Improving Care for People With Aphasia: Communication Training for Healthcare Providers

Communication barriers significantly impact the quality of care for people with aphasia (PWA). To address this, training healthcare professionals (HCPs) who interact with PWA is essential. The Health Professionals and Aphasia Questionnaire (HPAQ) assess the effectiveness of such training by measuring changes from pre- to post-intervention.

This study aimed to translate and validate the HPAQ into European Portuguese (HPAQ-EP) and to analyse the effectiveness of the Communicative Training in Aphasia program by examining changes in HCPs' communication skills at a clinical centre in Portugal using the newly developed HPAQ-EP.

A pre-post intervention study was conducted in two phases. Phase 1 involved translating the HPAQ-EP and validating it through expert panel review, in accordance with international guidelines. Content validity was assessed using the Content Validity Index (CVI). In Phase 2, the HPAQ-EP was administered to HCPs at a clinical centre before and after a training session based on the Supported Conversation for Adults with Aphasia (SCA) approach.

The HPAQ-EP demonstrated strong content validity (CVI > 0.80) and good internal consistency (α = 0.912), comparable to the original tool. Following implementation of the Communicative Training in Aphasia program (n = 23), significant improvements were observed, as reported by the HPAQ-EP, in items related to 'Knowledge', 'Skills', 'Attitudes and Emotions' (items 8 and 9) and 'Environment (item 14). Participants found the aphasia simulation the most challenging part and it was particularly insightful for understanding the lived experience of PWA.

This study shows that targeted communication training significantly enhances HCPs' readiness to engage with PWA, highlighting its clinical value. The findings also confirm the HPAQ-EP as a valid and reliable tool for assessing HCPs' attitudes toward aphasia and for guiding the implementation of such training. Future efforts should emphasise long-term follow-up and broader implementation across healthcare settings.

What is already known on this subject PWA often experience communication barriers that negatively affect their healthcare experiences and outcomes. HCPs frequently lack the specific training needed to effectively communicate with PWA, leading to frustration, miscommunication, increased medical errors and reduced patient involvement in their healthcare process and decisions. Communication Partner Training (CPT), particularly SCA, is an evidence-based approach shown to improve HCPs communication skills. In Portugal, there is a lack of validated tools to assess the impact of such training and few interventions have targeted HCPs directly within clinical settings. What does this study adds to existing knowledge The HPAQ was translated and validated into European Portuguese (HPAQ-EP), demonstrating high content validity and internal consistency. It was used to evaluate the effectiveness of a theoretical-practical Communicative Training in Aphasia program for HCPs. Post-training results showed statistically significant improvements in knowledge, communication skills and attitudes towards PWA. Despite its limitations, this study offers a culturally adapted and psychometrically robust tool for Portuguese-speaking HCPs, while also providing evidence of the short-term effectiveness of communication training for multidisciplinary teams working with PWA in clinical settings. What are the potential or actual clinical implications of this work? The findings support integrating targeted communication training into routine professional development for HCPs who interact with PWA. By improving HCPs knowledge, confidence and communicative strategies, such training fosters more inclusive, patient-centred care and reduces the risk of marginalisation and medical errors. The validated HPAQ-EP enables ongoing evaluation of training impact in Portuguese-speaking settings. Broader implementation and long-term follow-up are recommended to maximise benefits and promote sustainable changes in clinical practice. This study advocates for the inclusion of aphasia-specific communication modules in healthcare curricula to better prepare future HCPs.