Better Conversations With Parkinson's: Feasibility and Acceptability of a Novel Communication Partner Training Telehealth Intervention.

چکیده اصلی

BACKGROUND: Communication Partner Training (CPT) has an established evidence base in aphasia, dementia and traumatic brain injury. It has been shown to improve the skills, attitudes and knowledge of the communication partner, and improve communicative participation and confidence of the person with communication difficulties. CPT therefore holds potential value for people living with Parkinson's and their everyday conversation partners who report significant impact of communication changes on their day-to-day lives. However, the CPT evidence base is less well established in this population. People living with Parkinson's and their communication partners report wanting support with everyday communication. They also describe online intervention as acceptable. AIMS: The primary aim was to evaluate the feasibility and acceptability of a novel CPT intervention, Better Conversations with Parkinson's (BCP), when delivered via telehealth in an NHS setting. Feasibility was explored in terms of completion of BCP intervention and assessment data when delivered via telehealth, and the ability to recruit and retain participants in an NHS trial. Acceptability was investigated for: (1) dyads completing the therapy (people with a diagnosis of Parkinson's and their communication partners) and (2) the speech and language therapist (SLT) delivering it. METHODS AND PROCEDURES: This feasibility study recruited dyads comprising a person living with Parkinson's and a familiar communication partner. Participants were involved for 6 weeks of direct BCP intervention, delivered remotely by one SLT, and completed pre- and post-intervention measures. Descriptive statistics were used to report on recruitment, attendance, and attrition. Feasibility was further explored using logs and a focus group with study recruiters. Acceptability was evaluated using participant interviews, analysed using reflexive thematic analysis, and the SLT's reflective diary and interview feedback, which were analysed using qualitative content analysis. RESULTS AND OUTCOMES: Seven dyads were recruited to the study, with an overall recruitment rate of 10%. Participants completed all therapy sessions and data collection for all outcome measures was achieved. Qualitative themes reflected a high degree of acceptability from dyads concerning their own agency, the therapeutic alliance, methods used, and expectations/beliefs. The acceptability for the SLT delivering the therapy was also high. CONCLUSIONS AND IMPLICATIONS: The results indicated the BCP programme was feasible in terms of online delivery within an NHS setting, and acceptable for clients and the SLT. These results pave the way for a large-scale study that will evaluate the effectiveness of a BCP programme. WHAT THIS PAPER ADDS: What is already known on the subject Despite an identified need for treatments beyond the impairment level, communication partner training (CPT) for people living with Parkinson's lacks evidence for acceptability or feasibility. What this study adds to the existing knowledge This study suggests that CPT for people living with Parkinson's is feasible to deliver via telehealth and acceptable to people living with Parkinson's, their communication partners, and SLTs. What are the clinical implications of this work? UK NHS speech and language therapy services could feasibly run online CPT programmes for people living with Parkinson's. Further work is required to move toward a full-scale trial of CPT for people living with Parkinson's and to establish whether such programmes may be most effectively run alongside impairment-based approaches or independently.

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