JCPSLP Vol 17 No 2 2015_web

Method Research strategy and participants Permission for this study was granted by the Behavioural and Social Sciences Ethical Research Committee of The University of Queensland. With little past research in the area, qualitative descriptive methodology was chosen to explore the perceptions of 10 speech pathologists working in aged care, summarising participant perspectives using their everyday language (Sandelowski, 2000). Participants were recruited through the public directory of speech pathologists provided on The Speech Pathology Association of Australia website (The Speech Pathology Association of Australia Ltd, n.d). All participants were female, aged between 23 and 63 years ( M = 46; SD = 15.7), and currently working in residential aged-care settings. Participants had worked in residential aged care for between 9 months and 21 years ( M = 13.7; SD = 11.3). Of the 10 participants, three worked in public speech pathology services and seven worked in private practice. Procedure Individual in-depth semi-structured interviews were conducted with each of the participants. A semi-structured interview guide was used to ensure key topics of enquiry were addressed across participants, while providing flexibility to enable new topics to emerge during data collection (Patton, 2002). Interviews were conducted either face-to-face or via telephone, at a time convenient to the participant. During the interview participants were asked to comment about: 1) the value of communication assessment and intervention in residential aged care; 2) the nature and frequency of communication assessment and intervention in residential aged care; and 3) education and support they had received pre- and post-qualification relevant to communication management in residential aged-care

settings. Each interview was recorded and transcribed verbatim. Interviews ranged in duration from 26 to 67 minutes ( M = 39; SD = 14.1). The accuracy of the transcriptions was checked by a second analyst. All interviews were conducted by the primary author (MB). Data analysis Each transcribed interview was analysed by two speech pathologists, the first and fourth authors, guided by the systematic stages of the framework approach to qualitative analysis (Ritchie & Spencer, 1994). The framework approach provides transparency in qualitative analysis through the use of explicit stages, reducing bias and increasing the credibility of the interpretations (Pope, Ziebland, & Mays, 2000; Rabiee, 2004). Throughout analysis, both inductive and deductive methods of enquiry were used to address questions underpinning the research aims while remaining open to new concepts and ideas evident in the data (Pope et al., 2000; Ritchie & Spencer, 1994). An outline of the stages of analysis is provided in Table 1. To increase the accuracy of the analysis, member checking was completed following analysis of the interview data. Member checking provided participants with the opportunity to review and comment on the interpretation of the data and to answer any additional questions arising from the analysis (Hoffart, 1991). Completed member checking documents were received from 8 out of the 10 participants, showing majority agreement with all key themes identified. Results Three key themes were identified: 1) there are mixed views about the importance of communication management in residential aged care; 2) communication management in residential aged care is limited and impacted by numerous factors; and 3) speech pathologists have a desire to advance communication management in residential aged care. Theme 1: There are mixed views about the importance of communication management in residential aged care Participants expressed disparate views about the importance of communication management in residential aged care. Some participants viewed communication management as being of high importance and “intrinsic to all needs” (Participant 1). Other participants reported a belief that communication management is not as important as managing swallowing difficulties, “communication not as important, they need to be able to communicate basic needs … nothing we can do for severe communication difficulties” (Participant 2). Despite expressing different views about the importance of communication management in residential aged care, most participants commented that social interaction is a key determinant of residents’ quality of life. Participants emphasised the importance of taking a genuine interest in each resident as an individual, treating residents with compassion and dignity, and providing residents with opportunities for social interaction. In doing so, one participant commented, “with the knowledge speech pathologists have of different speech and language difficulties, and you know, strategies and facilitation techniques to improve social interaction, there’s just enormous potential in nursing homes” (Participant 8).

Nerina A. Scarinci (top), and Monique C. Waite

Table 1. Steps of data analysis

Step

Description

Familiarisation

Each transcript was read and re-read by the first and fourth authors in its entirety, to familiarise the analysts with the data and to identify key meanings and ideas within each transcript. Each analyst compared data across participants to identify and chart key themes and subthemes common across participants. Themes identified were inclusive to represent the data in its entirety. The first and fourth authors cross compared their analyses, collaborating to modify the themes and subthemes until consistency between the analysts was reached. Disagreement, overlap or ambiguity in the themes or sub-themes not resolved by the first and fourth authors was discussed with the second and third authors until consensus was reached. The first and fourth authors synthesised their analyses into a single analysis containing all themes and sub-themes in their entirety.

Comparison across participants

Comparison across analysts

Synthesis

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JCPSLP Volume 17, Number 2 2015

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