RESUMO
BACKGROUND: People with aphasia are vulnerable recipients of healthcare. The nature of the communicative environment and the communication disability can adversely impact access to timely and quality healthcare. Student healthcare professionals are often underprepared to interact successfully with people with aphasia and may benefit from communication partner training (CPT). AIMS: To investigate the potential effectiveness and acceptability of a brief, two-part introductory Supported Conversation for Adults with Aphasia (SCA™)-based CPT package, delivered to a sample of students across a diverse range of healthcare disciplines. METHODS & PROCEDURES: A pre-post-within group experimental design was used to investigate the potential effectiveness and acceptability of an online CPT package (50 minute module + 1 hour workshop) for healthcare students. The Aphasia Attitudes, Strategies and Knowledge (AASK) survey measured participants' knowledge of aphasia, facilitative communication strategies and attitudes towards people with aphasia. Data were collected pre-training, following the training module and following the workshop, and 6 weeks post-training. Statistical analysis was conducted on the AASK data. In addition, participant feedback (ratings and open text responses) was collected after the workshop. Ratings were analysed descriptively, and thematic content analysis was used for open text responses. OUTCOMES & RESULTS: 236 participants completed the pre-training AASK and 106 completed the AASK at subsequent time points. Statistically significant gains were demonstrated from pre- to post-module completion. Between the end of the module and the end of the workshop, some gains were maintained and others showed further statistically significantly improvements. While all gains were not maintained at the 6-week follow-up, statistically significantly improvements from pre-training scores remained evident. Student feedback was predominantly positive, with suggested improvements for training content and length. CONCLUSIONS & IMPLICATIONS: The results provide preliminary evidence that a brief, online CPT package can support student healthcare professionals' knowledge and attitudes towards aphasia and communicating with people with aphasia. Online training was acceptable to students and feasible as an embedded or optional component of curriculum. Ongoing training (e.g., in the form of refresher sessions) and inclusion of a skills-based component are recommended to maximize communication skill development. WHAT THIS PAPER ADDS: What is already known on the subject Student healthcare professionals recognize the need to develop knowledge and skills to successfully support people with communication disability, such as aphasia, to participate effectively in their healthcare. Evidence in favour of online communication partner training for student healthcare professionals is currently limited. What this study adds to the existing knowledge This study demonstrates that a brief introductory online communication partner training program can be efficacious for improving knowledge and attitudes regarding communicating with people who have aphasia. What are the potential or actual clinical implications of this work? Students will likely need further ongoing refresher training with inclusion of practical components to develop and maintain the knowledge and skills required to be proficient communication partners with people with aphasia.
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Afasia , Estudantes , Adulto , Humanos , Comunicação , Pessoal de Saúde/educação , Atenção à SaúdeRESUMO
PURPOSE: Community aphasia groups (CAGs) can provide a range of benefits to people with aphasia and support long-term psychosocial wellbeing. However, the dominant speech-pathologist-led service delivery model is inherently limited in scope. Peer-led groups hold potential as a sustainable and empowering extension of this traditional model. The implementation of peer-led models likely requires targeted training and support, however little is known about the characteristics and impacts of CAG facilitation. This study reviews the literature on CAGs and their facilitation. MATERIALS AND METHODS: We conducted a scoping review on this topic. RESULTS: One hundred and seventy-seven texts were included, reporting on a heterogeneous range of activities. Most texts reported on speech-pathologist-led groups, however, a range of alternative models were also represented. While no studies directly compared the impacts of different facilitation models, some comparative benefits could be drawn from the literature. Facilitation was perceived as complex and challenging, and significant gaps were identified in the training of facilitators. Ten qualitative studies investigated characteristics and impacts of facilitator behaviours, providing a useful foundation for future development of training and evaluation tools. CONCLUSIONS: Further investigation into alternative facilitation models and facilitator training needs will likely support the proliferation of high-quality CAGs.Implications for RehabilitationCommunity aphasia groups (CAGs) play an important role in supporting identity and wellbeing for individuals with chronic aphasia.The traditional speech-pathology led model of group service delivery is limited in scope; the addition of peer- and volunteer-led CAGs may facilitate access to groups and meet a range of different needs for individuals with aphasia.CAG facilitation is a complex and challenging task, likely requiring specialised training, however, this has not been widely available to facilitators.The development of specialised facilitator training will likely support the proliferation of sustainable and high-quality CAGs.
