Evaluating A Communication Partner Training Program For Health Professionals Communicating With People With Aphasia

BACKGROUND: Aphasia affects a third of all stroke survivors and > 50% of people with other acquired brain injuries, hindering effective communication between patients and healthcare professionals. Aphasia makes it difficult for patients to get the attention of healthcare professionals, communicate basic healthcare needs, and get oral and written health information. Consequently, initiatives towards reducing the communicative barriers in healthcare is needed, including the use of alternative and augmentative communication and adapted written materials, but also “top-down” system changes. Such initiatives include training of medical staff, often labelled communication partner training (CPT), to enable supported communication. A Danish CPT program, KomTil, was co-developed with collaborators with aphasia, significant others of people with aphasia, and multidisciplinary healthcare professionals across sectors, and the current study aimed to investigate:
1: Immediate and long-term possible benefits of CPT KomTil on knowledge and skills
2: Possible predictors of benefits of CPT KomTil
METHODS: Participants included staff with different professional backgrounds providing neurorehabilitation to people with aphasia in hospital or municipalities. Participants received training in CPT KomTil, and knowledge and skills were assessed using the Health Professionals and Aphasia Questionnaire (HPAQ) before training, six to eight weeks post-training, and one-year post-training. HPAQ consists of 16 items answered on a visual analogue scale concerning the following domains: Knowledge, skills, attitudes and emotions, practice, and environment. The total score of the HPAQ ranges from 1-100. Data were analysed using linear mixed-effects regression models.

RESULTS: A total of 240 healthcare professionals participated in the survey. The HPAQ total score changed over time (χ2(3) = 328.8; p < .001). Compared to baseline, HPAQ improved by 14.5 points (SE = 0.76; p < .001) 6-8 weeks post-training, and by 13.1 points (SE = 0.92; p < .001) one-year post-training. Sector and years of experience were significant predictors of perceived benefit. Healthcare professionals at the municipalities reported greater immediate improvements compared to hospital staff (χ2(3) = 9.9, p = .02). Among hospital staff, acute units reported greater improvements than rehabilitation units (χ2(4) = 22.6, p < .001). Professionals with less experience (≤ 5 years) reported greater improvements compared to more experienced staff (> 5 years) (χ2(3) = 18.2, p < .001). There was no difference across three groups of professions (therapists vs. nurses and assistants vs. others), (χ2(8) = 13.5, p = .10).
CONCLUSIONS: The participating healthcare professionals reported benefits of the Danish CPT program indicating that they perceived themselves and their work environment as more competent for health communication with people with aphasia after having received training in the CPT scheme, and the benefit was maintained one-year post-training. Furthermore, healthcare professionals at municipalities and acute units reported greater benefits, as did healthcare professionals with fewer years of experience.