Associate Professor Emma Power is a speech pathologist and academic at the University of Technology Sydney. She has worked in the area of communication disorders following acquired brain injury for over 23 years in a variety of clinical and academic positions.
Emma has led research on the development of 82 post-stroke aphasia best practice guidelines published in BMJOpen and the development of the Australian Aphasia Rehabilitation pathway. She has also developed efficacious training programs for communication partners of people with TBI, TBI Express.
Emma has over 70 peer reviewed publications and $3 million worth of grant funding. She supervises PhD students in acquired brain injury and implementation science and has won awards for excellence in publications and conference papers in implementation science as well as for her curriculum development and teaching in neurogenic communication disorders.
She is currently on the Research Advisory Committee of the Stroke Foundation of Australia and a member of the Stroke Foundation clinical practice living guidelines working party.
- CPSP MSPAA
- The Stroke Society of Australasia (SSA)
- Australian Aphasia Association
- SpeechBITE (committee member)
2018 - 2017 Editors Award, article of highest merit (Ludemann et al, 2017), American Speech and Hearing Association (ASHA)
2017 - Smart Strokes Conference Implementation Best Abstract Award (study into increasing ward based practice in stroke rehabilitation)
2014 - Vice Chancellor’s Outstanding Teaching Award (ECR) for innovative curriculum redesign (USyd)
2013 - Faculty of Health Sciences Outstanding Teaching Award (ECR) for innovative curriculum redesign (USyd)
2013 - Smart Strokes Conference Implementation Best Abstract Award (study into what influences speech pathologists’ implementation of clinical practice guidelines)
2010 - Speech Pathology Association ‘Recognition of Service Award’ for outstanding service as president of the NSW branch.
Can supervise: YES
- Communication partner training in acquired neurogological disorders including stroke, brain injury and progressive diseases (e.g., dementia)
- Increasing access to quality health through health services research and implementation science to reduce the evidence to practice gap
Advancing knowledge, assessments and treatments for people with acquired neurological disorders and their families in:
- Aphasia rehabilitation
- Intimacy and sexuality after stroke/aging
- Recovery in Traumatic Brain Injury
- Cross-cutting theme of research in all these areas is digital health
- Acquired communication disability (including aphasia and cognitive-communication disorders)
- Research design
- Knowledge translation / Implementation of Evidence-Based Practice (EBP)
- Integrated and complex practice
© 2019 Elsevier Inc. Background: Communication partner training could be employed to train people working in the community to facilitate interaction with individuals who live with a variety of communication disorders. However, current evidence syntheses are limited to a single disorder (e.g., aphasia) and focus on a variety of familiar and unfamiliar communication partners. An understanding of the scope of literature across the evidence-base of acquired neurological populations may provide a better basis to develop interventions and future research tailored for community workers. Aims: To explore the scope of literature on paid worker and unfamiliar partner communication training for acquired neurogenic communication disorders with a focus on describing: 1) the types of communication disorders addressed by interventions; 2) the types of learners who received the interventions; 3) the nature of the interventions; and 4) the reported effects on trainees and people with a communication disorder. Methods & procedures: A scoping review was conducted. Studies were selected by a systematic keyword search, undertaken through four databases. Eligibility criteria included studies that: (i) reported an intervention directed at paid workers or unfamiliar partners where the primary goal was to improve communication with people with acquired neurogenic communication disorders, (ii) reported original results, (iii) contained quantitative or qualitative data on the effects of the intervention, (iv) were written in English or French and (v) were published in a peer-reviewed journal. The PRISMA-ScR was used to guide design and reporting of the scoping review. Results: Seventy publications met the inclusion criteria. Interventions were mostly disorder-specific and addressed communication with people with dementia, aphasia or traumatic brain injury. 15/70 studies examined training programs that were not restructured to a specific population (e.g., aphasia). Learners were mostly work...
Chia, AA, Power, E, Kenny, B, Elbourn, E, McDonald, S, Tate, R, MacWhinney, B, Turkstra, L, Holland, A & Togher, L 2019, 'Patterns of early conversational recovery for people with traumatic brain injury and their communication partners.', Brain injury, vol. 33, no. 5, pp. 690-698.View/Download from: UTS OPUS or Publisher's site
PRIMARY OBJECTIVE:To investigate whether the degree of participation by people with severe Traumatic Brain Injury (TBI), and the degree of support by their communication partners (CPs) changes in conversation during subacute recovery. METHODS AND PROCEDURES:Seventeen pairs of participants with TBI and their CPs were video-recorded during a 10 min casual conversation at 3 and 6 months post-injury. Communication behaviors were rated using the adapted Measure of Participation in Conversation (MPC) and the adapted Measure of Support in Conversation (MSC) at both time points and compared. RESULTS:Inferential analyses showed that there was no significant change in the degree of participation in conversation by participants with TBI and the degree of conversation support by their CPs from 3 to 6 months post. Comparison of qualitative field notes revealed that specific conversational behaviors changed over time, including better turn-taking and topic maintenance. CONCLUSION:Documenting early communication recovery is a complex and challenging endeavor. The lack of change in conversational effectiveness during the sub-acute period using global rating scales highlights the need for social communication tools that are sensitive to communication recovery following severe TBI.
Elbourn, E, Kenny, B, Power, E & Togher, L 2019, 'Psychosocial outcomes of severe traumatic brain injury in relation to discourse recovery: A longitudinal study up to 1 year post-injury', American Journal of Speech-Language Pathology, vol. 28, no. 4, pp. 1463-1478.View/Download from: Publisher's site
© 2019 American Speech-Language-Hearing Association. Purpose: The interrelationship between psychosocial outcomes and discourse after severe traumatic brain injury remains largely unknown. This study examines outcomes relating to work, relationships, and independence within the context of discourse recovery across the 1st year post-injury. Method: An inception cohort comprising 57 participants with severe traumatic brain injury was assessed at 3, 6, 9, and 12 months post-injury. Outcomes were measured with the Sydney Psychosocial Reintegration Scale–2 (Tate et al., 2012; Tate, Simpson, Loo, & Lane-Brown, 2011), and discourse was evaluated with Main Concept Analysis of a narrative retell. Correlation and linear regression analyses were utilized. Results: Significant correlations were found between psychosocial outcomes reported by relatives and discourse performance across the 1st year. The 6-month discourse scores significantly predicted the 12-month psychosocial outcomes reported by relatives. Initial discourse severity and recovery pattern also informed outcomes. Conclusions: Discourse disorders have a strong relationship with everyday outcomes relating to work, relationships, and independence as reported by relatives. Six months post-injury is a beneficial time for assessment, education, and service planning. Age, years of education, and aphasia may mediate recovery and outcomes. A clinical decision tree is offered to support goal setting.
Elbourn, E, Kenny, B, Power, E, Honan, C, McDonald, S, Tate, R, Holland, A, MacWhinney, B & Togher, L 2019, 'Discourse recovery after severe traumatic brain injury: exploring the first year', BRAIN INJURY, vol. 33, no. 2, pp. 143-159.View/Download from: UTS OPUS or Publisher's site
Hickey, J, Shrubsole, K, Worrall, PL & Power, E 2019, 'Implementing aphasia recommendations in the acute setting: speech-language pathologists' perspectives of a behaviour change intervention', Aphasiology, vol. 33, no. 5, pp. 606-628.View/Download from: UTS OPUS or Publisher's site
© 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group. Background: Evidence-practice gaps have been identified in the implementation of post-stroke aphasia guideline recommendations. To address this, an implementation intervention tailored to local barriers was developed to target speech-language pathologists' implementation of two aphasia recommended management guidelines in the acute setting (targeting either information provision or collaborative goal setting). A qualitative process evaluation is recommended to understand the mechanisms of action and how context affects the implementation outcomes. Aims: This study aimed to understand the nature of the impact of an implementation intervention as perceived by the speech-language pathologists who participated in a pilot cluster randomised controlled trial (AAIMS). Speech-language pathologists' perceptions of the feasibility, acceptability, and potential effectiveness of the tailored implementation interventions were investigated. Methods & Procedures: Focus groups were conducted with speech-language pathologists (n = 19) as part of the process evaluation, after they completed the implementation interventions at four acute hospital sites. Focus groups explored speech-language pathologists' perceptions of the feasibility, acceptability, and potential effectiveness of the implementation strategy. Using content analysis, the qualitative data were analysed to determine themes. Outcomes & Results: Six interrelated themes were identified including the acute speech-language pathologists': (1) understanding of the workshop facilitators; (2) perceptions of the impact of the workshop on clinical practice; (3) understanding of facilitators for implementation of aphasia recommendations; (4) perceived challenges impacting the workshop and implementation; (5) perceived change in practice; and (6) understanding of the focus group acting as a follow-up reflective opportunity. The findings provide support for the...
