Dil ve Konuşma Terapistlerinin Teleterapi Uygulamalarıyla İlgili Görüşlerinin ve Değişime Hazır Olma Düzeylerinin İncelenmesi

Yıl 2021, Cilt: 4 Sayı: 2, 159 - 191, 30.08.2021

Nurcan Alpüran Kocabıyık , Hüseyin Demirci

Öz

Amaç: Tele-terapi; dil ve konuşma terapistlerinin (DKT) danışanlara telekonferans sistemleri aracılığı ile değerlendirme, danışmanlık ya da terapi hizmeti sunmasıdır. Değişime hazır olma; örgüt üyelerinin değişimin uygulanması ve gerekliliğine yönelik kararlılıklarını, inançlarını ve tutumlarını açıklamakla birlikte örgütün değişimi başarabilme kapasitesini ifade etmektedir. Bu çalışma tele-terapi uygulamalarıyla ilgili DKT görüşlerini ortaya çıkarmayı ve değişime hazır olma düzeylerini tespit etmeyi amaçlamaktadır. Yöntem: Betimsel bir araştırma olan bu çalışmaya 87 DKT katılmıştır. Çalışmada veri toplama aracı olarak 9 maddeden oluşan tele-terapi uygulamalarıyla ilgili bir anket ve 12 maddeden oluşan değişime hazır olma ölçeği kullanılmıştır. Değişime hazır olma düzeyini belirlemekte olan anket aynı zamanda kararlılık (niyetsel) boyutunda değişime hazır olma, bilişsel boyutta değişime hazır olma ve duygu boyutunda değişime hazır olma gibi alt boyutları da değerlendirme olanağı vermektedir. Kararlılık (niyet), bilişsel ve duygu boyutunun güvenirlik katsayıları sırasıyla 0,90, 0,87 ve 0,75 düzeyindedir. Bulgular: DKT’lerin tele-terapi uygulamalarında en çok akıcılık bozuklukları alanını ve 13-25 yaş aralığını uygun buldukları belirlenmiştir. Katılımcılardan elde edilen verilere göre tele-terapinin en büyük avantajı ulaşılabilir olması iken en büyük dezavantajı online bağlantı sorunlarıdır. Tele-terapi uygulamalarında seans sürecine ilişkin danışanın özelliğine göre terapinin veriminin değiştiği ifade edilmiştir. Araştırmanın ikinci bölümünde DKT’lerin değişime hazır olma düzeyleri incelenmiş ve elde edilen bulgulara göre DKT’lerin değişime hazır olma toplam düzeylerinin yüksek olduğu ortaya çıkmıştır. Değişime hazır olma düzeylerinin 3 alt boyutu incelendiğinde DKT’lerin bilişsel boyutta yüksek düzeyde, duygusal boyutta yüksek düzeyde ve kararlılık (niyet) boyutunda orta seviyede değişime hazır oldukları görülmüştür. Değişime hazır olma duygu boyutu ve kararlılık boyutu arasında anlamlı fark bulunmuştur. Değişime hazır olma boyutları incelendiğinde en yüksek düzeyde değişime hazır olma duygu boyutundadır. Sonuç: DKT’lerin çoğunluğunun tele-terapi uygulamalarını seanslarında kullanmak istedikleri ve bu tür değişimlere hazır oldukları görülmektedir. Bu çalışmayla birlikte, DKT’lerin değişime hazır olma seviyelerinin yüksek olduğu; değişime direnç göstermedikleri, yeniliklere ve öğrenmeye açık oldukları sonucuna varılabilir.
Anahtar sözcükler: dil ve konuşma terapisi, değişime hazır olma, tele-pratik, tele-terapi, tele-rehabilitasyon.

