A Qualitative Exploration Of Patient Experience Of Speech And Language Therapy For Dysarthria In The Acute Phase Post Stroke

BackgroundDysarthria is a neurological speech impairment which can have a pervasive impact on an individuals independence, psychological well-being and social participation following a stroke. Speech and language therapy (SLT) in the acute hospital phase aims to provide the stroke survivor with the means to communicate effectively and reintegrate socially following their discharge. However, there is limited understanding of how patients perceive their experience of SLT at this time and how effectively it addresses their needs. AimTo explore the patients experience of dysarthria in the acute hospital phase following a stroke and perceptions of the SLT received during this time. MethodsParticipants for this qualitative study were recruited as hospital in-patients from the acute SLT service caseload. Semi-structured interview data was analysed with reflexive thematic analysis and themes constructed. Results & DiscussionThe themes of speech as a competing priority, feeling disempowered in rehabilitation and the need for human connection and their relevance for clinical practice are discussed. Speech difficulties are perceived as one of several priorities competing for participants time and energy with the impact of speech often minimised. Feelings of disempowerment come from both internal and external factors, but the importance of hope and belief in potential recovery was emphasised. The expressed need for human connections highlights the need for positive social communication experiences and the value of a communication affirming rehabilitation setting. ConclusionsThese themes highlight the multidimensional impact of dysarthria and how it is inextricably linked to the wider psychological, and social dimensions of stroke. SLT during acute hospital rehabilitation must go beyond the physical impairment and address the patients evolving priorities, their self-esteem, capacity for positive self-management and social reintegration.