Research Proposal – Using AAC for HD Patients

Posted: January 4th, 2023

Research Proposal – Using AAC for HD Patients

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Research Proposal – Using AAC for HD Patients

Introduction

Huntington Disease (HD) affects communication capabilities of patients, which requires the use of a communication style that would allow such individuals to communicate with each other without much difficulty. The neurodegenerative disorder is accompanied by psychiatric, motor, and cognitive complications that tamper with speech production and utterances, and interfere with the patient’s cognitive capabilities. The condition affects speech in the way it causes increasing breathing when one tries to speak, and in the way it hinders proper articulation. The patient finds it difficult to understand complex information, and often have a problem initiating conversations with others. Other speech-related complications that arise from HD include inability to pay attention, poor eye-hand coordination, and reduction in short-term memory capabilities. The speech and language complications in people with HD cause patients to have increased frustration and may experience psychotic encounters. The disease ends up affecting social and familial interactions, which calls for proper intervention. The report is a research proposal on how to identify suitable AAC approaches that would help patients to improve their communication. The study would include other stakeholders such as the caregivers and the family members. The theory of change requires interveners to apply an AAC system that will help HD patients communicate well and ease the pressure of not be able to relay messages quickly and effectively.

Logic Model

The executors of the research should adhere to a logic model that would provide clear guidance on how to achieve success. It is vital to consider inputs such as the intervening groups and the outputs, which comprise of activities that improve health outcomes such as interaction with practitioners. The researchers must focus on meeting the short, medium, and long outcomes that require different effort to achieve.

Literature Review

Researches on how to improve communication practices among HD patients identify AAC as a suitable intervention mechanism. AAC devices are increasingly taking the place of anti-psychotic medications by becoming the new behavioral adjustment mechanism for the management of HD. AAC includes all the ways people share feelings and ideas without talking (ISAAC). People employ a wide range of AACs ever day, sometimes without a person’s knowledge. A person uses an AAC when they apply gestures or facial expressions instead of talking, or when they write a note and pass it to the target audience. Individuals with severe language or speech complications such as HD may require AAC to improve their communication with those around them (ISAAC). People with speech difficulty such as HD patients may either apply unaided AAC systems where they only use their bodily gestures and body language, or may use aided systems where they utilize a sort of device (ISAAC). Aided systems, include touching pictures or symbols on a computer screen that speaks for the patient. HD patients and their caregivers should identify the appropriate AAC that would improve communication, and ease the frustrations that come with the inability to converse effectively.

Little awareness on how to improve communication between patients and their family members and friends during critical illness affects interaction despite the increased awareness that ACC improves how people with HD interact with others. Broyles et al. (25) perform a qualitative secondary analysis with the objective of identifying the AAC tools and devices families use with HD patients and how they are applied, and what nurses and families say about communication of patients with family members. Broyles et al. (26) performed an analysis of existing information from a clinical trial assessing interventions to advance communication between caregivers and HD patients. The researchers evaluate narrative study data, including interviews and field notes from 127 HD patients to find evidence of family interaction with ACC devices. Broyles et al. (26) who employ a qualitative content analysis to examine the data discover that family engagement with AAC tools was evident in 45% of the 94 patients who passed the primary study protocol. The study also reveals how lack of awareness and unpreparedness, misguided families’ views of communication efficiency, families’ encounter with past AAC tools, and HD patients’ communication features hinder the adoption of the right approach or device. Overcoming the constraints that prevent nurses, HD patients and their families from identifying and applying the suitable AAC tools and devices may help to improve communication and ease the discomfort that comes when one cannot interact well.

Applying AAC to improve the communication of HD patients has several advantages to the sick person and those who relate or take care of them. AAC tools help HD patients towards easing the frustrations patients develop when they cannot express their feelings and opinions (Sanders and Burdick 315). The devices are effective because they ease some of the speech problems HD patients experience when they do not apply any intervention method such as shortened phrases, dysarthria (inability to speak), imprecise speech, and aphasia, which is characterized by difficulties in understanding things (Sanders and Burdick 315). Applying AAC further allows for effective application of other intervention approaches such as medication and psychotherapy. The many benefits of using AAC approaches should prompt more researches to understand how to improve applicability.

Future researches are necessary to find out whether the AAC structure is a suitable way to improve communication among patients living with HD. The study should address various aspects, including exploring the effects of the intervention method at different ages, and to identify and clarify the maximum match between the skills of the patients who require AAC and the form of AAC framework given (ISAAC). More fundamentally, the study should match personal requirements in early intercession with targeted AAC intervention, which is a high priority because of the extensive effects that the prosperous formation of communication capabilities has on individuals. 

Study Aims

The goal of the study is to determine the effectiveness of modeling-based intervention approaches in the language formation of people living with HD and use AAC. The research shall assess various AAC tools as communication devices for patients in the later stages of HD, and explore their influence on developing communication practices.

Hypothesis

The communication practices between HD patients and their caregivers will improve immensely if the HD participants and caregivers correctly and adequately implement the key components of the AAC system.

