Clinical interpretation and application of patient-reported communicative participation outcomes after stroke, and the influence of psychosocial factors - Project Summary/Abstract Many people who have experienced a stroke have language and/or speech impairments. These impairments alter how a person communicates, and significantly impacts their participation in life in both major and minor ways. Clinicians who work with individuals with communication impairments, called Speech- Language Pathologists or SLPs, often use questionnaires to learn about their clients’ participation in different communication situations. One such questionnaire is the Communicative Participation Item Bank, or the CPIB. This questionnaire helps SLPs understand the impact of the client’s communication impairment on their daily life, and they use this information to help create treatment plans and goals. However, research evidence tells us that factors other than the speech/language impairment may contribute to how a person answers questions on the CPIB. Some factors that may influence responses to the CPIB include psychosocial factors such as chronic stress, depression, resilience, and self-efficacy. If the SLP does not ask about these factors in addition to providing the CPIB, they may misinterpret CPIB scores and miss important needs of their client. The connection between each individual’s communicative participation and psychosocial factors is often neglected because SLPs have little training on measuring these factors or how they impact treatment and its outcomes. This misunderstanding about clients’ needs may influence treatment plans and goals in a way that does not help individual clients. To address this problem, this research project will examine how responses to the CPIB are related to these psychosocial factors for people with communication impairments after stroke. The project is divided into 2 studies. The purpose of Study 1 is to examine the CPIB and psychosocial factors of chronic stress, depression, resilience, and self-efficacy with individuals with post-stroke communication impairments to understand how these factors may influence their participation in daily life. The research team will ask participants to provide basic information about themselves (age, stroke date, etc.), complete speech and language tests, complete the CPIB and questionnaires that ask about the psychosocial factors, and answer interview questions about the topics presented in these questionnaires. Nine months later, the research team will ask these individuals to repeat the questionnaires and part of the interview to help understand how these factors change over time. The purpose of Study 2 is to examine how SLPs use the CPIB to understand the participation and other experiences of their clients, and how they consider psychosocial factors in treatment goals and activities. The research team will ask SLPs who use the CPIB to complete a survey and follow-up interview about how they use this questionnaire, including how they consider the psychosocial experiences of their clients in treatment planning. The results of this research project will clarify the important but neglected connection between communicative participation and psychosocial factors following a stroke, and provide critical information about how SLPs can use the CPIB to create better treatment plans for individual clients.
