JCPSLP Vol 18 no 2 2016

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JCPSLP Volume 18, Number 2 2016 91
in September and the post training assessments were
conducted immediately afterwards in September and
October 2013. A total of 34 nurses were recruited to the
study. Twenty-eight completed the demographic and pre
training assessments. Twenty nurses completed the online
training and 19 completed the post training assessments.
Each of the 19 nurses who completed all the assessments
patients with aphasia in conversation, drawing on materials
that the first author had acquired from attending training at
the Aphasia Institute in Canada and Connect in the United
Kingdom. Information on ways to support patients with
aphasia was separated into four categories: (a) health care
professional behaviours that communicate a respectful,
positive attitude towards people with aphasia; (b)
communication strategies that help patients understand the
message; (c) communication strategies to help patients get
their message out, and (d) ways to check that the health
care professional has understood the patient’s message.
The online training included video material of people with
aphasia who described what it is like to have aphasia in
hospital. There was also video material demonstrating how
health care professionals might communicate with people
with aphasia in supportive and less supportive ways. Pilot
testing indicated that the online module took approximately
30 minutes to complete.
Data analysis
A Wilcoxon’s Signed Rank Test was used to investigate
changes in perceived knowledge and confidence when
communicating with patients with aphasia. In order to
investigate any changes to the number of appropriate
communication strategies following training, the second
author reviewed all the strategies that nurses listed, and
categorised those strategies as appropriate or inappropriate
for people with aphasia. For example, when asked to
identify communication strategies that help the patient with
aphasia understand you, one nurse provided the following
strategies before training: “speak loudly”, “speak slowly”,
and “speak clearly”. The two strategies “speak slowly”, and
“speak clearly” were categorised as appropriate, and the
communication strategy “speak loudly” was categorised as
inappropriate. The first author then checked the
categorisations. When any categorisation of a strategy was
unclear to the first author, both authors discussed the
categorisation until they reached agreement. A repeated
measures t-test was used to investigate any change in the
number of appropriate communication strategies identified
before and after training using SPSS, version 22.0 (IBM,
2013). The feasibility of the online training program was
analysed by calculating the number of nurses who enrolled
in and completed the training program. Feasibility was also
explored qualitatively by conducting a descriptive coding of
the feedback provided by the nurses about the online
training (Morse & Richards, 2002).
Results
Sample demographics
The pre training assessments were conducted between
July and August 2013. Nurses completed the online training
Rating the videos observed in the online training program
and online training had worked as a registered nurse for
less than a year to more than 12 years (mode 1–4 years).
Similarly they had cared for patients with aphasia for less
than a year to more than 12 years (mode 1–4 years). Seven
of the 19 participants had completed some training in
communicating with patients with aphasia prior to this
study. No further details on the nature of this training were
collected. The following results are based on analysis of the
19 participants who completed all the assessments.
Changes in knowledge of communicating
with patients with aphasia
As described above, knowledge was assessed in three
ways. The median score on “perceived understanding of
aphasia” rating scale increased from a pre-training level of
“basic understanding” to “good understanding” following
training. Despite having fewer than 28 participants
complete the training, a Wilcoxon Signed Rank Test
indicated that this was a statistically significant increase, z =
–3.358, p < .01, with a large effect size (r = .54). There was
also a significant increase in the nurses’ rating of their
knowledge of communication strategies from a median
score of basic knowledge of strategies pre training to a
median score of good knowledge of strategies after
training, z = –2.887, p < .01, with a moderate to large effect
size (r = .46).
Table 1. Knowledge of appropriate communication strategies before and immediately after training
Appropriate strategies before
training (n = 19)
Appropriate strategies after
training (n = 19)
p
Purpose of communication strategy Range Mean (SD) Range Mean (SD)
To promote respectful communication 1–5 2.89 (1.29) 1–14 5.11 (3.32) 0.01
To help patients with aphasia understand the message 0–6 2.53 (1.35) 0–7 3.68 (2.16) 0.047
To help patients with aphasia get their message out 1–4 2.16 (0.96) 1–5 3.05 (1.22) 0.025
To check the nurse has understood 0–2 1.05 (0.62) 0–5 2.16 (1.3) 0.005