James, N, Power, E, Hogden, A & Vucic, S 2019, 'Patients' perspectives of multidisciplinary home-based e-Health service delivery for motor neurone disease.', Disability and Rehabilitation: Assistive Technology, vol. 14, no. 7, pp. 737-743.View/Download from: UTS OPUS or Publisher's site
To explore the views of people with motor neurone disease (MND) on the barriers, facilitators and potential benefits of using home-based e-Health service delivery (telehealth) to access MND multidisciplinary clinic care.Twelve patients from three MND multidisciplinary clinics and an MND support association group completed a survey of information technology (IT) use and participated in interviews, to gather participants' experiences and perceptions of home-based telehealth for MND clinic care. Survey data were analyzed descriptively, with interview data analyzed using a stepwise inductive approach.Surveys revealed that participants used IT to communicate with family and friends, but were less likely to use the phone, email or videoconferencing with health professionals. Two themes of participants' use of IT in MND care reflected their experiences of MND care; and personal preferences for modes of healthcare delivery. Participants were willing to use telehealth for MND care, with family members acting as patients' main support for telehealth participation. Nevertheless, participants preferred face-to-face contact with the MND clinic team in the initial and early stages of the disease.People living with MND may wish to participate in individual care planning to facilitate their access to a variety of e-Health service modalities. Additionally, individual care planning may allow healthcare professionals to deliver e-Health-based care, such as telehealth, to increase the scope of care provided. Research to ascertain the views of health professionals and family members as co-participants in service delivery via telehealth is needed to fully assess the potential contribution of e-Health. Implications for Rehabilitation People living with MND face a range of barriers to attending specialized multidisciplinary care, including fatigue, caregiver availability and logistical challenges to travel. Patients have indicated willingness to use e-Health applications to improve thei...
Johnson, R, Purcell, A, Power, E & Thomson, K 2019, 'University teachers' perceptions of screening students' communication skills: A case study from speech pathology', International Journal of Practice-Based Learning in Health and Social Care, vol. 7, no. 1, pp. 32-46.View/Download from: UTS OPUS or Publisher's site
© 2019 Robyn Johnson, Alison Purcell, Emma Power, and Kate Thomson. Excellent communication and interpersonal skills are necessary for allied health professionals to provide effective care/treatment and underpin the practice-based competencies allied health students must develop. Communication skills of first year speech pathology (SP) students are screened at the major Australian metropolitan university where this study took place. Final year students screen their first year peers as part of their practice-based education experience. Although this identifies first year students with communication difficulties, the perceived value to university teachers (academics and practice educators) has not been investigated. This study described university staff perceptions of screening the communication skills of first year SP students. The qualitative, descriptive design included two focus groups. The dataset was analysed thematically. The analysis revealed the staff perception of value in screening communication skills to inform student support. Two sub-themes contributing to this perception were 'purpose of the screener' and 'content and administration of the screener'. Both staff groups strongly valued the screening process, stating that it is positive and useful. A similar screening process could identify first year students from a range of health fields with less skilled communication, who may require additional support to achieve competency.
Mallet, K, Shamloul, R, Pugliese, M, Power, E, Corbett, D, Hatcher, S, Shamy, M, Stotts, G, Zakutney, L, Dukelow, S & Dowlatshahi, D 2019, 'RecoverNow: A patient perspective on the delivery of mobile tablet-based stroke rehabilitation in the acute care setting.', International Journal of Stroke, vol. 14, no. 2, pp. 174-179.View/Download from: UTS OPUS or Publisher's site
BACKGROUND/AIM:We previously reported the feasibility of RecoverNow (a mobile tablet-based post-stroke communication therapy in acute care). RecoverNow has since expanded to include fine motor and cognitive therapies. Our objectives were to gain a better understanding of patient experiences and recovery goals using mobile tablets. METHODS:Speech-language pathologists or occupational therapists identified patients with stroke and communication, fine motor, or cognitive/perceptual deficits. Patients were provided with iPads individually programmed with applications based on assessment results, and instructed to use it at least 1 h/day. At discharge, patients completed a 19-question quantitative and open-ended engagement survey addressing intervention timing, mobile device/apps, recovery goals, and therapy duration. RESULTS:Over a six-month period, we enrolled 33 participants (three did not complete the survey). Median time from stroke to initiation of tablet-based therapy was six days. Patients engaged in therapy on average 59.6 min/day and preferred communication and hand function therapies. Most patients (63.3%) agreed that therapy was commenced at a reasonable time, although half expressed an interest in starting sooner, 66.7% reported that using the device 1 h/day was enough, 64.3% would use it after discharge, and 60.7% would use it for eight weeks. Sixty-seven percent of patients expressed a need for family/friend/caregiver to help them use it. CONCLUSION:Our results suggest that stroke patients are interested in mobile tablet-based therapy in acute care. Patients in the acute setting prefer to focus on communication and hand therapies, are willing to begin within days of their stroke and may require assistance with the tablets.
McGrath, M, Lever, S, McCluskey, A & Power, E 2019, 'Developing interventions to address sexuality after stroke: Findings from a four-panel modified Delphi study.', Journal of rehabilitation medicine, vol. 51, no. 5, pp. 352-360.View/Download from: UTS OPUS or Publisher's site
BACKGROUND:Although stroke has a profound impact on sexuality there are limited evidence-based interventions to support rehabilitation professionals in this area. The aim of the current research was to prioritize content areas and approaches to sexual rehabilitation from the perspective of stroke survivors, their partners, stroke rehabilitation clinicians and researchers. METHODS:A 2-step online Delphi method was used to prioritize the content of, and approaches to, sexual rehabilitation with stroke survivors, their partners, stroke rehabilitation clinicians and researchers. RESULTS:Stroke survivors (n = 30), their partners (n = 18), clinicians and researchers in stroke rehabilitation (n = 45) completed at least 1 of 2 investigator-developed surveys. Participants prioritized 18 core content areas for inclusion in sexual rehabilitation following stroke with a high degree of consensus. Another 27 content areas were considered moderately important. There was strong consensus that sexual rehabilitation should be offered in the subacute and chronic phases of stroke recovery. Participants would prefer health professionals to deliver the intervention face-to-face. CONCLUSION:This study presents opinions from stroke survivors, partners of stroke survivors, clinicians and researchers. The information about content, timing and mode of delivery will be used to develop and evaluate a comprehensive sexuality rehabilitation programme.
McGrath, M, Lever, S, McCluskey, A & Power, E 2019, 'How is sexuality after stroke experienced by stroke survivors and partners of stroke survivors? A systematic review of qualitative studies.', Clinical rehabilitation, vol. 33, no. 2, pp. 293-303.View/Download from: UTS OPUS or Publisher's site
OBJECTIVE::To synthesise how post-stroke sexuality is experienced by stroke survivors and partners of stroke survivors. METHODS::MEDLINE, PubMed, SCOPUS, CINAHL and PsycINFO were searched from inception to May 2018 using a combination of relevant Medical Subject Headings and Free Text Terms. Only papers published in English reporting original qualitative research were included. Methodological quality was assessed using the Critical Appraisal Skills Programme Qualitative Research Checklist. All text presented as 'results' or 'findings' in the included studies was extracted and subjected to a thematic analysis and synthesis which was discussed and agreed by the research team. RESULTS::The initial search yielded 136 unique papers with a further 8 papers identified through reference checking. Following full-text review, 43 papers were included in the final synthesis. Two analytical themes were identified: sexuality is silenced and sexuality is muted and sometimes changed, but not forgotten. These themes were made up of six descriptive themes: struggle to communicate within relationships, health professionals don't talk about sexuality, sexuality and disability is a taboo topic, changes to pre-stroke relationships, changed relationship with the stroke survivor's own body and resuming sexual intimacy - adaptation and loss. CONCLUSION::Stroke has a profound impact on how sexuality is experienced by both stroke survivors and partners of stroke survivors. Despite this, post-stroke sexuality is rarely discussed openly. Stroke survivors and partners value sexuality and may benefit from strategies to support adjustment to post-stroke sexuality.