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Afasia , Patologia da Fala e Linguagem , Humanos , Afasia/psicologia , Pesquisa Qualitativa , Grupo AssociadoRESUMO
Background: Community aphasia groups are recognized as an area of need and value for people with chronic aphasia and their significant others. However, our understanding of attendees' experiences is limited by the small amount of qualitative research available. The present study aimed to describe participant experiences of an Interdisciplinary Community Aphasia Group, as part of a better understanding of its underlying processes and value.Methods: Four people with chronic, severe aphasia and their spouses attended an Interdisciplinary Community Aphasia Group held at a university speech clinic for 2 h once weekly over 12 weeks. The group was co-facilitated by a speech-language pathologist and a social worker, with the support of two aides (one a person with aphasia, and the other a member of the general community). The group addressed the following areas: communication therapy, conversation, participation in meaningful and accessible activities, psychological and social support, and aphasia information and education. Following the program, the people with aphasia (via multimodal communication) and spouses participated in separate semi-structured interviews with an independent interviewer. The interviews addressed members' perceptions of the program (both in relation to themselves and their spouse) along with recommendations for improvement. The interviews were analyzed using Framework Analysis.Results: Members shared preferences for program activities and group format, with some experiences leading to suggestions for improvement. The group dynamics and environment were considered positive overall, and members highlighted a range of positive impacts for both themselves and their spouse. Together, these elements informed members' evaluation that the model contained something for everyone, but may not be a "one-stop shop" given ongoing needs for therapy. An overarching theme for spouses addresses therapy and recovery in relation to the impact of peers, views and beliefs, and adjustment.Conclusions: The Interdisciplinary Community Aphasia Group model has overall acceptability for people with chronic, severe aphasia and their spouses, and can be adapted to ensure feasibility in clinical practice. Ongoing research is required to best tailor community groups for people with aphasia and significant others, and to reinforce the need for their proliferation.Implications for rehabilitationPeople with aphasia and their spouses can benefit from a wide range of programming, including participation in meaningful and accessible non-verbal activitiesAn interdisciplinary staff team can contribute positively to member experience and impacts, with peer staff offering valuable mentoring roles. Various aspects of member identity and life narrative impact on community aphasia group participation; understanding members' needs in the context of previous experiences can improve tailoring of program content.
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Afasia , Patologia da Fala e Linguagem , Comunicação , Humanos , Pesquisa Qualitativa , CônjugesRESUMO
PURPOSE: This study reports on practices and challenges in developing community aphasia groups in Australia. METHOD: A 24-item web-based survey addressed the structure of existing community aphasia groups, funding models, group activities, facilitator satisfaction, challenges to group development and maintenance and suggestions for improvement. A total of 156 surveys were completed, mostly by speech-language pathologists (SLPs), with 66% urban and 34% regional/rural/remote participants representing all Australian states/territories consistent with their populations. RESULT: Seventy respondents indicated running a total of 86 groups, reflecting a substantial under-representation of service in proportion to the population of people with aphasia. Further, 23.6% of respondents reported dissatisfaction with aspects of their groups. The primary barriers to achieving satisfaction relate to limited resources and staffing, inability to run sufficient numbers of groups and to tailor them effectively, dispersed populations beyond major cities, group dynamics and a lack of group promotion and referral to groups. Respondents suggested means for improvement including changes to group structure, improved SLP training, dedicated funding and staffing, development of specific resources and better liaison and promotion. CONCLUSION: The major features differentiating the community aphasia groups run in Australia from those running overseas are discussed and practical ways to achieve service improvement are suggested.