Feasibility of a communication program: improving communication between nurses and persons with aphasia in a peripheral hospital

Background Training conversation partners of people with aphasia who use facilitative communication strategies is one method that can improve access to healthcare for people with aphasia. However, the efficacy of communication partner training (CPT) has been investigated almost exclusively in the context of face‐to‐face (F2F) delivery. Online training may offer more cost‐effective and accessible options to a wider range of conversation partners, including student healthcare professionals. Aims To conduct a pilot randomized controlled trial with student healthcare professionals comparing (1) an online aphasia CPT program, (2) a F2F CPT program and (3) no program (control group) on outcomes relating to attitudes and knowledge of aphasia. Methods & Procedures A 45‐min introductory aphasia CPT program was developed using the theories and techniques of Supported Conversations for Adults with Aphasia (SCA)™. A total of 30 first‐year undergraduates studying occupational therapy at The University of Sydney were randomly allocated to one of three conditions: online CPT delivery, F2F delivery or delayed training control (no program). Outcomes measures included pre‐post‐testing with the Aphasia Attitudes, Strategies and Knowledge (AASK) survey. Outcomes & Results A significant difference existed for the AASK survey pre‐post‐change scores between the online, F2F and control groups (χ2(2) = 20.038, p = 0.000). Post‐hoc analysis revealed that, compared with the control (Ctrl) group, participants in both the online and F2F groups had significantly higher knowledge of aphasia (Online versus Ctrl: p = 0.000; F2F versus control: p = 0.002), knowledge of facilitative strategies (Online versus Ctrl: p = 0.000; F2F versus Ctrl: p = 0.002), and positive attitudes towards aphasia (Online versus Ctrl: p = 0.031; F2F versus Ctrl: p = 0.032). No significant difference was observed between the online and F2F groups for the Total or any subtotals (p = 1.000). Conclusions and Implications The results from this pilot randomized controlled trial indicate that online delivery of the 45‐min introductory CPT is equally as efficacious as F2F delivery, and thus may be a viable mode of delivery for future aphasia CPT programs. These pilot results pave the way for a larger study that will comprehensively evaluate the efficacy of an online aphasia CPT program for improving attitudes, knowledge and skills in a broad range of student healthcare professionals.

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“…2015, van Rijssen et al . 2018, Cameron et al . 2017), there is little evidence of CPT efficacy for student healthcare professionals.…”

Section: Introductionmentioning

confidence: 99%

A pilot randomized controlled trial comparing online versus face‐to‐face delivery of an aphasia communication partner training program for student healthcare professionals

Power

Falkenberg

Barnes

et al. 2020

Intl J Lang & Comm Disor

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“…Since the 2016 review, further studies have reported improvements in health professionals' self-rated knowledge for communicating with PWA. For example, a mixed-methods feasibility study by van Rijssen et al (2019) found that nurses had increased knowledge and awareness of communicative strategies after 4 months of implementing a modified version of the Supported Conversation for Adults with Aphasia (SCA) programme (Kagan et al 2001). While the study involved quantitative and qualitative measures, feasibility was only examined through the perspective of the nurse participants.…”

Section: Introductionmentioning

confidence: 99%

“…For example, a mixed‐methods feasibility study by van Rijssen et al . (2019) found that nurses had increased knowledge and awareness of communicative strategies after 4 months of implementing a modified version of the Supported Conversation for Adults with Aphasia (SCA) programme (Kagan et al . 2001).…”

Section: Introductionmentioning

confidence: 99%

Delivering an iterative Communication Partner Training programme to multidisciplinary healthcare professionals: A pilot implementation study and process evaluation

