Ask an answerable question (PICO)：
Aphasia is a major factor in depression after stroke, verbal communication seriously affects self-care abilities. Which triggered the motivation to explore melodic intonation therapy effects on stroke patients with aphasia? PICO-P1:Ischemic Stroke, P2:Aphasia; I: Melodic intonation therapy; C: Speech therapy; O: Speech.
The Method and Analysis of Literature Review：
(一)The literature searching database includes Cochrane, UpToDate, PubMed, CINAHL, and Airiti Library, selected from the period of the published year from 2010 to 2020. (一)Keywords are includes as follows:P1(Ischemic Stroke), P2(Aphasia), I(Melodic intonation therapy), C(Speech therapy), O(Speech). Keywords is corresponding with PICO , Combine text term with searching with Boolean characters OR, AND & Truncation, the languages selected are Chinese and English. Totally 2 ranked as evidence level 2 papers including 2 of randomized controlled trial articles.
Critical Appraisal：
The CASP Systematic Review list (2020) was used as a tool to appraise the research quality, and the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence was used for ranking the level of evidence and strength of recommendations. Searching results: Melodic intonation therapy, reported statistically significant effects on improving stroke Speech ability.
Clinical Application of Evidence：
Evidence of clinical application: make the improvement by applying the 7 steps of empirical knowledge translation and make the result analysis with promoting at the same. The study design was conducted as an RCT to assess the clinical application. The Patient received Melodic intonation therapy as intervention. The Study period was started on February 1, 2021 to September 30, 2021. Enrolled hospitalized patients in a medical center in North Taiwan. The patients in the experimental group received Melodic intonation therapy sessions for 10-15 minutes, Three times a day. The patients in the control condition continued their usual care. All participants were evaluated at baseline and post-intervention.
Evaluation of Effectiveness：
A total of 30 patients were enrolled. The strategy intervention was conducted for 12 weeks. A t-test showed significant increases in speech fluency(t=3.141, p<.05), Reading comprehension(t=3.292, p<.05).The results indicate that melodic intonation therapy is significantly more effective than speech therapy in enhancing the Speech ability of stroke patient with aphasia. The number of samples was small During the epidemic prevention period, Which made it difficult to evaluate the intervention effect.
Conclusions and Recommendations：
According to the results of the empirical literature and the results of the application in this project, Melodic intonation therapy is regarded as safe and cost-effective. It is expected to contribute some efforts in the quality of nursing care with stroke patients with aphasia patients. It is recommended to extend the evidence-based care model to clinical care, promote the home care model to the community, supervise rehabilitation will be continuing.
