None listed
Conditions
Brief summary
Due to gaps in first-person communication with their clinicians, people with communication disability can experience poor health outcomes, lengthier hospital admissions and adverse events including preventable deaths. Despite numerous attempts to integrate augmentative and alternative communication (AAC) into health settings, patient input is often deferred to others, such as parents or carers, or is subject to the ‘best guess’ by healthcare professionals. The Talking Scrubs project aims to form a bridge to AAC by locating key communication icons on scrubs (and scrubs vest) to be used with patients (in and of themselves) and/or to prompt the use of patient individualised communication methods. Our study is propelled by the following hypothesis. A patients health improves, and adverse risk reduces, when the patient’s communication agency is understood and used (reflected back) by clinicians; when s/he has the first-person voice in their own health care; when s/he is no longer ‘spoken for’ but instead indicates their health concerns, feelings and consent.
Interventions
The study involves both patients and their health professionals of the participating health services to consent to be part of the study. For clinicians participating in the research, it will involve 2 hours of preliminary training in the use of the adapted scrubs and scrub vest. This involves the clinician becoming familiar with the protocols of using the scrubs. It will also require the participating clinician to practice their use of the scrubs with members of the research team who have commun
The study involves both patients and their health professionals of the participating health services to consent to be part of the study. For clinicians participating in the research, it will involve 2 hours of preliminary training in the use of the adapted scrubs and scrub vest. This involves the clinician becoming familiar with the protocols of using the scrubs. It will also require the participating clinician to practice their use of the scrubs with members of the research team who have communication disability. Once the clinician feels confident in how to use the scrubs and scrubs vest, they will be asked to use them with patient participants with communication disability. Before using the scrubs and vest both health professionals and their patients will be interviewed. Clinician and patient participant (dyads) will be interviewed by a researcher and invited to complete a survey before using the scrubs. This survey is used to measure how confident the participants are in communicating with each other. It will form a baseline of communication self-efficacy. The clinician and patient (dyads) will be interviewed using a combination of structured, semi structured, and open questions. The interviews will be video recorded. Participants with communication disability are welcome to include a trusted support or communication assistant to help them get their messages out, if required. The interviewer(s) are trained in augmentative and alternative communication (AAC) and are experienced in interviewing people with diverse and complex forms of disability. The participant dyads will then be invited to use the scrubs in their health appointments which can be once only or over several sessions (over a period of up to 4 months). Participants can decide to provide feedback on one session of using the scrubs or over multiple sessions. When the participant dyad is ready to give feedback, they will be re-interviewed which will involve answering the same survey that was answered before the use of the scrubs. We anticipate a period of four to six months will be required for clinicians to wear and use the scrubs/vest but this can be extended up to a maximum of eight months should participants wish to continue. At the end of this timeframe the scrubs/vest will be withdrawn, however, replica communication boards will be provided to assist clinicians continue using AAC in their communication with patients. We anticipate patient participant time of involvement in the study will vary. It is possible that a patient participant involvement may only be a single appointment with a GP, where diagnosis and treatment is discussed without need for diagnostic screening or a follow up appointment. It is also possible that a patient may require several appointments before diagnosis can be completed and thus be involved in the study over a longer period. Clinician and ongoing patient participants will be invited to keep a journal/scrap book centred on the interviewer questions such as what it felt like to use the scrubs/vest to communicate. Journal recordings are optional. What worked well or did not work well. Ideas for improving the scrubs/vest. Patient participants who are not ongoing (i.e., their involvement in the study does not extend beyond one appointment) will not be invited to keep a journal but will be interviewed instead. Please - see example of icons in attached document.
Sponsors
University of South Australia
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Diagnosis
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
• GPs providing diagnosis for patients with communication disability (people with a disability who cannot easily be understood using speech) • Patients of the GPs who have communication disability receiving a diagnosis • Flow-on, on-site, clinician colleagues of the GPs who will perform diagnostic screening services for the patient as requested by the GP e.g., participating onsite nurses or phlebotomists.
Exclusion criteria
Exclusion criteria • Patients where this is no diagnostic involvement/requirement. • Flow-on diagnostic screening clinicians external to the site agency. • Patients without communication disability such as those who can speak but not in English.
Outcome results
None listed