Power, E, Weir, S, Richardson, J, Fromm, D, Forbes, M, MacWhinney, B & Togher, L 2019, 'Patterns of narrative discourse in early recovery following severe Traumatic Brain Injury', BRAIN INJURY.View/Download from: Publisher's site
Shrubsole, K, Worrall, L & Power, E 2019, 'Closing the evidence-practice gaps in aphasia management: are we there yet? Where has a decade of implementation research taken us? A review and guide for clinicians', APHASIOLOGY, vol. 33, no. 8, pp. 970-995.View/Download from: UTS OPUS or Publisher's site
Shrubsole, K, Worrall, L, Power, E & O'Connor, DA 2019, 'Barriers and facilitators to meeting aphasia guideline recommendations: what factors influence speech pathologists' practice?', Disability and Rehabilitation, vol. 41, no. 13, pp. 1596-1607.View/Download from: UTS OPUS or Publisher's site
To explore factors influencing Australian speech pathologists' guideline recommended aphasia management practices.Semi-structured interviews were conducted with hospital-based speech pathologists (n = 20). Interviews focused on barriers and facilitators to implementing recommendations related to five practice areas: Aphasia-friendly Information; Collaborative Goal Setting; Timing of Therapy; Amount and Intensity of Therapy; and Conversation Partner Training.Speech pathologists working only in inpatient rehabilitation settings reported performing the recommended behaviours consistently, and identified few implementation barriers. However, clinicians working in the acute setting reported performing the majority of behaviours inconsistently or rarely. Seven (of 14) Theoretical Domains Framework domains were identified as key influencing factors. Three of these - "Environmental Context and Resources," "Beliefs about Consequences," and "Social Influences" - were consistently reported as influencing practice across all five behaviours. Other important domains included "Knowledge", "Beliefs about Capabilities," "Goals," and "Social/Professional Role and Identity", which each influenced at least two practice behaviours.Speech pathologists report a number of key factors influencing their practice, which differ in how they influence behaviours (i.e., a factor may be a barrier or a facilitator) depending on the behaviour and clinical setting. Future implementation interventions need to account for the strong influence of beliefs and social influences on speech pathology practice, which may facilitate successful implementation. Implications for rehabilitation Speech pathologists' aphasia management practices are often inconsistent with guideline recommendations. Environmental and contextual barriers were identified for all guideline-recommended practices that were investigated; however, these barriers did not necessarily impede implementation for speech pathologists working ...
Stewart, C, Power, E, McCluskey, A & Kuys, S 2019, 'Development of a participatory, tailored behaviour change intervention to increase active practice during inpatient stroke rehabilitation', DISABILITY AND REHABILITATION.View/Download from: Publisher's site
Wallace, SJ, Baker, C, Brandenburg, C, Bryant, L, Le Dorze, G, Power, E, Pritchard, M, Rose, ML, Rose, T, Ryan, B, Shrubsole, K, Simmons-Mackie, N, Togher, L & Trebilcock, M 2019, 'A how-to guide to aphasia services: celebrating Professor Linda Worrall's contribution to the field', APHASIOLOGY, vol. 33, no. 7, pp. 888-902.View/Download from: UTS OPUS or Publisher's site
Rietdijk, R, Power, E, Brunner, M & Togher, L 2019, 'A single case experimental design study on improving social communication skills after traumatic brain injury using communication partner telehealth training.', Brain Injury, vol. 33, no. 1, pp. 94-109.View/Download from: UTS OPUS or Publisher's site
PRIMARY OBJECTIVE:To investigate use of telehealth to deliver social communication skills training (TBIconneCT) to people with severe traumatic brain injury (TBI) and their communication partners (CPs). RESEARCH DESIGN:Feasibility study involving single case experimental design with two participants. METHODS AND PROCEDURES:TBI Express is an established program for improving social interactions between people with TBI and their CPs. To improve access to the program, we developed a modified version called TBIconneCT that can be delivered via videoconferencing. Two participants with TBI and their CPs completed TBIconneCT training. Outcome measures included exchange structure analysis of conversation samples, blinded ratings of conversation samples and self-report measures. MAIN OUTCOMES AND RESULTS:The study indicated positive change on blinded ratings of conversation and self-reported measures for both participants. Exchange structure analysis conducted on session-by-session data did not demonstrate treatment effects due to variability during baseline. CONCLUSION:This study indicated potential for using telehealth to provide social communication skills training to people with TBI and their families. The study findings provide a foundation for a phase one clinical trial which will compare in-person with videoconferencing delivery of TBIconneCT.
Rietdijk, R, Power, E, Brunner, M & Togher, L 2019, 'Protocol for a clinical trial of telehealth-based social communication skills training for people with traumatic brain injury and their communication partners', Brain Impairment.View/Download from: Publisher's site
© Australasian Society for the Study of Brain Impairment 2019. Background: A previous clinical trial of training communication partners of people with traumatic brain injury (TBI) demonstrated positive outcomes [Togher, Power, McDonald, Tate, & Rietdijk (2009). Brain Impairment, 10(2), 188-204]. Adapting communication partner training for delivery via telehealth could improve access to this intervention.Objectives: To compare outcomes across in-person communication partner training, telehealth communication partner training and a control groupMethod: Protocol for a partially randomised controlled trial. People with moderate-severe TBI will be allocated to either an in-person or telehealth-based training program. Comparison data will be drawn from the original trial control group, which was recruited using the same eligibility criteria as this protocol. Outcomes after training will be compared between the in-person training group, the telehealth training group and the historical control group.Discussion: This protocol uses specific design features with the aim of maximising the study's power, including a partially randomised allocation process and a historical control group. The results will inform about the feasibility and effectiveness of delivering TBI rehabilitation via telehealth.Trial registration: Australian and New Zealand Clinical Trials Registry: ACTRN12615001024538.
Rietdijk, R, Power, E, Brunner, M & Togher, L 2019, 'The reliability of evaluating conversations between people with traumatic brain injury and their communication partners via videoconferencing.', Neuropsychological Rehabilitation, pp. 1-18.View/Download from: Publisher's site
There is growing interest in using telehealth to work with people with traumatic brain injury (TBI). This study investigated whether established rating scales for evaluating conversations of people with TBI are reliable for use over videoconferencing. Nineteen participants with TBI and their communication partners completed two conversation samples during both in-person (IP) and videoconferencing-based (VC) assessment, with randomised order of assessment. Independent clinicians evaluated the conversations using the Adapted Measure of Participation in Conversation (MPC), the Adapted Measure of Support in Conversation (MSC) and the Global Impression scales. Comparisons between IP and VC ratings identified no significant differences on the MPC, MSC, and four out of five of the Global Impression scales. There was a significant difference between IP and VC recordings for "Task Completion" (p = .047), with participants performing significantly better in VC ratings. Inter-rater reliability was fair to excellent for the MPC and Global Impression scales for both IP and VC recordings. For the MSC scale, inter-rater reliability was poor to excellent. This study confirms the potential for using videoconferencing for evaluating conversations of people with TBI. Further development of training and rating procedures for these scales could facilitate more frequent and reliable use of these measures.
Carragher, M, Ryan, B, Worrall, L, Thomas, S, Rose, M, Simmons-Mackie, N, Khan, A, Hoffmann, TC, Power, E, Togher, L & Kneebone, I 2019, 'Fidelity protocol for the Action Success Knowledge (ASK) trial: A psychosocial intervention administered by speech and language therapists to prevent depression in people with post-stroke aphasia', BMJ Open, vol. 9, no. 5.View/Download from: UTS OPUS or Publisher's site
© 2019 Author(s) (or their employer(s)). Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Introduction Treatment fidelity is a complex, multifaceted evaluative process which refers to whether a studied intervention was delivered as intended. Monitoring and enhancing fidelity is one recommendation of the TiDIER (Template for Intervention Description and Replication) checklist, as fidelity can inform interpretation and conclusions drawn about treatment effects. Despite the methodological and translational benefits, fidelity strategies have been used inconsistently within health behaviour intervention studies; in particular, within aphasia intervention studies, reporting of fidelity remains relatively rare. This paper describes the development of a fidelity protocol for the Action Success Knowledge (ASK) study, a current cluster randomised trial investigating an early mood intervention for people with aphasia (a language disability caused by stroke). Methods and analysis A novel fidelity protocol and tool was developed to monitor and enhance fidelity within the two arms (experimental treatment and attention control) of the ASK study. The ASK fidelity protocol was developed based on the National Institutes of Health Behaviour Change Consortium fidelity framework. Ethics and dissemination The study protocol was approved by the Darling Downs Hospital and Health Service Human Research Ethics Committee in Queensland, Australia under the National Mutual Acceptance scheme of multicentre human research projects. Specific ethics approval was obtained for those participating sites who were not under the National Mutual Agreement at the time of application. The monitoring and ongoing conduct of the research project is in line with requirements under the National Mutual Acceptance. On completion of the trial, findings from the fidelity reviews will be disseminated via publications and conference presentations. Trial registrati...
