JCPSLP Vol 17 No 1 2015_lores

org/) and the Aphasia Institute (www.aphasia.ca/) and had completed training in supported conversation and the second author who had noticed that many inpatients with communication disorders in the hospital appeared bored and had few opportunities to engage in conversation. Together, they saw the opportunity to provide some Angel Volunteers with supported conversation partner training so that patients with acquired communication disorders following stroke could have more opportunities for enjoyable social interactions. While the authors were aware of a home-based supported conversation partner scheme for people with chronic aphasia living in the community (McVicker, Parr, Pound, & Duchan, 2009), this was the first program that they were aware of that provided supported conversation opportunities to hospital inpatients with acquired communication disorders. Members of the speech pathology department conducted a short survey of ten patients with acquired communication disorders to gauge their interest in the proposed program. All ten patients stated that they enjoyed having good conversations in hospital but only three said they were actually having good conversations. Six of the ten patients indicated that they would like more opportunities for good conversations. They also stated that health was the main topic of conversation in hospital and they had a desire to discuss other topics. This short survey indicated that there would be interest from patients for more opportunities for social conversation, therefore a Supported Conversation Volunteer (SCV) program was piloted. The Supported Conversation Volunteer Pilot Program A number of steps were taken to establish the pilot SCV program. The speech pathology manager (first author) engaged with the key stakeholders including the volunteer manager and acute stroke and inpatient rehabilitation nurse unit managers to inform them about the proposal and to gain their support. Then, the first author submitted the proposal to the Allied Health Quality Committee and it was subsequently approved. The volunteer manager then approached two volunteers to participate in the pilot. These volunteers had already completed all of the necessary induction and training processes required to volunteer at St Vincent’s. These included an interview, reference checks, a police check, attendance at a half-day orientation program for all new staff, and a full-day volunteer orientation program. The speech pathology team provided information and education about the SCV program to nursing, allied health, and medical staff in the acute stroke and inpatient rehabilitation units within the hospital. They also developed guidelines, procedures, and resources to support the implementation and evaluation of the program. These included criteria to identify suitable patients for the program, procedures for referring patients, and a referral form. Criteria included a recent diagnosis of stroke, presence of a post- stroke communication disability, ability to concentrate for 20–30 minutes, conversational English, and an interest in being visited by a volunteer. A position description that outlined the roles and responsibilities of supported conversation volunteers and a document detailing the procedures for volunteers were also written. To support the volunteers in conversation with patients, a communication history questionnaire and resource folders were also developed. The communication history questionnaire was designed to be completed by the patient or a close other and included information about the patient’s premorbid communication style, family, friends, lifestyle, hobbies, and interests. The resource folders included paper and markers, whiteboards,

a range of different maps, alphabet, and number boards, picture-based resources, topic cards, and word lists such as the months of the year and days of the week. Finally, a communication partner training program, tailored to meet the needs of this new program and the hospital setting was developed. This program is described in detail below. Supported conversation volunteer training Information and resources from The Communication Access Toolkit (Parr, Wimborne, Hewitt, & Pound, 2008) and the Supported Conversation for Adults Training Workshops (The Aphasia Institute, http://www.aphasia.ca/ health care-professionals/ai-training/) were combined with newly developed resources to create three separate workshops. In the first workshop, volunteers were

orientated to the program, given theoretical information about acquired communication disorders and supported conversation, and then participated in role plays. Further details about the first workshop are provided in Table 1. The second workshop, described in Table 2, included observation of a speech pathologist using supported conversation with inpatients with acquired communication disorders. These patients were current inpatients who had been referred to speech pathology and had agreed to assist with the training. The volunteers were then given the opportunity to try supported conversation strategies with these patients under the supervision of a speech pathologist. The final workshop, described in Table 3, provided volunteers with further opportunities to use supported conversation strategies with participating patients with acquired communication disorders. Opportunities for feedback and reflection were also included as part of the second and third workshops. The volunteers completed all of the training and completed a post-training questionnaire, which indicated that they felt confident providing conversation support to inpatients with acquired communication disorders before the SCV program commenced. The pilot program The pilot program began in February 2011 and ran for 6 weeks. Patients were referred by their treating speech pathologist and the coordinators allocated the patients to each volunteer. The treating speech pathologists on the rehabilitation units also scheduled the volunteers’ appointments on the patients’ weekly rehabilitation timetables. Every week, each volunteer engaged 1–2 patients in approximately 30 minutes of conversation each. In total, over the six-week trial, the two volunteers engaged ten patients in a total of 24 hours of conversation. After each supported conversation, the volunteer completed a reflective journal and documented the amount of time spent with the patient, the topics that were

Julia Shulsinger (top), and Robyn O’Halloran

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JCPSLP Volume 17, Number 1 2015

Journal of Clinical Practice in Speech-Language Pathology

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