The role of technology in healthcare communication between people with aphasia and healthcare professionals: an observational study.

Abstract

Effective healthcare communication underpins safe, person-centred care leaving people with communication disabilities, such as aphasia, vulnerable to adverse events in hospital and unmet needs. The Aphasia App is designed to support interactions between healthcare professionals (HCPs) and people with aphasia (PWA) in hospital. This study explored hospital-based interactions between HCPs and PWA in the context of the Aphasia App. A focused ethnography was conducted. Six patients with post-stroke aphasia participated. Data included fieldnotes from direct participant observation (this paper) and semi-structured interviews (reported elsewhere). iPads containing only the Aphasia App were loaned to participants from acute and subacute settings for use in care interactions. The lead author observed interactions and thematically analysed the data. HCPs were crucial to enabling PWA to communicate. Communication attempts evoked strong emotional responses in PWA and HCPs, such as frustration, and ineffective communication restricted important clinical information exchange. The Aphasia App had limited use, but observations revealed its clinical and communicative potential. Limited app use despite an observable need illuminates the complexity of implementing novel communication aids in hospitals. Interventions must address individual and systemic factors influencing adoption through end-user collaboration and tailored implementation.