Chang, HF, Power, E, O'Halloran, R & Foster, A 2018, 'Stroke communication partner training: a national survey of 122 clinicians on current practice patterns and perceived implementation barriers and facilitators.', International Journal of Language and Communication Disorders, vol. 53, no. 6, pp. 1094-1109.View/Download from: UTS OPUS or Publisher's site
Communication partners (CPs) find it challenging to communicate with people with communication disorders post-stroke. Stroke communication partner training (CPT) can enhance CPs' ability to support the communication and participation of people post-stroke. While evidence for the efficacy of aphasia-based CPT is strong, implementation in healthcare settings is unclear.To investigate Australian speech pathologists' current stroke CPT practices, factors influencing the implementation of CPT and how reported practice compares with the research evidence.Speech pathologists in Australia who had worked with people post-stroke were invited to complete a 99-item online survey. The survey was informed by a comprehensive review of the literature review, the Template for Intervention Description and Replication (TIDieR) intervention taxonomy, and the theoretical domains framework. data were analyzed using descriptive statistics and content analysis.A total of 122 clinicians were surveyed. Most participants reported providing CPT to treat a range of post-stroke communication disorders. While 98.3% reported training familiar CPs, only 66.1% reported training unfamiliar CPs. Current stroke CPT practice is characterized by one to two < 1 h sessions of informal face-to-face education and skills training. Only 13.3% and 10.0% of participants used evidence-based published programmes with unfamiliar and familiar CPs respectively. The main barriers included the perceived lack of behavioural regulation, skills, reinforcement, beliefs about consequences, positive social influences and resources. The main facilitators included clinicians' intentions to provide CPT, perception of CPT as part of their role and perceived compatibility of CPT with clinical practice.A significant evidence-practice gap exists. Research exploring the implementation of stroke CPT in healthcare settings, expanding evidence to support CPT for the range of post-stroke communication disorders, developing freely acc...
Croteau, C, McMahon-Morin, P, Le Dorze, G, Power, E, Fortier-Blanc, J & Davis, GA 2018, 'Exploration of a quantitative method for measuring behaviors in conversation', APHASIOLOGY, vol. 32, no. 3, pp. 247-263.View/Download from: UTS OPUS or Publisher's site
O'Rourke, A, Power, E, O'Halloran, R & Rietdijk, R 2018, 'Common and distinct components of communication partner training programmes in stroke, traumatic brain injury and dementia', INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS, vol. 53, no. 6, pp. 1150-1168.View/Download from: UTS OPUS or Publisher's site
Shrubsole, K, Worrall, L, Power, E & O'Connor, DA 2018, 'Implementing a tailored behaviour change intervention to improve speech pathologists' aphasia practices: results of a pilot cluster randomised controlled trial', Aphasiology, vol. 32, no. sup1, pp. 206-207.View/Download from: Publisher's site
Shrubsole, K, Worrall, L, Power, E & O'Connor, DA 2018, 'Priorities for Closing the Evidence-Practice Gaps in Poststroke Aphasia Rehabilitation: A Scoping Review', Archives of Physical Medicine and Rehabilitation, vol. 99, no. 7, pp. 1413-1423.View/Download from: UTS OPUS or Publisher's site
© 2017 American Congress of Rehabilitation Medicine Objective: To identify implementation priorities for poststroke aphasia management relevant to the Australian health care context. Data Sources: Using systematized searches of databases (CINAHL and MEDLINE), guideline and stroke websites, and other sources, evidence was identified and extracted for 7 implementation criteria for 13 topic areas relevant to aphasia management. These 7 priority-setting criteria were identified in the implementation literature: strength of the evidence, current evidence-practice gap, clinician preference, patient preference, modifiability, measurability, and health effect. Study Selection: Articles were included if they were in English, related to a specific recommendation requiring implementation, and contained information pertaining to any of the 7 prioritization criteria. Data Extraction: The scoping review methodology was chosen to address the broad nature of the topic. Evidence was extracted and placed in an evidence matrix. After this, evidence was summarized and then aphasia rehabilitation topics were prioritized using an approach developed by the research team. Data Synthesis: Evidence from 100 documents was extracted and summarized. Four topic areas were identified as implementation priorities for aphasia: timing, amount, and intensity of therapy; goal setting; information, education, and aphasia-friendly information; and constraint-induced language therapy. Conclusions: Closing the evidence-practice gaps in the 4 priority areas identified may deliver the greatest gains in outcomes for Australian stroke survivors with aphasia. Our approach to developing implementation priorities may be useful for identifying priorities for implementation in other health care areas.
Shrubsole, K, Worrall, L, Power, E & O'Connor, DA 2018, 'The Acute Aphasia IMplementation Study (AAIMS): a pilot cluster randomized controlled trial', INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS, vol. 53, no. 5, pp. 1021-1056.View/Download from: UTS OPUS or Publisher's site
Stubbs, E, Togher, L, Kenny, B, Fromm, D, Forbes, M, MacWhinney, B, McDonald, S, Tate, R, Turkstra, L & Power, E 2018, 'Procedural discourse performance in adults with severe traumatic brain injury at 3 and 6 months post injury', BRAIN INJURY, vol. 32, no. 2, pp. 167-181.View/Download from: UTS OPUS or Publisher's site
Tran, S, Kenny, B, Power, E, Tate, R, McDonald, S, Heard, R & Togher, L 2018, 'Cognitive-communication and psychosocial functioning 12 months after severe traumatic brain injury', BRAIN INJURY, vol. 32, no. 13-14, pp. 1700-1711.View/Download from: UTS OPUS or Publisher's site
Young, L, Shrubsole, K, Worrall, L & Power, E 2018, 'Factors that influence Australian speech-language pathologists' self-reported uptake of aphasia rehabilitation recommendations from clinical practice guidelines', APHASIOLOGY, vol. 32, no. 6, pp. 646-665.View/Download from: UTS OPUS or Publisher's site
Avramović, P, Kenny, B, Power, E, McDonald, S, Tate, R, Hunt, L, MacDonald, S, Heard, R & Togher, L 2017, 'Exploring the relationship between cognition and functional verbal reasoning in adults with severe traumatic brain injury at six months post injury.', Brain Injury, vol. 31, no. 4, pp. 502-516.View/Download from: UTS OPUS or Publisher's site
This study aims to determine the association between cognitive impairment and functional verbal reasoning in adults with severe traumatic brain injury (TBI), at six months post-injury.38 participants with severe TBI were assessed using the four tasks on the Functional Assessment of Verbal Reasoning and Executive Strategies (FAVRES)  and a battery of neuropsychological tests at 6 months post injury in a cross-sectional observational study.Overall performance on the FAVRES  was strongly associated with overall performance on the neuropsychological battery (rho = 0.60). FAVRES Task 2 and FAVRES Task 4 had the most significant positive associations with the cognitive indices of Attention and speed of processing, Memory and Executive functions. There was one weak significant association between the Task 1 Accuracy score and the Total Cognitive index (rho = 0.46).Performance on the FAVRES  is positively associated with cognitive processes. Participants with stronger verbal reasoning skills which may be required for activities in work, home and social contexts also had higher scores on tests of cognitive functioning. These findings may inform clinical practices for speech pathologists and other health professionals, in the assessment and treatment of cognitive communication disorders during early stages of recovery in people with severe TBI.
Elbourn, E, Togher, L, Kenny, B & Power, E 2017, 'Strengthening the quality of longitudinal research into cognitive-communication recovery after traumatic brain injury: A systematic review.', International Journal of Speech-Language Pathology, vol. 19, no. 1, pp. 1-16.View/Download from: UTS OPUS or Publisher's site
(i) To systematically review longitudinal and prognostic studies relating to the trajectory of cognitive-communication recovery after TBI and (ii) to provide recommendations to strengthen future research.Thirteen health literature databases were accessed up until July 2014.Articles were screened systematically against pre-determined inclusion and exclusion criteria. Quality reviews were performed on the selected articles using a modified Downs & Black Rating Scale. Two independent reviewers performed the reviews.Sixteen longitudinal and prognostic articles met the inclusion criteria. There was evidence of either maintenance or improvement of cognitive-communication skills during the first 3 years post-injury. However, the studies did not provide detailed recovery trajectories, by failing to evaluate numerous data points over time. No studies evaluated recovery beyond 3 years post-injury. Injury severity, lesion location, brain volume loss and conversation skills may predict specific cognitive-communication outcomes. There was high variability in study characteristics and measures.There is currently scarce evidence regarding cognitive-communication recovery and prognosis. People with TBI may recover or maintain pre-morbid cognitive-communication skills during the early rehabilitation stage. Further research detailing the recovery trajectory with a view to evaluating predictive factors is strongly indicated. Guidelines for future research are provided.
Guo, YE, Togher, L, Power, E & Heard, R 2017, 'Validation of the assessment of living with aphasia in Singapore', Aphasiology, vol. 31, no. 9, pp. 981-998.View/Download from: UTS OPUS or Publisher's site
© 2016 Informa UK Limited, trading as Taylor & Francis Group. Background: The Assessment of Living with Aphasia (ALA) is a pictographic, self-report measure of aphasia-related quality of life (QoL). It has yet to be used in the Singapore population or adapted to other languages. Aims: To examine the reliability and validity of the ALA and develop a Mandarin Chinese adaptation, the ALA-C, in the Singapore context. Methods & procedures: Linguistic validation of the ALA was conducted to derive the ALA-C. People with aphasia (PWA) who were at least 6 months post-onset underwent the ALA/ALA-C and a series of reference measures in their dominant language (English/Mandarin). Test–retest reliability was evaluated using intra-class correlations and internal consistency using Cronbach's alpha. Eight reference measures were administered to assess construct validity. Outcomes & results: Sixty-six PWA were recruited to the study. Both the ALA and ALA-C showed excellent internal consistency (α = 0.97/0.96) and test–retest reliability (intraclass correlation = 0.97/0.98), and acceptable convergent (r = 0.63–0.83 and 0.70–0.83 respectively) and discriminant (r = 0.45–0.60 and 0.39–0.53, respectively) validity. Conclusions: Both ALA and ALA-C demonstrated excellent reliability and good validity. Further research is warranted to examine use by more practicing clinicians and with more participants of varying degrees of aphasia severity to enable additional investigation of its psychometric properties.