Method

Study Design

A suitable approach to identify the effects of AAC tools and devices on HD patients and to learn about the most effective designs is observational research. The qualitative research method requires the researchers to observe and analyze the target population in their natural setting (Cotton et al. 464).observational research is more suitable in situations where other forms of collecting data such as questionnaires and surveys are not effective. It is more appropriate when the researchers’ primary objective is to assess an ongoing behavior, situation, or when observing particular physical outcomes (Cotton et al. 465). The surveyors should expect to gather qualitative data because they are observing the study population in their natural setting. The researchers improve the quality of their study when they know they have to perform a quantitative survey to authenticate particular observations and behaviors and to obtain more meaningful information (Cotton et al. 465). The main limitation of observational research is the tendency to gather a lot of unstructured data creating considerable challenges as for every hour of data generated (Cotton et al. 466). The observational research method is suitable in this study because some HD patients may not write or communicate well, which could affect the outcome.

The surveyors shall apply the descriptive research design where the researchers solely describe the situation or issue under their research study. Descriptive design entails collecting, assessing, and presenting collected information. The theory-based design permits researchers to offer insights into the research questions, and makes it easy for others to better know the importance of the study. A successful research in this case would depend on how well the implementers understand how to apply the descriptive research design.

Sample

The study shall observe 150 participants comprising of HD patients, healthcare givers, and their family members in an intervention facility. The major eligibility criteria for participation include being a registered HD patient at the facility, being an assigned healthcare giver, and being a family member. The surveyors shall apply the selective sampling technique also known as purposive sampling. The surveyors while using selective sampling apply their own judgment when selecting the participants (Palinkas et al. 538). The researchers may consider features such as poor communication skills as a result of HD and the hardship of communicating with patients as a family member or caregiver (Palinkas et al. 538). Applying selective sampling has merits and demerits that could influence the study’s outcome. The style is cost and time effective, and may be the only applicable method if the data sources are limited (Palinkas et al. 540). The implementers of the study should know the demerits of the style such as susceptibility to errors, unreliability, and high level of bias. The researchers should be cautious to avoid harming the sampling process due to inadequate awareness on how the approach functions by conducting prior investigation to acquire valuable insights.

Measurement

The researchers shall pay considerable attention to the independent and dependent variables during the study. The independent variable shall be the AAC tools and devices, while the dependent variables will be the participants, especially HD patients. The surveyors will regard the study as being successful if it identifies the most suitable AAC tools for HD patients with poor communication. The team in charge of the study shall assess intervention fidelity by adhering to the research plan and ensuring everything happens in the correct manner.

Data Collection

The observation and interview forms of collecting data will be applicable in the study. Observation will allow the researchers to record important information, while interviews shall facilitate face-to-face interaction with the study group. The researchers should carry out enough studies to understand how the data collection approaches work to achieve successful implementation.

Data Analysis

The study shall employ the content analysis to scrutinize the collected data. Content analysis allows the researchers to analyze documented content in the form of media, texts, or physical components (White and Marsh 23). The researchers in this study may choose to analyze the notes they put down during the observation of the study population, and give their findings based on what they saw. The researchers may have to apply discourse analysis that assesses interactions with other people. Discourse analysis may be important because the team in charge of the study may interact with some people such as the health practitioners and family members to acquire additional information which may require an assessment of the conversation (White and Marsh 28). The narrative analysis that analyzes information from various surveys, or fields may not be applicable in this case because the researchers shall solely focus on observing the target population. Data analysis is possibly the most essential aspect of the research. The analysts should know that weak evaluation produces wrong outcome that affects the authenticity of the study and make the results insignificant (White and Marsh 31). It is essential to select the data analysis style method keenly to ensure that the findings are practical and insightful.

Conclusion

The communication problems HD patients encounter require the application of a suitable research design that would uncover the effectiveness of AAC tools and devices in improving interaction practices among patients and those around them. HD makes it difficult for patients to interact, and affect speech and other language-related complications such as dysarthria and aphasia. An observational research method is appropriate because some HD patients may not engage in constructive communication, which could affect data collection. Using the selective sampling method shall make is possible to select participants the researchers find appropriate, while gathering data through observation and interviews offers the chance to acquire additional information. The research requires utter keenness at all stages to avoid mishaps that could affect the outcome.

Works Cited

Broyles, Lauren, Tate Judith and Happ Mary. “Use of Augmentative and Alternative Communication Strategies by Family Members in the Intensive Care Unit.” American Journal of Critical Care, vol. 21, no. 2, 2012, pp. 21-32. 

Cotton, Debby et al. “Using Observational Methods to Research the Study Experience.” Journal of Geography in Higher Education, vol. 34, no. 3, pp. 463-473.

ISAAC. “What is AAC?” ISAAC,2014,

https://www.isaac-online.org/english/what-is-aac/. Accessed 16, 2020.

Palinkas, Lawrence et al. “Purposeful Sampling for Qualitative Data Collection and Analysis in Mixed Method Implementation Research.” Administration and policy in mental health, vol. 42, no. 5, 2015, pp. 533–544.

Sanders, Karen and Burdick, Daniel. “Huntington’s Disease Case Study.” Physician’s Field Guide to Neuropsychology, 2, 2019, pp. 305-325.

White, Marilyn and Marsh Emily. “Content Analysis: A Flexible Methodology.” Library Trends, vol. 55, no. 1, 2006, pp. 22-33.