JCPSLP Vol 18 no 2 July 2016

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

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

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

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JCPSLP Volume 18, Number 2 2016

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