Shrubsole

Lin

Burton

et al. 2021

Intl J Lang & Comm Disor

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Background: Despite evidence that Communication Partner Training (CPT) can enable health professionals to communicate more effectively with people with aphasia (PWA), an evidence-practice gap exists. To address this, a tailored implementation intervention was developed and trialled to improve health professionals' implementation of communication strategies in a subacute setting. Aims: To explore the outcomes and perceived feasibility, acceptability and potential effectiveness of an iterative CPT implementation intervention on multidisciplinary healthcare professionals' communication with PWA. Methods & Procedures: The CPT implementation intervention was delivered to two groups of healthcare professionals (n = 6 and 7) approximately 6 months apart. The intervention underwent two iterations targeting emerging barriers to implementation success, with Group 2 receiving a modified version of the Group 1 intervention. A concurrent qualitative process evaluation was conducted to understand key factors determining implementation outcomes. Quantitative outcomes were recorded at baseline and 3-month follow-up, including the Measure of Skill in Supported Communication (MSC), a customized behavioural determinants survey mapped to the Theoretical Domains Framework (TDF) and the Organizational Readiness for Change survey. Focus groups and semi-structured interviews were conducted with health professional participants and the speech-language therapist trainer to explore perceptions of feasibility, acceptability and potential effectiveness. Content analysis was used to analyse the qualitative data, with categories and themes generated.Outcomes & Results: The Group 2 implementation intervention was adapted based on feedback and reflections from Group 1 participants to incorporate more time for practice interactions and discussion during training, individual follow-up sessions and provision of accessible resources to aid communication attempts. There were greater improvements seen in the Group 2 outcomes on both the MSC and the TDF survey, suggesting that the iterative tailoring of the intervention was successful in addressing the barriers to change and led to improved implementation. The difference between the group's outcomes may also partly be explained by the impact of organizational readiness, which decreased during Group 1's implementation period. Despite similar themes emerging from the stakeholder perspectives in both groups (training factors, implementation facilitators, implementation barriers, and changes in knowledge and practice), these diverted in ways which served to explain the different implementation outcomes. Conclusions & Implications: An iteratively adapted CPT implementation intervention targeting healthcare professionals' use of supported communication strategies was feasible and acceptable for most participants. The implementation intervention was potentially effective in changing participants' communication with PWA, particularly

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“…In non-psychiatric contexts research has been conducted describing nurses' interactions with patients who have communication disabilities, mainly aphasia (Gordon et al, 2009;Pound & Jensen, 2018;van Rijssen et al, 2019). In psychiatric nursing there is less research focussing on caring for and communicating with patients who never or rarely speak.…”

Section: Introductionmentioning

confidence: 99%

Navigating between Compassion and Uncertainty – Psychiatric Nurses’ Lived Experiences of Communication with Patients Who Rarely Speak

Donner

Gustin

2020

Issues in Mental Health Nursing

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Caring conversations are considered essential in psychiatric and mental health nursing. However, some patients are more or less silent and rarely express themselves verbally. This can be challenging for nurses who also need to find ways of communicating with these patients. Therefore, the aim of this study is to describe psychiatric nurses' lived experiences of communication with patients who rarely speak. Five nurses were recruited from a psychiatric nursing home. Participants were encouraged in interviews to reflect on their experiences of caring for patients who are more or less silent. The transcribed interviews were subject to a phenomenological hermeneutic analysis. The findings are reflected in three main themes: (i) giving space for the unspoken narrative, (ii) remaining in uncertainty, and (iii) being in reflective vigilance. The themes were synthesised and reflected on in the light of Fredriksson's theory of caring conversations. The comprehensive understanding reveals that nurses' understanding of the patient's unspoken narrative relies both on compassion and a willingness to engage, but also on a preparedness to remain in the uncertainty of not knowing. Balancing good intentions and the fear of one's own shortcomings requires reflections not only in actions during encounters with the patient, but on actions. When nurses can apprehend and respond to what the patient expresses non-verbally, a joint narrative can emerge.

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Feasibility of a communication program: improving communication between nurses and persons with aphasia in a peripheral hospital

Cited by 19 publications

References 24 publications

A pilot randomized controlled trial comparing online versus face‐to‐face delivery of an aphasia communication partner training program for student healthcare professionals

A pilot randomized controlled trial comparing online versus face‐to‐face delivery of an aphasia communication partner training program for student healthcare professionals

Delivering an iterative Communication Partner Training programme to multidisciplinary healthcare professionals: A pilot implementation study and process evaluation

Navigating between Compassion and Uncertainty – Psychiatric Nurses’ Lived Experiences of Communication with Patients Who Rarely Speak

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