Anahtar Kelimeler

dil ve konuşmaterapisi,, değişime hazırbuluşluluk,, telepratik, telerehabilitasyon, bilişsel-duygusal- kararlılık boyutunda hazırbuluşluluk

Destekleyen Kurum

yok

Proje Numarası

yok

Examination of Speech and Language Therapists' Views on Teletherapy Practices and Their Readiness for Change

Öz

Purpose: Tele-therapy is a service which speech and language therapists make assessments, counseling, and therapy with their clients across the tele- conference systems. Becoming ready for change describes not only the organizational commitment (intentions), beliefs and attitudes of the members of the organization towards the implementation and necessity of the change, but it also describes the capacity of the organization to achieve the change. This study aims to reveal the opinions of speech and language therapists about teletherapy practices and to determine their level of readiness for change. Method: 87 speech and language therapists participated in this descriptive research. The data collection tool was a questionnaire that was prepared for speech and language tele-therapy practices. All the questions in the questionnaire which was consisted of 9 items were revised by two experienced speech and language therapists and “readiness for change scale which consisted of 12 items were used. This scale determines the level of readiness for change, and at the same time, it provides an opportunity to evaluate readiness for change in the commitment (intentional) dimension, readiness for change in the cognitive dimension, and readiness for change in the emotional dimension. Reliability coefficients of the commitment (intention), cognitive and emotional dimensions were 0.90, 0.87 and 0.75, respectively. The data was obtained were analyzed through the SPSS 20 package program. Results: It was found that fluency disorders which was the most preferable field and 13-25 was the most preferable age group for teletherapy practices in speech and language therapy. The results also showed that while the biggest advantage of teletherapy was its being accessible, its biggest disadvantage was to experience online connection problems. In teletherapy practices, it has been stated that the efficiency of the teletherapy can change according to the characteristics of speech and language disorders. İn general speech and language therapists seem to have high levels of readiness for change. When the 3 sub-dimensions of readiness for change were examined, it was seen that speech and language therapists were ready for a high level of cognitive and emotional dimension and moderate level of commitment (intent) dimension. When the sub-dimensions of readiness for change were compared with each other, it was found that speech and language therapists were mostly ready for change in the emotion dimension. There was a significant difference between emotional readiness for change and commitment readiness for change. Conclusion: It was seen that the majority of speech and language therapists want to use teletherapy practices in their sessions and they seem to be ready for this. The high level of readiness for change on the part of speech and language therapists indicates that they are not resistant to change. They are open to innovation and learning new pedagogic techniques for change and they intent to use teletherapy practices in their practice.
Keywords: speech and language therapy, readiness for change, tele-practice, tele-therapy, telerehabilitation.

Anahtar Kelimeler

speech and language threapy, telepractice, telerehabilitation, readiness for change, readiness for change in the cognitive, emotinal and commitment dimensions

