“Communication strategies used by health professionals and senior health professional students with people with aphasia – an overview of the Portuguese reality”

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ABSTRACT Introduction Aphasia is a communicative disorder prevalent in about one-third of stroke survivors. People with aphasia (PWA) typically require lifelong healthcare support and frequent consultations with various health professionals (HP) who must be well-prepared to adapt their communication to effectively communicate with them. This study aims to analyse the communication strategies used by Portuguese HP, namely nurses, physiotherapists, occupational therapists, speech and language therapists, and other professionals in contact with PWA, as well as senior health professional students (SHPS) of these professions, when communicating with PWA. Methods & Procedures A cross-sectional mixed-methods convergent design, incorporating a self-developed survey with both quantitative and qualitative strands was conducted. The content validity of the questionnaire was ensured by an expert panel, based on individual agreement with its items. Seven HP (3 speech and language therapists, 2 physiotherapists, 1 physician, 1 neuropsychologist) were part of this expert panel. The Content Validity Index (CVI) was calculated, and a value of > 0.90 was obtained for all its items. The questionnaire developed, which includes both quantitative and qualitative sections, was completed online by HP/SHPS. HP/SHPS who underwent training in Portugal and have/had contact with PWA were included. Quantitative analysis was performed using Microsoft Excel (2013 version). Open-ended questions were analyzed using deductive content analysis. Results HP/SHPS (N = 223) reported using mostly verbal strategies (e.g. Ask PWA to explain in an alternative way, time to respond, slow down speech rate, yes/no questions, rephrase/clarify) and visual strategies (e.g. writing, drawing, pictures, augmentative and alternative communication) when communicating with PWA. The same strategies are reportedly for different purposes (improving PWA expression and comprehension and revealing PWA competence). Conclusions HP/SHPS, independently of their professional background, tended to use the same strategies for different purposes, which may indicate a lack of knowledge about PWAs’ competencies and limitations, as well as the best strategies to facilitate communication with them. Given the increasing aging of the Portuguese population and the estimated number of PWA, more information in this area is recommended, particularly by integrating these topics into the formal training of HP and/or offering additional training throughout their careers.