Speech and Language Therapy Weekend Service in Inpatient Rehabilitation: A Qualitative Study Exploring Perspectives of People With Stroke

Abstract

Background: An allied health weekend service in subacute inpatient stroke rehabilitation can improve patient and organisational outcomes. However, there is insufficient evidence to justify the role of a speech and language therapy (SLT) weekend service in this setting. Exploring the perspectives of individuals who have received SLT services in inpatient stroke rehabilitation will assist with understanding the current role of SLT and the potential for SLT weekend services in inpatient stroke rehabilitation.

Aims: This study aimed to: (1) determine the aspects of an SLT inpatient rehabilitation service that are perceived to be important to people with stroke who have an acquired communication and/or swallowing impairment, and (2) establish which of these valued aspects are also relevant to the provision of an SLT weekend service.

Methods and procedures: A generic qualitative approach was employed. Adults admitted to inpatient rehabilitation for a minimum 2-week stay, including two weekends, and who engaged in communication and/or swallowing-related rehabilitation were invited to participate in semi-structured, in-depth interviews. Interview data were recorded, transcribed, and analysed using reflexive thematic analysis.

Outcomes and results: Six people with stroke were interviewed. Two main themes informed participants' perspectives of important aspects of inpatient rehabilitation: (1) 'recovering from my stroke' which described factors relating to the patients' participation in their rehabilitation program and their therapy progress, and (2) 'supporting my wellbeing' which reflected the value of social connections, feeling supported by staff, dedicated rest periods, and engagement in meaningful activities outside of scheduled therapy sessions. Although some participants supported the idea of an SLT weekend service to receive additional therapy, weekends were also perceived as important to support wellbeing by participating in activities that were not directly part of their rehabilitation program.

Conclusions and implications: Weekends were perceived to provide both the opportunity for additional therapy and to facilitate valued experiences that went beyond participation in the rehabilitation program. These experiences included rest, maintaining or developing social connections and engagement in social-based activities. This study's findings have important implications for the development of an SLT weekend service in inpatient stroke rehabilitation.

What this paper adds: What is already known on the subject Existing evidence on allied health weekend services within inpatient stroke rehabilitation has primarily focused on the outcomes of physical-based interventions, provided by physiotherapy and /or occupational therapy. The effectiveness of an SLT weekend service in this setting remains unclear. Furthermore, the perspectives of people with lived experience of this service are unknown. What this paper adds to existing knowledge This study provides insights into the perspectives of people with acquired communication and/or swallowing impairments post stroke on the role of an SLT weekend service within inpatient stroke rehabilitation. Although weekends were considered to provide an opportunity for the delivery of additional therapy, participants also perceived weekends to play an important role in ensuring rest, facilitating social connections with existing social networks, and participating in meaningful, social activities outside of the therapeutic context. What are the potential or actual clinical implications of this work? Participants perceived that weekends were important not only to extend their weekday rehabilitation program but also to facilitate rest, social connections and engagement in socially-based activities. Understanding the experiences and preferences of people with lived experience of inpatient stroke rehabilitation is essential when planning and implementing an SLT weekend service within an inpatient stroke rehabilitation setting.

Keywords: SLT; patients’ perspectives; qualitative research; rehabilitation; stroke; weekend service.