Proje Numarası

yok

Kaynakça

• Appleby, E., Gill, S. T., Hayes, L. K., Walker, T. L., Walsh, M., ve Kumar, S. (2019). Effectiveness of telerehabilitation in the management of adults with stroke: A systematic review. PloS One, 14(11), e0225150. https://doi.org/10.1371/journal.pone.0225150
• Armenakis, A. A., & Bedian, A. G. (1999). Organizational change: A review of theory and research in the 1990s. Journal of Management, 25(3), 293-315. https://doi.org/10.1177%2F014920639902500303
• American Speech-Language-Hearing Association. (2002). Survey report on telepractice use among audiologist and speech and language pathologists.
• www.asha.org/uploadedFiles/practice/telepractice/SurveyofTelepractice.pdf adresinden alınmıştır (Erişim Tarihi: 01.08.2021).
• American Speech-Language-Hearing Association. (2016). Scope of practice in speech-language pathology. www.asha.org/policy/ adresinden alınmıştır (Erişim Tarihi: 01.08.2021).
• American Speech-Language-Hearing Association. (2020). Telepractice, https://www.asha.org/practice-portal/professional-issues/telepractice/ adresinden alınmıştır (Erişim Tarihi: 01.08.2021).
• Backer T. E. (1995). Assessing and enhancing readiness for change: implications for technology transfer. NIDA research monograph, 155, 21–41. https://doi.org/10.1037/e495742006-003
• Baharav, E., & Reiser, C. (2010). Using telepractice in parent training in early autism. Telemedicine journal and e-health: the official journal of the American Telemedicine Association, 16(6), 727–731. https://doi.org/10.1089/tmj.2010.0029
• Boisvert, M., Lang, R., Andrianopoulos, M., Boscardin, M. L. (2010). Telepractice in the assessment and treatment of individuals with autism spectrum disorders: A systematic review. Developmental Neurorehabilitation, 13(6), 423-432. https://doi.org/10.3109/17518423.2010.499889
• Bouckenooghe, D., Devos, G., ve Van den Broeck, H. (2009). Organizational Change Questionnaire-Climate of change, processes, and readiness: Development of a new instrument. The Journal of Psychology, 143(6), 559–599. https://doi.org/10.1080/00223980903218216
• Cangi, M. E., & Toğram, B. (2020). Stuttering therapy through telepractice in Turkey: A mixed method study. Journal of Fluency Disorders, 66(4), 105793. https://doi.org/10.1016/j.jfludis.2020.105793
• Cohn, E. R., & Cason, J. (2012). Telepractice: A wide-angle view for persons with hearing loss. The Volta Review, 112(3), 207-226.
• Combe, M. (2014). Change readiness: Focusing change management where it counts. PMI White Paper. Constantine, K. M. (2015). Survey of telepractice in speech-language pathology graduate programs. (Yayımlanmamış Lisans Bitirme Projesi). The University of Akron.
• Çalışkan, S. C. (2011). Çalışanların psikolojik güçlendirme algıları üzerinde işyeri arkadaşlıkları ve örgütsel iletişimin etkisi. Çukurova Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 20(3), 77-92. https://dergipark.org.tr/tr/pub/cusosbil/issue/4388/60305
• Dil ve Konuşma Terapistleri Derneği. (2020). Dil ve Konuşma Terapisinde Tele-terapi Uygulama Klavuzu, https://www.dktd.org/tr/files/download/p1e6rb7ov61ok91179k9r16j7kue4.pdf adresinden alınmıştır (Erişim Tarihi 01.03.2020).
• Dixon, B. E., Hook, J. M. ve McGowan, J. J. (2008). Using telehealth to improve quality and safety: Finding from the AHRQ Portfolio. Rockville, MD: Agency for Healthcare Research and Quality.
• Fong, B., Fong, A. C. M., ve Li, C. K. (2011). Telemedicine technologies: Information technologies in medicine and telehealth. West Sussex: John Wiley & Sons.
• French, W., Bell, C., ve Zawacki, R. (2004). Organization development and transformation: Managing effective change. New York: McGraw-Hill.
• Gabel, R., Grogan-Johnson, S., Alvares, R., Bechstein, L. ve Taylor, J. (2013). A field study of telepractice for school intervention using the ASHA NOMS K-12 database. Communication Disorders Quarterly, 35(1), 44–5. https://doi.org/10.1177%2F1525740113503035
• Grogan-Johnson, S., Alvares, R., Rowan, L., ve Creaghead, N. (2010). A pilot study comparing the effectiveness of speech language therapy provided by telemedicine with conventional on-site therapy. Journal of telemedicine and telecare, 16(3), 134–139. https://doi.org/10.1258%2Fjtt.2009.090608
• Grogan-Johnson, S., Schmidt, A. M., Schenker, J., Alvares, R., Rowan, L. E., ve Taylor, J. (2013). A comparison of speech sound intervention delivered by telepractice and side by-side service delivery models. Communication Disorders Quarterly, 34(4), 210-220. https://doi.org/10.1177%2F1525740113484965
• Houston, K. T., Stredler-Brown, A., ve Alverson, D. C. (2012). More than 150 years in the making: The evolution of telepractice for hearing, speech, and language services. The Volta Review, 112(3), 195–205.