Guo, YE, Togher, L, Power, E, Heard, R, Luo, N, Yap, P & Koh, GCH 2017, 'Sensitivity to change and responsiveness of the Stroke and Aphasia Quality-of-Life Scale (SAQOL) in a Singapore stroke population', Aphasiology, vol. 31, no. 4, pp. 427-446.View/Download from: UTS OPUS or Publisher's site
© 2016 Informa UK Limited, trading as Taylor & Francis Group. Background: The health-related quality of life (HRQoL) of people with aphasia (PWA) in Singapore is unknown. Aims: To compare outcomes between stroke survivors with and without aphasia in Singapore and examine the sensitivity and responsiveness to change of the Stroke and Aphasia QOL Scale (SAQOL-39g) and its Singapore (Mandarin) variant, SAQOL-CSg. Methods & Procedures: A longitudinal cohort study was conducted with stroke survivors with and without aphasia. Participants underwent a series of questionnaires at 3 and 12 months post-stroke including SAQOL-39g/SAQOL-CSg, Barthel Index, Modified Rankin Scale (MRS), Mini Mental State Examination, Frontal Assessment Battery, Center for Epidemiologic Studies Depression Scale and the EQ-5D. The following data analyses were conducted: comparison of stroke outcomes between participants with and without aphasia, computation of floor and ceiling effects, calculation of effect sizes (ESs) to determine sensitivity to change and estimation of minimally important differences (MIDs) for examining responsiveness. Outcomes & Results: A total of 78 participants (29.5% female, 29.5% PWA, mean age 64.1 years) completed all the assessments on both occasions. At 12 months post-stroke, PWA had higher levels of disability on the MRS (Mann–Whitney U = 294.5, p < 0.01) and reported significantly lower quality of life on the SAQOL-39g/SAQOL-CSg (U = 349, p < 0.01) and the EQ-5D index (U = 447, p < 0.05). In terms of sensitivity to change, the SAQOL-39g/SAQOL- 35CSg showed a small degree of improvement for the entire sample (ES, r = 0.22) but change was only significant for participants without aphasia. MID estimates for improvement were 0.21 on the SAQOL-39g/SAQOL-CSg and 0.17 on the EQ-5D index. Conclusions: PWA reported poorer HRQoL even when physical function was comparable. SAQOL-39g/SAQOL-CSg was found to have adequate sensitivity to change (i.e., reflect at least small ch...
Guo, YE, Togher, L, Power, E, Hutomo, E, Yang, Y-F, Tay, A, Yen, S-C & Koh, GC-H 2017, 'Assessment of Aphasia Across the International Classification of Functioning, Disability and Health Using an iPad-Based Application.', Telemedicine Journal and e-Health, vol. 23, no. 4, pp. 313-326.View/Download from: UTS OPUS or Publisher's site
Access2Aphasia™ is an iPad™-based aphasia assessment application that enables real-time audiovisual communication between people with aphasia (PWA) and speech-language pathologists (SLPs), and the use of supported conversation techniques. This study aimed to establish the reliability of aphasia assessment across the International Classification of Functioning, Disability and Health (ICF) using Access2Aphasia, and compare it with face-to-face (FTF) assessment. Consumer perspectives of Access2Aphasia were also examined.Thirty PWA were randomized into two conditions: online-led and FTF assessment. Participants in the online-led group were assessed remotely using Access2Aphasia™ in their own homes, while an FTF SLP scored silently simultaneously. Participants in the FTF group were assessed FTF using standard administration materials. Assessment included two subtests of the Psycholinguistic Assessment of Language Processing Activities (PALPA) and the Assessment of Living with Aphasia (ALA) to allow for outcomes to be captured across the ICF domains. Consumer perspectives on Access2Aphasia were obtained from both PWA and research SLPs in the online-led group.Kappa statistics indicated moderate to almost perfect agreement between online and FTF SLPs (k = 0.71-1.00). Intrarater and interrater reliability was excellent (ICC = 0.99-1.00) and equivalent for the online-led and FTF conditions. Both PWA and research SLPs in the online-led group reported being satisfied with the experience overall, with suggestions provided by research SLPs to improve Access2Aphasia.This study supports the provision of iPad-based aphasia assessments across the ICF in the online environment, with comparable reliability to FTF assessments. Future research is warranted to support the development of iPad-based aphasia assessment and treatment as an alternative mode of service delivery to PWA.
Ludemann, A, Power, E & Hoffmann, TC 2017, 'Investigating the Adequacy of Intervention Descriptions in Recent Speech-Language Pathology Literature: Is Evidence From Randomized Trials Useable?', American Journal of Speech-Language Pathology, vol. 26, no. 2, pp. 443-455.View/Download from: UTS OPUS or Publisher's site
To evaluate the completeness of intervention descriptions in recent randomized controlled trials of speech-language pathology treatments.A consecutive sample of entries on the speechBITE database yielded 129 articles and 162 interventions. Interventions were rated using the Template for Intervention Description and Replication (TIDieR) checklist. Rating occurred at 3 stages: interventions as published in the primary article, secondary locations referred to by the article (e.g., protocol papers, websites), and contact with corresponding authors.No interventions were completely described in primary publications or after analyzing information from secondary locations. After information was added from correspondence with authors, a total of 28% of interventions was rated as complete. The intervention elements with the most information missing in the primary publications were tailoring and modification of interventions (in 25% and 13% of articles, respectively) and intervention materials and where they could be accessed (18%). Elements that were adequately described in most articles were intervention names (in 100% of articles); rationale (96%); and details of the frequency, session duration, and length of interventions (69%).Clinicians and researchers are restricted in the usability of evidence from speech-language pathology randomized trials because of poor reporting of elements essential to the replication of interventions.
Shrubsole, K, Worrall, L, Power, E & O Connor, DA 2017, 'Recommendations for post-stroke aphasia rehabilitation: an updated systematic review and evaluation of clinical practice guidelines', Aphasiology, vol. 31, no. 1, pp. 1-24.View/Download from: UTS OPUS or Publisher's site
© 2016 Informa UK Limited, trading as Taylor & Francis Group. Background: Clinical practice guidelines (CPGs) have been shown to improve patient care and outcomes. For speech pathologists working with people with post-stroke aphasia, there is currently no single high-quality guideline that summarises all of the available research knowledge into recommendations to guide decision-making. While multiple stroke and aphasia guidelines exist, some are of low methodological quality, are out of date, or do not provide recommendations that specifically guide aphasia management. As such, it may be difficult for clinicians to choose one particular guideline to follow. Aim: To identify, extract, and evaluate recommendations from high-quality CPGs to inform the management of post-stroke aphasia by speech pathologists. Methods & Procedures: An updated systematic review of stroke and speech pathology-specific clinical guidelines was conducted in January 2015. The search included multiple databases (MEDLINE, Embase, CINAHL), guideline and stroke websites, and other sources. The quality of included guidelines was assessed using the Appraisal of Guidelines and Research and Evaluation (AGREE) II tool. Guidelines that obtained a high AGREE II 'Rigour of Development' score were retained and the aphasia-relevant recommendations from these guidelines were extracted for further analysis. Recommendations were evaluated according to their applicability to aphasia and the clarity of linkages between the recommendations and underlying evidence. Outcomes & Results: Five new guidelines were identified. Their AGREE II ratings ranged from 31.3 to 71.9, and one met the cut-off of 66.67 for further analysis. One hundred and eleven recommendations from four guidelines were extracted and evaluated. From these, 76 recommendations met the inclusion criteria, 25 of which were specifically targeted at aphasia management, the remainder being general rehabilitation principles that may apply to aphasia....
