Aphasia disrupts usual care: the stroke team’s perceptions of delivering healthcare to patients with aphasia

Abstract

Purpose

Communication disability, including aphasia, is prevalent in the stroke population and impacts service delivery. This study explored the experiences of the multidisciplinary stroke team in delivering healthcare to patients with aphasia.

Materials and methods

A phenomenological approach was used to understand the experiences of delivering healthcare services in the presence of aphasia. Healthcare professionals (n = 16) were recruited across acute and subacute stroke care, with a range of discipline backgrounds and experience. Participants took part in focus groups and data were analysed using an inductive thematic approach.

Results

Five themes were evident: 1) aphasia is time consuming, 2) health professionals do not know how to help, 3) health professionals limit conversations with patients with aphasia, 4) health professionals want to know how to help, and 5) health professionals feel good after successful communication.

Conclusions

Aphasia disrupts usual care. Health professionals want to help but are working in a non-optimal environment where communication and patient-centred care are not adequately resourced.

A video abstract is available in Supplementary Material.

IMPLICATIONS FOR REHABILITATION

• Current hospital systems and ward culture make it difficult to offer patient-centred care to patients with aphasia.

• Health professionals want to help patients with aphasia but are working in an environment where patient-provider communication is not adequately resourced.

• As a result, health professionals dread, limit or avoid talking with patients with aphasia.

• Health professionals need support which may include ongoing education and on-the-job training, and a change in ward culture including key performance indicators focusing on patient-provider communication.

Keywords:

• Hospital
• communication
• aphasia
• multidisciplinary
• health professionals

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Acknowledgements

The authors warmly thank the health professionals who participated in this study and generously shared their experiences of healthcare communication; efforts have been made to convey these experiences honestly and respectfully. Special thanks go to Kathryn McKinley for her support and assistance in coordinating the focus groups, and to research assistant Hien My Pham for the many hours spent transcribing the data.

Disclosure statement

Focus group data were collected to inform the design of a healthcare communication app that may be commercialised in the future.

Notes

1 The transcription protocol included documenting the location, date, names of participants, name of facilitator, name of the transcriber, the date of transcription, the length of the recording, and the time stamps for when transcription started and ended. Audio recordings were orthographically transcribed. Excluded from transcription were general settling-in discussions at the start of the group and concluding comments that did not directly relate to the topic. Transcription focused on identifying the speaker and their verbal output. Nonverbal communication (such as gesture, facial expression, pointing, or nodding) was not transcribed, nor was overlaps in turns.