• Keidel, M., Vauth, F., Richter, J., Hoffmann, B., Soda, H., Griewing, B., ve Scibor, M. (2017). Telerehabilitation nach Schlaganfall im häuslichen Umfeld [Home-based telerehabilitation after stroke]. Der Nervenarzt, 88(2), 113–119.
• Keck, C. S., & Doarn, C. R. (2014). Telehealth technology applications in speech-language pathology. Telemedicine and e-Health, 20(7), 653-659. https://doi.org/10.1089/tmj.2013.0295
• Kwahk, K. Y., & Lee, J. N. (2008). The role of readiness for change in ERP implementation: Theoretical bases and empirical validation. Information & Management, 45(7), 474–481. https://doi.org/10.1016/j.im.2008.07.002
• Kondakçı, Y., Zayim, M., ve Çalışkan, Ö. (2013). Değişime hazır olma ölçeğinin geçerlilik ve güvenilirlik çalışması. Elementary Education Online, 12(1), 23-35. https://dergipark.org.tr/en/pub/ilkonline/issue/8586/106667
• Levent, F. (2016). Öğretmenlerin değişime hazır olma durumlarının farklı değişkenlere göre incelenmesi. Marmara Üniversitesi Atatürk Eğitim Fakültesi Eğitim Bilimleri Dergisi, 43, 117-134. https://doi.org/10.15285/ebd.09059
• Lowman, J. J., & Kleinert, H. L. (2017). Adoption of telepractice for speech-language services. Rural Special Education Quarterly, 36(2), 92–100. https://doi.org/10.1177%2F8756870517712490
• McGill, M., Noureal, N., ve Siegel, J. (2019). Telepractice treatment of stuttering: A systematic review. Telemedicine journaland e-health: The official journal of the American Telemedicine Association, 25(5), 359–368. https://doi.org/10.1089/tmj.2017.0319
• Mohan, H. S., Anjum, A., ve Rao, P. (2017). A survey of telepractice in speech-language pathology and audiology in India. International Journal of Telerehabilitation, 9(2), 69–80. https://doi.org/10.5195/ijt.2017.6233
• Molini-Avejonas, D. R., Rondon-Melo, S., Amato, C. A., ve Samelli, A. G. (2015). A systematic review of the use of telehealth in speech, language and hearing sciences. Journal of telemedicine and telecare, 21(7), 367–376. https://doi.org/10.1177%2F1357633X15583215
• Nikolaou, I., Gouras, A., Vakola, M., ve Bourantas, D. (2007). Selecting change agents: Exploring traits and skills in a simulated environment. Journal of Change Management, 7(3-4), 291–313. https://doi.org/10.1080/14697010701779173
• Nuño-Solinís R. (2018). Are healthcare organizations ready for change? Comment on "Development and content validation of a transcultural instrument to assess organizational readiness for knowledge translation in healthcare organizations: the OR4KT." International Journal of Health Policy and Management, 7(12), 1158–1160. https://doi.org/10.15171/ijhpm.2018.95
• Piderit, S. K. (2000). Rethinking resistance and recognizing ambivalence: A multidimensional view of attitudes toward an organizational change. The Academy of Management Review, 25(4), 783-794. https://doi.org/10.2307/259206
• Prochaska, J. O., & Prochaska, J. (2016). Changing to thrive. Center City, MN: Hazelden Publishing.
• Prochaska, J. O., Norcross, J. C., ve Diclemente, C. C. (1994). Changing for good. New York: Avon Books.
• Sarfo, F. S., Ulasavets, U., Opare-Sem, O. K., ve Ovbiagele, B. (2018). Tele-rehabilitation after stroke: An updated systematic review of the literature. Journal of Stroke and Cerebrovascular Diseases,, 27(9), 2306–2318. https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.05.013
• Tchero, H., Tabue Teguo, M., Lannuzel, A., ve Rusch, E. (2018). Telerehabilitation for stroke survivors: Systematic review and meta-analysis. Journal of medical Internet research, 20(10), e10867. https://doi.org/10.2196/10867
• Towey, M. P. (2012). Speech therapy telepractice for vocal cord dysfunction (VCD): MaineCare (Medicaid) cost savings. International Journal of Telerehabilitation, 4(1), 33-36. https://doi.org/10.5195/ijt.2012.6095
• Tucker J. K. (2012). Perspectives of speech-language pathologists on the use of telepractice in schools: The qualitative view. International journal of telerehabilitation, 4(2),47–60. https://doi.org/10.5195/ijt.2012.6102
• Vaishnavi, V., Suresh, M., ve Dutta, P. (2019). A study on the influence of factors associated with organizational readiness for change in healthcare organizations using TISM. Benchmarking: An International Journal, 26(4), 1290-1313.
• Valentine D. T. (2015). Stuttering intervention in three service delivery models (direct, hybrid, andtelepractice): two case studies. International Journal of Telerehabilitation, 6(2), 51–63. https://doi.org/10.5195/ijt.2014.6154
• Weiner, B. J. (2009). A theory of organizational readiness for change. Implementation Science, 4, 67.
• Whitehead, E., Dorfman, V., Tremper, G., Kramer, A., Sigler, A., ve Gosman, A. (2012). Telemedicine as a means of effective speech evaluation for patients with cleft palate. Annals of Plastic Surgery, 68(4), 415–417. https://doi.org/10.1097/sap.0b013e31823b6897
• Wootton, R. (2001). Recent advances: Telemedicine. BMJ, 323(7312), 557–560. https://doi.org/10.1136/bmj.323.7312.557