The Emerging Contribution of Speech and Language Therapists in Awake Craniotomy: A National Survey of Their Roles, Practices and Perceptions

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Autor/inn/en	O'Neill, Michelle; Henderson, Mo; Duffy, Orla M.; Kernohan, W. George
Titel	The Emerging Contribution of Speech and Language Therapists in Awake Craniotomy: A National Survey of Their Roles, Practices and Perceptions
Quelle	In: International Journal of Language & Communication Disorders, 55 (2020) 1, S.149-162 (14 Seiten) PDF als Volltext Verfügbarkeit
Zusatzinformation	ORCID (O'Neill, Michelle)
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	1368-2822
DOI	10.1111/1460-6984.12510
Schlagwörter	Brain; Stimulation; Surgery; Cancer; Intervention; Patients; Speech Communication; Networks; Speech Language Pathology; Allied Health Personnel; Social Media; Communications; Speech Therapy; Content Analysis; Specialists; Speech Evaluation; Language Impairments; Barriers; Cognitive Mapping; Interdisciplinary Approach; Financial Support; Language Tests; Outcomes of Treatment; Language Usage; Foreign Countries; National Surveys; Speech Impairments; Role; Attitudes; United Kingdom + Suchen Sie Ihr Suchwort? Gehirn; Chirurgie; Carcinoma; Karzinom; Krebs (med); Krebserkrankung; Patient; Soziale Medien; Nachrichtenwesen; Entwicklungsproximale Sprachtherapie; Logotherapie; Inhaltsanalyse; Speech disorder; Speech disorders; Speech disabilities; Speech disability; Speech handicap; Speech handicaps; Speech impairment; Speech impairments; Language handicaps; Sprachbehinderung; Fächerübergreifender Unterricht; Fächerverbindender Unterricht; Interdisziplinarität; Finanzielle Förderung; Language test; Sprachtest; Sprachgebrauch; Ausland; Language handicps; Language impairments; Rollen; Attitude; Einstellung; Verhalten; Großbritannien
Abstract	Background: Awake craniotomy with electrical stimulation has become the gold standard for tumour resection in eloquent areas of the brain. Patients' speech during the procedure can inform the intervention and evidence for language experts to support the procedure is building. Within the UK a burgeoning speech and language therapist awake craniotomy network has emerged to support this practice. Further evidence is needed to underpin the specific contribution of speech and language therapists working within the awake craniotomy service. Aims: To investigate and analyse the current practices of speech and language therapists: their role, pre-, intra- and postoperative assessment, and management practice patterns and skill set within awake craniotomy. Methods & Procedures: Speech and language therapists in the UK, who work in awake craniotomy, were invited to complete an online questionnaire. Participants were recruited via several networks supported by a social media campaign. Data were analysed using a mixed methodology approach including descriptive statistics, summative and conventional content analysis. Outcomes & Results: A total of 24 speech and language therapists completed the survey, an unknown proportion of the available population. All four UK countries were represented. The majority were highly specialist clinicians 58% (n = 14) with the remainder clinical leads 25% (n = 6) or specialist clinicians 17% (n = 14). Only 29% (n = 7) had funding for awake craniotomy or had awake craniotomy in their job description. Median experience with awake craniotomy was 3 years. Median estimated contact time per case was 10.3 h. Current intraoperative practice is characterized by a sustained period of real-time, dynamic, informal assessment of speech, language, oromotor and cognitive functions. Respondents described a range of intraoperative clinical deficits that, once detected, are immediately communicated to surgeons. There was evidence of variable and diverse language mapping practices and barriers to the translation of information at multidisciplinary team level. Barriers to participation in awake craniotomy included lack of: standardized validated language mapping methods, funding, standardized training methods and guidance to direct practice. Conclusions & Implications: The evidence suggests areas of consistent practice patterns in preoperative preparation and intraoperative assessment. However, considerable variability exists within language testing and mapping that would benefit from validation. These speech and language therapists support improved outcomes of awake craniotomy by real-time intraoperative speech, language, oromotor and cognitive assessment, rapid detection of clinical deterioration and immediate communication to surgeons. Further research exploring intraoperative language testing, consistent use of language mapping terminology, and selection of test methods is recommended. (As Provided).
Anmerkungen	Wiley-Blackwell. 350 Main Street, Malden, MA 02148. Tel: 800-835-6770; Tel: 781-388-8598; Fax: 781-388-8232; e-mail: cs-journals@wiley.com; Web site: http://www.wiley.com/WileyCDA
Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2024/1/01