Development & user-testing of a communication intervention decision-making support tool for non-specialist SLTs working with people with Alzheimer's

英国有85万痴呆患者，其中阿尔茨海默病（AD）占三分之二。在未来的25年里，英国治疗痴呆症的费用预计将增加一倍以上（英国阿尔茨海默氏症研究所）。语言障碍出现在所有痴呆亚型中，影响例如找词和理解他人。语言障碍的恶化与问题行为的增加有关。阿尔茨海默症患者的想法和需求交流能力下降，社交和维持关系的困难增加。沟通困难对照顾者有负面影响。言语和语言治疗师（slt）是在评估和治疗语言和沟通障碍方面具有专业知识的医疗保健专业人员。很少有slt在专门的痴呆症服务部门工作——大多数人在非专业病例中遇到阿尔茨海默病患者，例如在急性住院期间或在普通社区治疗团队中。随着AD诊断的提高，非专业的SLT服务需要有效的方法来管理转诊，确定哪些AD患者将在什么时间点从哪种沟通干预中受益。该项目的主要目标是与利益相关者和用户共同开发一种沟通干预决策支持工具，用于治疗AD的非专业slt。它将语言学的研究方法应用于医疗保健，以解决被忽视的AD的沟通相关的社会和心理影响。它解决了ESRC的精神健康和保健创新的优先领域，特别是在痴呆症方面提供SLT服务的挑战，以及对服务使用者/护理者关系和生活质量的影响。这是一个四阶段的项目。第一阶段涉及对AD的沟通干预进行范围审查。第二阶段旨在通过焦点小组的专题分析，了解非痴呆症专家的经验、做法和需求。第三阶段包括利益相关者研讨会，使用基于经验的共同设计和共识方法，共同制作沟通干预决策支持工具。第4阶段，用户在非专业SLT服务中测试工具，使用实现科学理论探索和解决变化问题。

There are 850,000 UK dementia cases, with Alzheimer's disease (AD) accounting for two-thirds. The cost of dementia in the UK is expected to more than double in the next 25 years (Alzheimer's Research UK). Language difficulties occur in all dementia sub-types, affecting e.g. word-finding, and understanding others. Worsening language difficulties correlate with increased problem behaviours. People with AD experience declining ability to communicate thoughts and needs, and increasing difficulties with social interaction and sustaining relationships. Communication challenges negatively affect caregivers. Speech and language therapists (SLTs) are healthcare professionals with expertise in assessing and treating language and communication disorders. Few SLTs work in specialist dementia services - most encounter people with AD within a non-specialist caseload, e.g. during acute hospital admission or within a general community therapy team. As AD diagnosis improves, non-specialist SLT services need effective ways to manage referrals, determining which people with AD would benefit from what communication intervention at what time point. The project's primary aim is to coproduce with stakeholders and user-test a communication intervention decision-making support tool for non-specialist SLTs treating AD. It applies research methods in linguistics to healthcare to tackle the neglected communication-related social and psychological impacts of AD. It addresses the ESRC's priority areas of mental health and innovation in healthcare, specifically the challenges of SLT service delivery in dementia, with implications for service-user/carer relationships and quality-of-life. This is a four stage project. Stage 1 involves a scoping review of communication interventions in AD. Stage 2 seeks to understand the experiences, practice and needs of non-dementia specialist SLTs through thematic analysis of focus groups. Stage 3 comprises stakeholder workshops to coproduce a communication intervention decision-making support tool, using experience-based co-design and consensus methodologies. Stage 4 user-tests the tool in non-specialist SLT services to explore and address issues of change using implementation science theory.