Speech and language therapy for burn injuries in South Africa : knowledge and experience, evidence-based involvement, access, referral pathways, and training and education needs

Date
2021-03
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY : Background: In South Africa (SA), there is a high incidence of burn injuries (BIs) which is a growing area of involvement and interest among South African speech and language therapists (SLTs). However, there is limited knowledge and experience among practising SLTs. This includes a poor understanding of the aetiology of BIs, the physical and psychosocial acute and long-term effects of BIs, and the specific role of SLTs in the assessment and management of BIs. This novel study is exploratory in nature due to limited existing evidence. Objectives: The study aimed to determine SLTs’ knowledge and experience, referral pathways and SLT accessibility, the use of evidence-based practice (EBP), and education and training required to equip SLTs to work in the BI population. Method: A convergent mixed method design was utilised for this study in which quantitative and qualitative data were collected simultaneously. Two instruments were utilised for data collection: an online questionnaire aimed at SLTs practising in SA, and semi-structured interviews with heads of departments of burn units or wards caring for people with BIs in SA. The questionnaire yielded both quantitative and qualitative data, and the interviews yielded further qualitative data. Results: Results indicated limited knowledge and experience in BIs among SLTs in SA leading to a lack of awareness and involvement in this population. Despite a willingness from SLTs to work in this population, low levels of confidence and competence were described. Although there appeared to be established methods for referral and general accessibility to SLT, there was a lack of criteria for referral. This may due to a lack of education and training opportunities at undergraduate and postgraduate levels, and a lack of contextually relevant evidence and guidance. Conclusion: Due to the high incidence of burns in SA and the clinical relevance of SLT in this population, there is a need for undergraduate and post-graduate training and exposure to BIs in SLT. The assessment and management of BIs is contextually relevant in SA and should be included in the scope of practice with clear practice or competency guidelines from professional bodies. This will ensure adequate knowledge, experience, and awareness so that SLTs can confidently provide competent services to this population. The findings of this study will be useful in informing future planning and the provision of education and training. It may encourage awareness among SLTs of their role in burns and lead to research and the emergence of contextually relevant practice-based evidence.
AFRIKAANSE OPSOMMING : Agtergrond: In Suid-Afrika (SA) is daar ‘n hoë insidensie van brandwonde wat ‘n groeiende area van belangstelling en betrokkenheid onder Suid-Afrikaanse Spraak-Taalterapeute (STTe) is. Daar is egter beperkte kennis en ervaring van brandwonde onder praktiserende STTe, insluitend swak begrip van die etiologie van brandwonde, die akute en lang-termyn fisiese en psigososiale impak van ernstige beserings, sowel as die spesifieke rol van STTe in die evaluasie en behandeling van brandwonde. Hierdie verkennende studie is die eerste van dié aard, gegewe die beperkte bestaande navorsing. Doelwitte: Die doel van hierdie studie was om die volgende te bepaal: STTe se kennis en ervaring van brandwonde, verwysingsbane en STT beskikbaarheid, gebruik van navorsing, en opleidingsgeleenthede wat benodig word om STTe te bemagtig om met die brandwonde populasie te werk. Metodologie: Die studie het ‘n konvergente gemengde metodes navorsingsontwerp gevolg, waartydens kwantitatiewe en kwalitatiewe data insameling tegelyktydig plaasgevind het. Twee instrumente is gebruik om data te bekom: ‘n aanlyn vraelys gemik op praktiserende STTe in SA, en semi-gestruktureerde onderhoude met die hoofde van brandwondeenhede of sale waar mense met brandwonde versorg word in SA. Die vraelys het beide kwantitatiewe en kwalitatiewe data ingewin, en die onderhoude het verdere kwalitatiewe data bekom. Resultate: Resultate dui op beperkte kennis en ervaring van brandwonde onder Suid-Afrikaanse STTe, wat tot ‘n gebrek aan bewustheid en betrokkenheid in hierdie populasie lei. Ten spyte van STTe se gewilligheid om met hierdie populasie te werk, was daar lae vlakke van selfvertroue en bevoegdheid gerapporteer. Alhoewel daar gevestigde verwysingsbane en algemene toeganklikheid na STT gerapporteer is, was daar ‘n gebrek aan verwysingskriteria. Hierdie bevindinge kan toegeskryf word aan gebrekkige opleidingsgeleenthede op voor- en nagraadse vlak, sowel as kontekstueel relevante bewyse en leiding. Gevolgtrekking: Gegewe die hoë insidensie van brandwonde in Suid-Afrika en due kliniese relevansie van STTe in hierdie populasie, is daar ‘n behoefte aan voor- en nagraadse opleiding en blootstelling aan brandwonde as deel van STT. Die evaluasie en behandeling van brandwonde is kontekstueel relevant in Suid-Afrika en behoort by die omvang van praktyk ingesluit te word, met duidelike praktyk en bevoegdheidsriglyne. Dit sal voldoende kennis, ervaring, en bewustheid onder STTe sal kweek, en bevoegdheid met hierdie populasie bevorder. Die bevindinge van hierdie studies sal nuttig wees vir die toekomstige beplanning en aanbieding van opleidingsgeleenthede. Bevindinge kan ook bewustheid onder STTe van hul rol in brandwonde aanmoedig, en tot verdere navorsing en kontekstueelrelevante bewysgebaseerde praktyk lei.
Description
Thesis (MSL&HT)--Stellenbosch University, 2021.
Keywords
Speech therapy -- South Africa, Burns and scalds -- Patients -- Rehabilitation -- South Africa, Speech therapists -- Knowledge and learning -- South Africa, Medical referral, UCTD
Citation