ABSTRACT Background: People with aphasia (PWA) may have difficulty accessing information in their environment, including the hospital setting. Prior research has recommended the use of aphasia-friendly text-formatting principles, including using graphics when providing information to PWA. There is limited research into the impact of using such principles for hospital menus. Aims: To evaluate the impact of an aphasia-friendly menu with assistance from a Speech Pathology Therapy Assistant (SPTA) compared with usual hospital menus in PWA on 1) oral intake, 2) self-reported involvement and 3) ease in meal ordering and 4) meal preference. The secondary aim was to investigate the feasibility of implementing the aphasia-friendly menu by exploring staff and caregiver experiences regarding the perceived barriers and facilitators to its implementation, along with time required to assist PWA to order meals. Methods and procedures: This embedded mixed-methods design study was piloted at two hospitals in Queensland, Australia. Hospital inpatients with aphasia due to non-progressive neurological damage, their caregivers and SPTAs participated. Each day PWA received either the 1) aphasia-friendly menu: professional photos of menu items on an iPad with SPTA support, or 2) usual hospital menus provided in random order for up to 15 days during their inpatient stay. Each day, oral intake was measured and PWA rated their perceived involvement and ease with ordering from the menu provided on a 10-point Likert scale. SPTAs recorded time assisted using the menus and reported barriers and facilitators to the use of the menus daily. At the completion of the pilot, the PWA’s preferred menu type was recorded, SPTAs participated in a focus group and caregivers completed a questionnaire. Outcomes and results: There was no significant difference in oral intake between menu types. PWA rated the aphasia-friendly menu more favourably for involvement (p = 0.004) and ease (p = 0.015) when ordering. Nineteen out of 20 PWA who provided a response preferred the aphasia-friendly menu (p = 4 × 10−5). SPTA comments were analysed using qualitative content analysis and outlined their perceived barriers and facilitators to the use of aphasia-friendly menus, experience with usual menus and recommendations for future directions. Meal ordering was approximately 4.4 minutes longer with PWA using the aphasia-friendly menus. Conclusions: The aphasia-friendly menu was positively perceived by PWA, caregivers and SPTAs and may be a viable and preferred option for PWA when ordering food in hospitals. Staff are encouraged to consider the contextual barriers and facilitators identified in the pilot, prior to implementation of such aphasia-friendly menus.

中文翻译：

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住院医院环境中 iPad 上支持的失语友好照片菜单工具的使用和影响：一项试点研究

摘要背景：失语症 (PWA) 患者可能难以获取环境中的信息，包括医院环境。先前的研究建议使用对失语症友好的文本格式原则，包括在向 PWA 提供信息时使用图形。关于将这些原则用于医院菜单的影响的研究有限。目的：评估在言语病理学治疗助理 (SPTA) 的帮助下，与 PWA 中通常的医院菜单相比，失语友好菜单在 1) 口服摄入量、2) 自我报告的参与和 3) 轻松点餐和4）饮食偏好。次要目的是通过探讨工作人员和护理人员在实施过程中所感知的障碍和促进因素方面的经验，调查实施失语友好菜单的可行性，以及协助 PWA 点餐所需的时间。方法和程序：这项嵌入式混合方法设计研究在澳大利亚昆士兰的两家医院进行了试点。由于非进行性神经损伤导致失语症的住院患者、他们的护理人员和 SPTA 参与了。PWA 每天都会收到 1) 对失语症友好的菜单：支持 SPTA 的 iPad 上菜单项的专业照片，或 2) 在住院期间以随机顺序提供的通常医院菜单，最多 15 天。每天，测量口腔摄入量，PWA 对他们感知的参与度和从按李克特 10 点量表提供的菜单中订购的难易程度进行评分。SPTA 记录辅助使用菜单的时间，并报告每天使用菜单的障碍和协助者。在试点完成时，记录了 PWA 的首选菜单类型，SPTA 参加了一个焦点小组，护理人员完成了一份问卷。结果和结果：菜单类型之间的口服摄入量没有显着差异。PWA 在订购时对失语症友好菜单的参与度 (p = 0.004) 和轻松度 (p = 0.015) 给予了更高的评价。提供回复的 20 个 PWA 中有 19 个更喜欢失语友好菜单 (p = 4 × 10−5)。SPTA 评论使用定性内容分析进行分析，并概述了他们对使用失语友好菜单的感知障碍和促进因素、常用菜单的经验以及对未来方向的建议。使用 PWA 使用失语友好菜单点餐时间增加了大约 4.4 分钟。结论：PWA 对失语友好菜单有积极的看法，在医院订购食物时，护理人员和 SPTA 可能是 PWA 的可行和首选选项。鼓励工作人员在实施此类失语友好菜单之前考虑试点中确定的背景障碍和促进因素。