Purpose: Speech-language pathologists (SLPs) and audiologists from around the world were forced to enter the world of telepractice at the start of the COVID-19 pandemic. This study investigated which types of applications SLPs and audiologists used most frequently at that time. It also examined what the main obstacles then were to provide speech, language, and hearing services through telepractice. Method: A short electronic survey with 13 questions was distributed around the world. In total, 1,466 surveys from SLPs and audiologists from 40 countries were used for the analysis. Most of them (77.4%) delivered care through online real-time communication. A minority (40.1%) also delivered care through videos or exercises that they sent to their clients, 37.8% delivered through face-to-face intervention in the same room, 30.0% delivered through telephone without video, and 21.5% provided distant computer-based treatment. Results: The most frequently used applications were those that establish synchronous video communication with the client (60.5%). SLPs and audiologists reported using applications to create exercises more frequently than applications that contain exercises or training (15.0% vs. 12.0%). The most reported obstacle (31.2%) referred to technical problems (poor Internet connection, poor quality, or poor access to resources). Other frequently reported obstacles included the difficulty to perform assessment or treatment procedures (13.8%), concentration issues during sessions (12.4%), and lack of interaction between professional and client or patient (10.9%). Conclusions: Many SLPs and audiologists reported using telepractice technology, mainly in the form of real-time videoconferencing. However, existing barriers included technical problems such as poor Internet connection.

Background: Communication between people with aphasia and their healthcare professionals (HCPs) can be greatly improved when HCPs are trained in using supportive conversation techniques and tools. Communication partner training (CPT) is an umbrella term that covers a range of interventions that train the conversation partners of people with aphasia. Several CPT interventions for HCPs have been developed and used to support HCPs to interact successfully with people with aphasia. Aims:The objective of this study was to identify the mechanisms of change as a result of a Dutch CPT intervention, named CommuniCare, in order to evaluate and optimise the intervention. Methods & procedures:A total of 254 HCPs from five different healthcare centres received CommuniCare. An explorative qualitative research design was chosen. Two interviews were conducted with 24 HCPs directly after and 4 months after receiving the training that was part of CommuniCare. Two conceptual frameworks were used to deductively code the interviews. HCPs' perspectives were coded into a four-part sequence following CIMO logic: the self-reported use of supportive conversation techniques or tools pre-intervention (Context), the intervention elements (Intervention) that evoked certain mechanisms (Mechanisms), resulting in the self-reported use of supportive conversation techniques and tools post-intervention (Outcomes). The Capabilities Opportunities Motivation-Behaviour (COM-B) model was used to fill in the Mechanisms component.Outcomes & results: Three themes were identified to describe the mechanisms of change that led to an increase in the use of supportive conversation techniques and tools. According to HCPs, (i) information, videos, e-learning modules, role-play, feedback during training and coaching on the job increased their psychological capabilities; (ii) information and role-play increased their automatic motivations; and (iii) information, videos and role-play increased their reflective 1190

Background. There is an increasing amount of research that investigates the needs and wishes of people with aphasia and their relatives with regards to improving the accessibility of communication with healthcare professionals (HCP). An important way to improve this is by training HCP to use supportive conversation techniques and tools.Objectives. This study aimed to inform the development of such a training, by adding to previous findings in the literature regarding the experiences, needs and wishes of people with aphasia and their relatives. We were interested in their experiences with the accessibility of communication and support from HCP and how they believed this can be improved.Methods. An exploratory qualitative research design was chosen. Data was collected through qualitative semi-structured interviews with 20 people with aphasia and 12 relatives. The time post stroke ranged from 3 months to 41 years.Results. Four themes described the data. According to people with aphasia and relatives (1) information transfer in healthcare settings and (2) the use of supported conversation techniques by HCP are inadequate, (3) there is a lack of shared decision-making in healthcare settings, and (4) support, guidance, counseling and education is mainly targeted at the person with aphasia. Conclusions.People with aphasia and relatives reported a variety of positive and negative experiences in all themes. Even though guidelines and interventions have been developed to improve healthcare for people with aphasia and their relatives, we found that people still encounter substantial challenges in access to-and provision of information, shared decisionmaking, support and communication with HCP. The findings in this study provide some important recommendations for improvement, including the improvement of transfer of information, shared decision-making and individual support for the relatives.

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