke across a typical care pathway of acute hospital ward, specialist stroke unit, and community rehabilitation. PARTICIPANTS: 37 staff members from a range of professions. MAIN OUTCOME MEASURES: Healthcare staff perceptions of teamworking. RESULTS: Through detailed coding and analysis of the transcripts, five perceptions regarding the impact of teamworking on staff and patients were identified. These were: (1) mutual staff support, (2) knowledge and skills sharing, (3) timely intervention/discharge, (4) reduced individual decision-making and responsibility and (5) impact on patient contact time. CONCLUSIONS: Teamworking practice may be associated with a number of perceived benefits for staff and patient care; however, the potential for losses resulting from reduced patient contact time and ill-defined responsibility needs further investigation.

Informing educational change to improve clinical competence.

The factors that have influenced the current approaches to speech and language therapy education in Great Britain are discussed. A project is presented which will provide data on how educational approaches can more clearly reflect professional practice.

The development and validation of the Visual Analogue Self-Esteem Scale (VASES).

OBJECTIVES: To develop a visual analogue measure of self-esteem and test its psychometric properties. DESIGN: Two correlational studies involving samples of university students and aphasic speakers. METHOD: Two hundred and forty-three university students completed multiple measures of self-esteem, depression and anxiety as well as measures of transitory mood and social desirability (Study 1). Two samples of aphasic speakers (N = 14 and N = 20) completed the Visual Analogue Self-Esteem Scale (VASES), the Rosenberg (1965) self-esteem scale and measures of depression and anxiety. (Study 2). RESULTS: Study 1 found evidence of good internal and test-retest reliability, construct validity and convergent and discriminant validity for a 10-item VASES. Study 2 demonstrated good internal reliability among aphasic speakers. CONCLUSION: The VASES is a short and easy to administer measure of self-esteem that possesses good psychometric properties.

The measurement of psychological well-being in the person with aphasia.

This paper will introduce the construct of psychological well-being and discuss its relevance to speech and language therapy. Measures of psychological well-being are used routinely in psychological contexts, both as diagnostic and research indicators, and also as outcome measures. There is not a tradition of measuring psychological well-being in the speech and language therapy context, yet the clinical significance of well-being to therapeutic outcome is recognised. This paper will evaluate the existing measures available and discuss the development and validation of the Visual Analogue Self Esteem Scale for use with aphasic speakers (Brumfitt and Sheeran, 1998). Problems inherent in evaluating self-knowledge in communicatively disordered speakers will be discussed.

An evaluation of short-term group therapy for people with aphasia.

This paper reports an evaluation of a group therapy intervention conducted with aphasic people (n = 6). The intervention comprised 10 sessions of approximately 90 min duration and included two participants with stuttering difficulties. The therapy programme consisted of communication activities within the group which encouraged sharing of personal experiences, videotaping of role-play activities for self- and group-evaluation and practice tasks completed outside the group. Measures of functional communicative ability, attitudes to communication and psychological adjustment were obtained before and after the intervention. Findings showed significant improvements in communicative competence and attitudes to communication over the course of the intervention. Before the intervention self-esteem and communicative competence were highly intercorrelated. By the end of the therapy sessions the correlation between self-esteem and communicative competence was significantly smaller and was non-significant. This indicates that communicative function was not related to feelings of self-worth by the end of the intervention. Improvements in attitude to communication, greater attendance and completion of assignments were each predictive of reduced levels of depression. There was also evidence that stronger beliefs about the role of personal effort in improving speech were predictive of improvements in communication attitudes. A measure of satisfaction showed extremely positive evaluation of the intervention by participants. It is concluded that shortterm group therapy can produce improvements in communicative abilities and attitudes, and have psychological benefits for participants. Several suggestions for future research are outlined.