Taylor-Rubin, C, Croot, K, Power, E, Savage, SA, Hodges, JR & Togher, L 2017, 'Communication behaviors associated with successful conversation in semantic variant primary progressive aphasia.', International Psychogeriatrics, vol. 29, no. 10, pp. 1619-1632.View/Download from: UTS OPUS or Publisher's site
Primary progressive aphasia (PPA) affects a range of language and cognitive domains that impact on conversation. Little is known about conversation breakdown in the semantic variant of PPA (svPPA, also known as semantic dementia). This study investigates conversation of people with svPPA.Dyadic conversations about everyday activities between seven individuals with svPPA and their partners, and seven control pairs were video recorded and transcribed. Number of words, turns, and length of turns were measured. Trouble-indicating behaviors (TIBs) and repair behaviors were categorized and identified as successful or not for each participant in each dyad.In general, individuals with svPPA were active participants in conversation, taking an equal proportion of turns, but indicating a great deal of more trouble in conversation, shown by the significantly higher number of TIBs than evidenced by partners or control participants. TIBs were interactive (asking for confirmation with a shorter repetition of the original utterance or a repetition which included a request for specific information) and non-interactive (such as failing to take up or continue the topic or a minimal response) and unlike those previously reported for people with other PPA variants and dementia of the Alzheimer type. Communication behaviors of the partner were critical to conversational success.Examination of trouble and repair in 10-min conversations of individuals with svPPA and their important communication partners has potential to inform speech pathology interventions to enhance successful conversation, in svPPA and should be an integral part of the comprehensive care plan.
Rietdijk, R, Power, E, Brunner, M & Togher, L 2017, 'Reliability of Videoconferencing Administration of a Communication Questionnaire to People With Traumatic Brain Injury and Their Close Others.', Journal of Head Trauma Rehabilitation, vol. 32, no. 6, pp. E38-E44.View/Download from: UTS OPUS or Publisher's site
To compare in-person with videoconferencing administration of a communication questionnaire for people with traumatic brain injury (TBI) and their close others.Repeated-measures design with randomized order of administration.Twenty adults with severe TBI and their close others.Both participants with TBI and their close others completed the La Trobe Communication Questionnaire (LCQ) via interview with a clinician, once via Skype and once during a home visit.Total LCQ score and time taken for completion.There were no significant differences between videoconferencing and in-person conditions in the total scores or time taken to complete the questionnaire.Videoconferencing-based administration of the LCQ is as reliable and efficient as in-person administration.
Hines, M, Brunner, M, Poon, S, Lam, M, Tran, V, Yu, D, Togher, L, Shaw, T & Power, E 2017, 'Tribes and tribulations: interdisciplinary eHealth in providing services for people with a traumatic brain injury (TBI)', BMC Health Services Research, vol. 17, pp. 1-13.View/Download from: UTS OPUS or Publisher's site
Background eHealth has potential for supporting interdisciplinary care in contemporary traumatic brain injury (TBI) rehabilitation practice, yet little is known about whether this potential is being realised, or what needs to be done to further support its implementation. The purpose of this study was to explore health professionals' experiences of, and attitudes towards eHealth technologies to support interdisciplinary practice within rehabilitation for people after TBI. Methods A qualitative study using narrative analysis was conducted. One individual interview and three focus groups were conducted with health professionals (n = 17) working in TBI rehabilitation in public and private healthcare settings across regional and metropolitan New South Wales, Australia. Results Narrative analysis revealed that participants held largely favourable views about eHealth and its potential to support interdisciplinary practice in TBI rehabilitation. However, participants encountered various issues related to (a) the design of, and access to electronic medical records, (b) technology, (c) eHealth implementation, and (d) information and communication technology processes that disconnected them from the work they needed to accomplish. In response, health professionals attempted to make the most of unsatisfactory eHealth systems and processes, but were still mostly unsuccessful in optimising the quality, efficiency, and client-centredness of their work. Conclusions Attention to sources of disconnection experienced by health professionals, specifically design of, and access to electronic health records, eHealth resourcing, and policies and procedures related to eHealth and interdisciplinary practice are required if the potential of eHealth for supporting interdisciplinary practice is to be realised.
Phillips, J, Poon, SK, Yu, D, Lam, M, Hines, M, Brunner, M, Power, E, Keep, M, Shaw, T & Togher, L 2017, 'A Conceptual Measurement Model for eHealth Readiness: a Team Based Perspective', AMIA ... Annual Symposium proceedings. AMIA Symposium, vol. 2017, pp. 1382-1391.
Despite the shift towards collaborative healthcare and the increase in the use of eHealth technologies, there does not currently exist a model for the measurement of eHealth readiness in interdisciplinary healthcare teams. This research aims to address this gap in the literature through the development of a three phase methodology incorporating qualitative and quantitative methods. We propose a conceptual measurement model consisting of operationalized themes affecting readiness across four factors: (i) Organizational Capabilities, (ii) Team Capabilities, (iii) Patient Capabilities, and (iv) Technology Capabilities. The creation of this model will allow for the measurement of the readiness of interdisciplinary healthcare teams to use eHealth technologies to improve patient outcomes.
Phillips, J, Yu, D, Poon, SK, Lam, M, Hines, M, Brunner, M, Keep, M, Power, E, Shaw, T & Togher, L 2017, 'E-Health Readiness for Teams: A Comprehensive Conceptual Model.', Studies in health technology and informatics, vol. 239, pp. 119-125.View/Download from: UTS OPUS
The use of information technology in the delivery of healthcare services is pervasive but faces many barriers. We propose a four-factor comprehensive conceptual model to provide a measure of interdisciplinary healthcare readiness to provide healthcare services using e-health. We incorporate factors from a series of focus group studies and the wider literature and construct a conceptual model. We utilise the Delphi method to establish content validity and use a series of Q sorts for initial construct validity. This model will improve patient outcomes through healthcare teams identifying barriers to using e-health effectively and efficiently.
Yu, D, Poon, SK, Tran, V, Lam, MK, Hines, M, Brunner, M, Power, E, Shaw, T & Togher, L 2017, 'Enabler for Interdisciplinary eHealthcare: A Qualitative Study.', Studies in Health Technology and Informatics, vol. 239, pp. 160-166.View/Download from: UTS OPUS or Publisher's site
The complex relations between Health Technologies and clinical practices have been the focus of intensive research in recent years. This research represents a shift towards a holistic view where evaluation of health technologies is linked to organisational practices. In this paper, we address the gaps in existing literature regarding the holistic evaluation of e-health in clinical practice. We report the results from a qualitative study conducted to gain insight into e-health in practice within an interdisciplinary healthcare domain. Findings from this qualitative study, provides the foundation for the creation of a generic measurement model that allows for the comparative analysis of health technologies and assist in the decision-making of its stakeholders.
Brandenburg, C, Worrall, L, Copland, D, Power, E & Rodriguez, AD 2016, 'The development and accuracy testing of CommFit (TM), an iPhone application for individuals with aphasia', APHASIOLOGY, vol. 30, no. 2-3, pp. 320-338.View/Download from: Publisher's site
Brassel, S, Kenny, B, Power, E, Elbourn, E, McDonald, S, Tate, R, MacWhinney, B, Turkstra, L, Holland, A & Togher, L 2016, 'Conversational topics discussed by individuals with severe traumatic brain injury and their communication partners during sub-acute recovery', Brain Injury, vol. 30, no. 11, pp. 1329-1342.View/Download from: Publisher's site
© 2016 Taylor & Francis Group, LLC. Primary objective: To investigate the nature and patterns of conversational topics discussed by individuals with severe TBI and familiar communication partners at 3 and 6 months post-injury, and to examine changes occurring in conversational topics during sub-acute recovery. Research design: Qualitative content analysis was used to explore the nature of topics and generate conversational themes. Topic analysis provided an understanding of conversational topic management by identifying patterns of topic initiation and maintenance. Methods: Twenty-two people with severe TBI and a familiar communication partner engaged in a 10-minute casual conversation on self-selected topics at 3 and 6 months post-injury. Main outcomes and results: Three main conversational themes were identified: connecting; re-engaging; and impacts of injury. The nature of topics related to these themes changed over time to reflect participants' sub-acute rehabilitation experiences. Most conversational dyads maintained similar conversational and topic patterns during sub-acute recovery. Conclusions: Qualitative analysis provides a new insight into the conversational topics of individuals with severe TBI. Many participants engaged in appropriate conversations and discussed mutually important topics with familiar communication partners. Findings may inform speech-language pathology intervention in sub-acute recovery to improve conversational discourse abilities of individuals with severe TBI and support their communication partners.
