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

英国有85万例痴呆症患者，其中阿尔茨海默病(AD)占三分之二。预计未来25年，英国痴呆症的成本将增加一倍以上(英国阿尔茨海默氏症研究中心)。语言障碍出现在所有痴呆症亚型中，影响例如单词查找和理解他人。语言困难的恶化与问题行为的增加相关。阿尔茨海默病患者交流思想和需求的能力下降，在社交和维持关系方面也越来越困难。沟通方面的挑战会对照顾者产生负面影响。言语和语言治疗师(SLT)是医疗保健专业人员，在评估和治疗语言和沟通障碍方面拥有专业知识。很少有SLT在专科痴呆症服务中工作--大多数人在非专科病例工作量内遇到AD患者，例如在急性住院期间或在一般社区治疗团队中。随着AD诊断的改善，非专科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什么沟通干预中受益。该项目的主要目标是与利益攸关方共同制作并用户测试一种用于治疗AD的非专业SLT的沟通干预决策支持工具。它将语言学的研究方法应用于医疗保健，以解决被忽视的与沟通相关的AD的社会和心理影响。它涉及ESRC的精神健康和医疗保健创新的优先领域，特别是痴呆症患者提供SLT服务的挑战，以及对服务-用户/照顾者关系和生活质量的影响。这是一个分四个阶段的项目。阶段1涉及对AD中的沟通干预进行范围划分的审查。第二阶段旨在通过对焦点群体的专题分析，了解非痴呆症专家SLT的经验、做法和需求。第三阶段包括利益攸关方研讨会，利用基于经验的共同设计和协商一致的方法，共同制作传播干预决策支持工具。阶段4-用户在非专业SLT服务中测试该工具，以使用实施科学理论探索和解决变更问题。

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.