Background: Aphasia is one of those clinical conditions, where the role of affiliated professionals, mainly speech language pathologists (SLPs) is substantial in diagnostic assessments, therapy, and rehabilitation. There is no study to focus on neurologists, with respect to their perceptions and practices about aphasia, the disease, as well as the profession of SLP. Objective: To reach out to the neurologist community in India and learn about their perceptions and practices about the nature of the ailment and role of speech language therapy (SLT). Our premise was that observations and inferences from a questionnaire-based survey will be subsequently helpful in planning educational activities targeted to neurologists with more focus on specific gaps in perceptions and practices. Material and Methods: Three neurologists and two SLPs collaboratively developed the questionnaire. The aim was to probe the issues which were likely to have a bearing upon optimum service delivery to persons with aphasia by a dyad of neurologist and SLP. The survey was set in “Google Forms” and sent by “WhatsApp” and email to approximately 500 practicing neurologists in India. We employed a nonprobability sampling design for ease of administration with a combination of “chunk sampling” and “snowball sampling.” Telephonic reminders were made to almost all. Results and Discussion: We received 100 responses. The mean age of respondents was 50.64 (SD +/− 12.60) with a range of 28–78 years. The mean number of years of experience as a neurophysician was 19.88 (SD. +/− 12.72) with range of 1–47 years. Females were only 8%. Apparently, the proportion of neurologists working in large corporate and large public sector institutions from tier one and tier two cities was higher, who are more likely to have SLP and related rehabilitation facilities in their institutions and hence harbor more conducive attitudes to SLT in aphasia. The ground reality from tier three cities and small private and public sector hospital and solo practitioners may be somewhat worse than this. Many responses were in conformity with facts and in tune with desirable attitudes as per guidelines like aphasia being a detrimental factor in stroke recovery, doing assessment of handedness, paying attention to neuroimaging correlations and associated cognitive functions, not resorting to unnecessary pharmacotherapy, being aware about efficacy of SLT, and fairly good chances of recovery. However, many more answers highlighted a need for emphasis in Continuing Medical Education like not being aware about community burden of aphasia in comparison to a few better known neurological diseases, not paying attention to psychosocial aspects apart from biological ones in assessment and rehabilitation, not using a standardized and validated battery, not confidant about role of SLT in chronic stable aphasia and need for longer and intensive therapy, and being unconcerned for the value of advocacy for aphasia, like the role of Self-Help Groups. Conclusion: The thrust areas, pertaining to gaps in perception and practices identified through this study, can be viewed as “an in-time input.” We hope that changes in some of the perceptions and practices can be attained through an emphasis on education and training at multiple levels right from the undergraduate to the practicing physicians. A few more themes and domains will need advocacy actions targeted to different stakeholders.


中文翻译：

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神经病学实践中的失语症：关于感知和实践的调查


背景：失语症是其中一种临床病症，附属专业人士，主要是语言病理学家 (SLP) 在诊断评估、治疗和康复方面的作用非常重要。没有研究关注神经学家，关于他们对失语症、疾病以及 SLP 专业的看法和实践。目的：与印度的神经学家社区联系，了解他们对疾病性质和语言治疗 (SLT) 作用的看法和实践。我们的前提是，基于问卷调查的观察和推论随后将有助于规划针对神经科医生的教育活动，更加关注认知和实践中的特定差距。材料和方法：三位神经科医生和两位 SLP 合作开发了问卷。目的是探讨可能影响神经学家和 SLP 对失语症患者提供最佳服务的问题。该调查设置在“谷歌表格”中，并通过“WhatsApp”和电子邮件发送给印度大约 500 名执业神经科医生。为了便于管理，我们采用了非概率抽样设计，结合了“块抽样”和“雪球抽样”。几乎所有人都收到了电话提醒。结果与讨论：我们收到了 100 份回复。受访者的平均年龄为 50.64（SD +/- 12.60），范围为 28-78 岁。作为神经内科医生的平均经验年数为 19.88（SD. +/- 12.72），范围为 1-47 年。女性仅占 8%。显然，在一二线城市的大型企业和大型公共部门机构工作的神经科医生比例较高，他们的机构内更可能拥有 SLP 和相关康复设施，因此对失语症患者对 SLT 持更积极的态度。来自三线城市和小型私立和公立医院以及个体从业者的实际情况可能比这更糟糕。根据指南，许多反应符合事实并符合理想的态度，例如失语症是中风恢复的不利因素，评估左右手习惯，注意神经影像学相关性和相关认知功能，不诉诸不必要的药物治疗，了解 SLT 的疗效，以及相当好的康复机会。然而，更多的答案强调了继续医学教育需要强调的必要性，例如与一些更知名的神经系统疾病相比，不了解失语症的社区负担，在评估和康复中不关注除了生物学方面的心理社会方面，不使用标准化和经过验证的电池组，不知道 SLT 在慢性稳定性失语症中的作用以及需要更长时间和强化治疗，并且不关心宣传失语症的价值，例如自助团体的作用。注意神经影像学的相关性和相关的认知功能，不诉诸不必要的药物治疗，了解 SLT 的疗效，以及相当好的康复机会。然而，更多的答案强调了继续医学教育需要强调的必要性，例如与一些更知名的神经系统疾病相比，不了解失语症的社区负担，在评估和康复中不关注除了生物学方面的心理社会方面，不使用标准化和经过验证的电池组，不知道 SLT 在慢性稳定性失语症中的作用以及需要更长时间和强化治疗，并且不关心宣传失语症的价值，例如自助团体的作用。注意神经影像学的相关性和相关的认知功能，不诉诸不必要的药物治疗，了解 SLT 的疗效，以及相当好的康复机会。然而，更多的答案强调了继续医学教育需要强调的必要性，例如与一些更知名的神经系统疾病相比，不了解失语症的社区负担，在评估和康复中不关注除了生物学方面的心理社会方面，不使用标准化和经过验证的电池组，不知道 SLT 在慢性稳定性失语症中的作用以及需要更长时间和强化治疗，并且不关心宣传失语症的价值，例如自助团体的作用。了解 SLT 的功效，以及相当好的恢复机会。然而，更多的答案强调了继续医学教育需要强调的必要性，例如与一些更知名的神经系统疾病相比，不了解失语症的社区负担，在评估和康复中不关注除了生物学方面的心理社会方面，不使用标准化和经过验证的电池组，不知道 SLT 在慢性稳定性失语症中的作用以及需要更长时间和强化治疗，并且不关心宣传失语症的价值，例如自助团体的作用。了解 SLT 的功效，以及相当好的恢复机会。然而，更多的答案强调了继续医学教育需要强调的必要性，例如与一些更知名的神经系统疾病相比，不了解失语症的社区负担，在评估和康复中不关注除了生物学方面的心理社会方面，不使用标准化和经过验证的电池组，不知道 SLT 在慢性稳定性失语症中的作用以及需要更长时间和强化治疗，并且不关心宣传失语症的价值，例如自助团体的作用。结论：与通过本研究确定的感知和实践差距有关的重点领域可以被视为“及时输入”。我们希望通过强调从本科生到执业医师的多个层次的教育和培训，可以实现一些观念和实践的改变。更多的主题和领域将需要针对不同利益相关者的宣传行动。