Chan, A, Purcell, A & Power, E 2016, 'A systematic review of assessment and intervention strategies for effective clinical communication in culturally and linguistically diverse students', Medical Education, vol. 50, no. 9, pp. 898-911.View/Download from: Publisher's site
© 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education Objective: Culturally and linguistically diverse (CALD) students often experience difficulties with the clinical communication skills that are essential for successful interactions in the workplace. However, there is little evidence on the effectiveness of assessment and intervention strategies for this population. The two aims of this study were: to evaluate the effectiveness of assessment tools in identifying and describing the clinical communication difficulties of CALD health care students; and to determine whether communication programmes improved their clinical communication skills. Methods: Systematic review based on the Cochrane protocol. Articles were identified through a search of established databases using MeSH and key search terms. Studies published in English from 1990 to March 2015 were included if they described assessment strategies or a training programme for communication skills of CALD students. Studies were excluded if they did not describe implementation of a specific assessment or intervention programme. Data were extracted independently by the first author and verified by the second author. Quality was measured by the Best Evidence Medical Education guide and the Educational Interventions Critical Appraisal Tool. The Kirkpatrick hierarchy was used to measure impact. Meta-analysis was not conducted because of the heterogeneity of programme design and outcome measures. Results: One hundred and twenty-nine articles met the criteria for full text review. Eighty-six articles were excluded. Thirteen articles addressing assessment and 30 articles reporting on communication training programmes were included in this review. Assessment tools used rubrics and rating scales effectively. Intervention studies focused on speech and language skills (n = 20), interpersonal skills (n = 7) and faculty-level support (n = 5). Although 17 studies reported positive findings on ...
Guo, YE, Togher, L, Power, E & Koh, GCH 2016, 'Validation of the Stroke and Aphasia Quality of Life Scale in a multicultural population', Disability and Rehabilitation, vol. 38, no. 26, pp. 2584-2592.View/Download from: Publisher's site
© 2016 Taylor & Francis. Purpose: This study aimed to determine the reliability and validity of the Stroke and Aphasia Quality of Life Scale (SAQOL-39 g) and its Mandarin adaptation SAQOL-CSg in Singaporean stroke patients. Method: First-time stroke survivors were recruited at three months post-stroke and underwent a series of questionnaires in their dominant language (English/Mandarin). This included: SAQOL-39 g/CSg, National University Hospital System (NUHS) Aphasia Screening Test, Barthel Index, Modified Rankin Scale, Mini Mental State Examination, Frontal Assessment Battery, Center for Epidemiologic Studies Depression Scale and the Eurol-Qol Health Questionnaire (EQ-5D). The SAQOL-39 g/SAQOL-CSg was repeated within 1 week (± 6 days). Results: Ninety-four participants (96.9%) were able to self-report and their results presented here. Both the SAQOL-39 g/SAQOL-CSg showed good internal consistency (α = 0.96/0.97), test–retest reliability (ICC= 0.99/0.98), convergent (r s = 0.64–0.81 and 0.66–0.88, respectively) and discriminant (rs = 0.35–0.53 and 0.48–0.62, respectively) validity. The correlation between the SAQOL-39 g and the EQ-5D Visual Analogue Scale was 0.27. Further inspection of the EQ-5DVAS scores revealed correlations in different directions for Malay versus Chinese participants. Conclusions: Both the SAQOL-39 g and SAQOL-CSg demonstrated good reliability and validity. Our results suggested some influence of ethnicity in self-rating of health status in relation to SAQOL-39 g scores. Further research is warranted to examine its use with stroke survivors with greater stroke severity and over time. Implications for Rehabilitation Validation of SAQOL in Singapore: Both the SAQOL-39g and the SAQOL-CSg may be used to measure the HRQoL of stroke survivors with and without aphasia in Singapore. Further investigation is required to examine use with stroke survivors with greater stroke severity and over time.
Togher, L, McDonald, S, Tate, R, Rietdijk, R & Power, E 2016, 'The effectiveness of social communication partner training for adults with severe chronic TBI and their families using a measure of perceived communication ability', NeuroRehabilitation, vol. 38, no. 3, pp. 243-255.View/Download from: Publisher's site
© 2016 - IOS Press and the authors. All rights reserved. BACKGROUND: Training for communication partners of people with traumatic brain injury (TBI) is efficacious when using blinded independent ratings of casual conversations measured in the clinic. However, the question remains as to whether participants with TBI and their significant other perceive changes to everyday social communication as a result of training. OBJECTIVE: To determine whether treatment focused on improving the conversational skills of everyday communication partners of people with severe TBI using a program called TBI Express resulted in improvements in perceived communicative ability as measured by the La Trobe Communication Questionnaire (LCQ). METHODS:Non randomized controlled trial comparing treatment of people with TBI together with communication partners (JOINT) with treatment of people with TBI without partner involvement (TBI SOLO) and a waitlist control group (CTRL) with follow-up at 6 months post-Treatment. Forty-four outpatients from brain injury units in Sydney with severe chronic acquired brain injuries were recruited. A further 27 eligible outpatients refused to participate or could not be contacted. A total of 41 people completed treatment and 38 completed 6 month follow up assessment. The measure of perceived communication ability is the report of the participant with TBI and their partner on the LCQ. RESULTS: Communication partner training (JOINT) improved conversational performance relative to training the person with TBI alone and a waitlist control group on the LCQ. The TBI SOLO group improved in terms of report on the LCQ relative to the CONTROL group. Results were maintained at six months post-Training. CONCLUSION: Training communication partners of people with chronic severe TBI using TBI Express led to perceived improvements in everyday communication ability by both the person with TBI and their family member.
Worrall, L, Ryan, B, Hudson, K, Kneebone, I, Simmons-Mackie, N, Khan, A, Hoffmann, T, Power, E, Togher, L & Rose, M 2016, 'Reducing the psychosocial impact of aphasia on mood and quality of life in people with aphasia and the impact of caregiving in family members through the Aphasia Action Success Knowledge (Aphasia ASK) program: study protocol for a randomized controlled trial.', Trials, vol. 17, pp. 1-7.View/Download from: UTS OPUS or Publisher's site
People with aphasia and their family members are at high risk of experiencing post stroke depression. The impact of early interventions on mood and quality of life for people with aphasia is unknown.This study will determine whether an early intervention for both the person with aphasia after stroke and their family members leads to better mood and quality of life outcomes for people with aphasia, and less caregiver burden and better mental health for their family members. This is a multicenter, cluster-randomized controlled trial. Clusters, which are represented by Health Service Districts, will be randomized to the experimental intervention (Aphasia Action Success Knowledge Program) or an attention control (Secondary Stroke Prevention Information Program). People with aphasia and their family members will be blinded to the study design and treatment allocation (that is, will not know there are two arms to the study). Both arms of the study will receive usual care in addition to either the experimental or the attention control intervention. A total of 344 people with aphasia and their family members will be recruited. Considering a cluster size of 20, the required sample size can be achieved from 18 clusters. However, 20 clusters will be recruited to account for the potential of cluster attrition during the study. Primary outcome measures will be mood and quality of life of people with aphasia at 12 months post stroke. Secondary measures will be family member outcomes assessing the impact of caregiving and mental health, and self-reported stroke risk-related behaviors of people with aphasia.This is the first known program tailored for people with aphasia and their family members that aims to prevent depression in people with aphasia by providing intervention early after the stroke.This trial is registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) as ACTRN12614000979651 . Date registered: 11 September 2014.
Lam, MK, Hines, M, Lowe, R, Nagarajan, S, Keep, M, Penman, M & Power, E 2016, 'Preparedness for eHealth: Health Sciences Students' knowledge, skills and confidence', Journal of Information Technology Education : Research, vol. 15, pp. 305-334.View/Download from: UTS OPUS
There is increasing recognition of the role eHealth will play in the effective and efficient delivery
of healthcare. This research challenges the assumption that students enter university as digital
natives, able to confidently and competently adapt their use of information and communication
technology (ICT) to new contexts. This study explored health sciences students' preparedness for
working, and leading change, in eHealth-enabled environments. Using a cross-sectional study
design, 420 undergraduate and postgraduate students participated in an online survey investigating
their understanding of and attitude towards eHealth, frequency of online activities and software
usage, confidence learning and using ICTs, and perceived learning needs. Although students
reported that they regularly engaged with a wide range of online activities and software and were
confident learning new ICT skills especially where they have sufficient time or support, their understanding
of eHealth was uncertain or limited. Poor understanding of and difficulty translating
skills learned in personal contexts to the professional context may impair graduates ability to confidently
engage in the eHealth-enabled workplace. These results suggest educators need to scaffold
the learning experience to ensure students build on their ICT knowledge to transfer this to
their future workplaces.
