A narrative review of communication accessibility for people with aphasia and implications for multi-disciplinary goal setting after stroke

Background: Guidelines to support accessible goal setting with stroke survivors with aphasia are lacking.
Aims: This review aimed to (i) determine the communication barriers and facilitators relevant to accessible goal setting for stroke survivors with aphasia and (ii) propose recommendations for accessible goal setting practice.
Design: We conducted a narrative literature review incorporating a systematic search strategy.
Methods & procedures: An electronic database search of abstracts was conducted from January 2003 to March 2018 in CINAHL, MEDLINE, AMED, ProQuest Central, and PsychINFO. We sought peer-reviewed articles including stroke survivors with aphasia, carers, or healthcare professionals that addressed (i) communication partner skills and behaviours and/or (ii) the physical environment. Study quality was appraised using the Mixed Methods Appraisal Tool (MMAT). Thematic analysis was conducted on key findings.
Outcomes & results: 647 articles were identified. 70 full-text articles were screened for eligibility; 34 of which were included. We propose a model and recommendations to support accessible goal setting, including supportive conversation strategies and a modified physical environment.
Conclusions: Specific evidence for accessible goal setting with stroke survivors with aphasia is lacking. Staff training and ongoing support is required for successful use of communication strategies and resources. Further research is needed to develop and evaluate accessible goal setting resources and training.