Behn, N, Togher, L & Power, E 2015, 'Experiences from a communication training programme of paid carers in a residential rehabilitation centre for people with traumatic brain injury', BRAIN INJURY, vol. 29, no. 13-14, pp. 1554-1560.View/Download from: Publisher's site
Kilov, AM, Togher, L & Power, E 2015, 'Reliability of a computer and Internet survey (Computer User Profile) used by adults with and without traumatic brain injury (TBI)', BRAIN INJURY, vol. 29, no. 11, pp. 1273-1291.View/Download from: Publisher's site
Mann, K, Power, E, Barnes, S & Togher, L 2015, 'Questioning in conversations before and after communication partner training for individuals with traumatic brain injury', APHASIOLOGY, vol. 29, no. 9, pp. 1082-1109.View/Download from: Publisher's site
Miao, M, Power, E & O'Halloran, R 2015, 'Factors affecting speech pathologists' implementation of stroke management guidelines: a thematic analysis', DISABILITY AND REHABILITATION, vol. 37, no. 8, pp. 674-685.View/Download from: Publisher's site
Power, E, Thomas, E, Worrall, L, Rose, M, Togher, L, Nickels, L, Hersh, D, Godecke, E, O'Halloran, R, Lamont, S, O'Connor, C & Clarke, K 2015, 'Development and validation of Australian aphasia rehabilitation best practice statements using the RAND/UCLA appropriateness method', BMJ OPEN, vol. 5, no. 7.View/Download from: Publisher's site
Guo, YE, Togher, L & Power, E 2014, 'Speech pathology services for people with aphasia: what is the current practice in Singapore?', DISABILITY AND REHABILITATION, vol. 36, no. 8, pp. 691-704.View/Download from: Publisher's site
Hadely, KA, Power, E & O'Halloran, R 2014, 'Speech pathologists' experiences with stroke clinical practice guidelines and the barriers and facilitators influencing their use: a national descriptive study', BMC HEALTH SERVICES RESEARCH, vol. 14.View/Download from: Publisher's site
Rose, M, Ferguson, A, Power, E, Togher, L & Worrall, L 2014, 'Aphasia rehabilitation in Australia: Current practices, challenges and future directions', INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, vol. 16, no. 2, pp. 169-180.View/Download from: Publisher's site
Taylor, C, Croot, K, Power, E, Savage, SA, Hodges, JR & Togher, L 2014, 'Trouble and repair during conversations of people with primary progressive aphasia', APHASIOLOGY, vol. 28, no. 8-9, pp. 1069-1091.View/Download from: Publisher's site
Murray, E, Power, E, Togher, L, McCabe, P, Munro, N & Smith, K 2013, 'The reliability of methodological ratings for speechBITE using the PEDro-P scale', INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS, vol. 48, no. 3, pp. 297-306.View/Download from: Publisher's site
Rietdijk, R, Simpson, G, Togher, L, Power, E & Gillett, L 2013, 'An exploratory prospective study of the association between communication skills and employment outcomes after severe traumatic brain injury', BRAIN INJURY, vol. 27, no. 7-8, pp. 812-818.View/Download from: Publisher's site
Sim, P, Power, E & Togher, L 2013, 'Describing conversations between individuals with traumatic brain injury (TBI) and communication partners following communication partner training: Using exchange structure analysis', BRAIN INJURY, vol. 27, no. 6, pp. 717-742.View/Download from: Publisher's site
Togher, L, McDonald, S, Tate, R, Power, E & Rietdijk, R 2013, 'TRAINING COMMUNICATION PARTNERS OF PEOPLE WITH SEVERE TRAUMATIC BRAIN INJURY IMPROVES EVERYDAY CONVERSATIONS: A MULTICENTER SINGLE BLIND CLINICAL TRIAL', JOURNAL OF REHABILITATION MEDICINE, vol. 45, no. 7, pp. 637-645.View/Download from: Publisher's site
Worrall, LE, Howe, T, O'Callaghan, A, Hill, AJ, Rose, M, Wallace, SJ, Rose, T, Brown, K, Power, E, O'Halloran, R & Rohde, A 2013, 'The World Report on Disability as a blueprint for international, national, and local aphasia services', INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, vol. 15, no. 1, pp. 106-112.View/Download from: Publisher's site
Behn, N, Togher, L, Power, E & Heard, R 2012, 'Evaluating communication training for paid carers of people with traumatic brain injury', BRAIN INJURY, vol. 26, no. 13-14, pp. 1702-1715.View/Download from: Publisher's site
Bogart, E, Togher, L, Power, E & Docking, K 2012, 'Casual conversations between individuals with traumatic brain injury and their friends', BRAIN INJURY, vol. 26, no. 3, pp. 221-233.View/Download from: Publisher's site
Rietdijk, R, Togher, L & Power, E 2012, 'SUPPORTING FAMILY MEMBERS OF PEOPLE WITH TRAUMATIC BRAIN INJURY USING TELEHEALTH: A SYSTEMATIC REVIEW', JOURNAL OF REHABILITATION MEDICINE, vol. 44, no. 11, pp. 913-921.View/Download from: Publisher's site
Togher, L, Power, E, Rietdijk, R, McDonald, S & Tate, R 2012, 'An exploration of participant experience of a communication training program for people with traumatic brain injury and their communication partners', DISABILITY AND REHABILITATION, vol. 34, no. 18, pp. 1562-1574.View/Download from: Publisher's site
Power, E, Anderson, A & Togher, L 2011, 'Applying the WHO ICF framework to communication assessment and goal setting in Huntington's Disease: A case discussion', JOURNAL OF COMMUNICATION DISORDERS, vol. 44, no. 3, pp. 261-275.View/Download from: Publisher's site
Togher, L, Yiannoukas, C, Lincoln, M, Power, E, Munro, N, McCabe, P, Ghosh, P, Worrall, L, Ward, E, Ferguson, A, Harrison, E & Douglas, J 2011, 'Evidence-based practice in speech-language pathology curricula: A scoping study', INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, vol. 13, no. 6, pp. 459-468.View/Download from: Publisher's site
Tu, LV, Togher, L & Power, E 2011, 'The impact of communication partner and discourse task on a person with traumatic brain injury: The use of multiple perspectives', BRAIN INJURY, vol. 25, no. 6, pp. 560-580.View/Download from: Publisher's site
Kilov, AM, Togher, L, Power, E & Turkstra, L 2010, 'Can teenagers with traumatic brain injury use Internet chatrooms? A systematic review of the literature and the Internet', BRAIN INJURY, vol. 24, no. 10, pp. 1135-1172.View/Download from: Publisher's site
Power, E, Code, C, Croot, K, Sheard, C & Rothi, LJG 2010, 'Florida Apraxia Battery-Extended and Revised Sydney (FABERS): Design, description, and a healthy control sample', JOURNAL OF CLINICAL AND EXPERIMENTAL NEUROPSYCHOLOGY, vol. 32, no. 1, pp. 1-18.View/Download from: Publisher's site
Smith, K, McCabe, P, Togher, L, Power, E, Munro, N, Murray, E & Lincoln, M 2010, 'An introduction to the speechbite database: Speech pathology database for best interventions and treatment efficacy', Evidence-Based Communication Assessment and Intervention, vol. 4, no. 3, pp. 148-159.View/Download from: Publisher's site
This paper describes the development of the Speech Pathology Database for Best Interventions and Treatment Efficacy (speechBITE) at The University of Sydney. The speechBITE database is designed to provide better access to the intervention research relevant to speech pathology and to help clinicians interpret treatment research. The challenges speech pathologists face when locating research to support evidence-based practice have been well documented and include inadequate time resources and difficulties in navigating and using a multiplicity of electronic databases. These barriers are addressed by speechBITE by providing the first open-access database on the internet that solely indexes treatment in the area of communication and swallowing disorders. The database includes the bibliographic details from systematic reviews, randomized controlled trials, nonrandomized controlled trials, case series, and singlecase experimental design studies. At present, randomized and nonrandomized controlled trials are rated with the Physiotherapy Evidence Database (PEDro) scale to assist clinicians with interpreting the methodological quality of the clinical studies of relevance to speech pathologists. © 2010 Psychology Press, an imprint of the Taylor & Francis Group.
Togher, L, Power, E, Tate, R, McDonald, S & Rietdijk, R 2010, 'Measuring the social interactions of people with traumatic brain injury and their communication partners: The adapted Kagan scales', APHASIOLOGY, vol. 24, no. 6-8, pp. 914-927.View/Download from: Publisher's site
Togher, L, McDonald, S, Tate, R, Power, E & Rietdijk, R 2009, 'Training Communication Partners of People With Traumatic Brain Injury: Reporting the Protocol for a Clinical Trial', BRAIN IMPAIRMENT, vol. 10, no. 2, pp. 188-204.View/Download from: Publisher's site
We welcome the lead article (Rose, 2006) and congratulate Miranda Rose for raising important issues for the utility of gesture and pantomime in the rehabilitation of people with aphasia. We take this opportunity to briefly discuss recent theoretical developments and experimental research in the cognitive neurosciences on the relationships between language and action. We comment briefly on some issues raised in the review, including the question of how it is that some people with aphasia are able to utilise gesture and others are not, the relationship between propositional and spontaneous gesture and the degree to which treatment utilising gesture is possible at all for people with severe limb apraxia. Research based on experimental and theoretical developments forms the promising basis for further investigations into the utility of gesture as a facilitator for language in aphasia. We wonder, however, if it is those most in need of gesture and pantomime to compensate for severe impairment who are the least likely to benefit from labour-intensive treatment. © The Speech Pathology Association of Australia Limited.
Agency for Clinical Innovation