Burton Bridget, Shrubsole Kirstine, Manchha Asmita, King Michelle, Wallace Sarah J
The Queensland Aphasia Research Centre, School of Health and Rehabilitation, Sciences, The University of Queensland, Herston, Australia.
Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Hospital and Health Service, Herston, Australia.
Int J Lang Commun Disord. 2025 Mar-Apr;60(2):e70016. doi: 10.1111/1460-6984.70016.
In aged-care settings, direct care staff play a crucial role in supporting older people with communication needs. Many direct care staff, however, have unmet skill needs in interpersonal, intercultural, and intergenerational communication. Communication Partner Training (CPT) provides a potential solution. However, it is not known if existing programs address the diverse communication needs encountered in aged-care settings. We sought to identify the key features of existing CPT programs to determine their suitability for the Australian aged-care context.
To identify existing CPT programs relevant to aged-care settings and to describe their content and format.
A scoping review was conducted in alignment with the Joanna Briggs Manual for Evidence Synthesis and Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews reporting guidelines. Using a systematic search, we identified peer-reviewed articles from five electronic databases: PubMed, PsycINFO, Embase, Cochrane and CINAHL. All retrieved articles were screened by title and abstract; 20% were independently screened by a second reviewer. All full-text articles were independently assessed by two reviewers. Data describing the content and format of identified CPT programs was extracted using the Intervention Taxonomy and an author-developed tool.
This review highlights critical gaps in existing CPT programs for aged-care settings. Identified programs were predominantly disorder-specific (79%), with the vast majority focusing on conditions like dementia or aphasia and failing to address broader communication needs arising from personal, social and environmental factors. Notably, no programs addressed intercultural communication, despite known cultural and linguistic diversity among aged-care workers and recipients in countries such as Australia. Furthermore, few (9%) included intergenerational communication considerations. Most programs relied on in-person delivery methods (67%), often led by health professionals (71%), which may be impractical for resource-constrained and geographically dispersed aged-care services. Furthermore, reported outcome measures varied (187 across 90 articles), and few evaluated both trainee and client (the 'dyad') outcomes. These findings underscore the need for comprehensive, scalable and contextually relevant CPT programs to address the complex communication challenges seen in aged-care settings.
There is a need for a comprehensive CPT program that is fit-for-purpose for direct care staff in aged-care settings. This program should address the multifaceted and intersecting communication support needs of aged-care recipients, including intercultural and intergenerational communication differences. The program should also incorporate resource-feasible delivery methods and evaluate dyadic communication outcomes. Closing these gaps is vital to enhancing quality of care and life for older adults in aged-care settings.
What is already known on the subject Many older Australians have complex, unmet communication support needs. In aged-care settings, direct care staff play a crucial role in supporting older people to communicate. Many aged-care workers, however, have their own unmet skill needs in interpersonal, intercultural and intergenerational communication. Communication partner training (CPT) provides a potential solution. However, it is not known if existing programs address the diverse communication support needs encountered in aged-care settings. What this paper adds to existing knowledge Using a scoping review methodology, we identified and described CPT programs for direct support staff who work with older adults. Most CPT programs were disorder-specific and targeted communication needs in dementia or aphasia. As aged-care recipients have multifaceted, complex and intersecting communication support needs, these programs may fall short of addressing the training needs of aged-care workers. The mode of training delivery was predominately in-person and health professional-led. Such delivery modes may not support implementation given resource constraints across the Australian aged-care sector. CPT that can be feasibly implemented in aged-care settings to address complex and intersecting communication support needs is required. What are the potential or actual clinical implications of this work? Our analysis highlights the need for comprehensive, disorder-agnostic CPT tailored for aged-care staff to address diverse communication support needs. This CPT should consider scalable delivery modes effective across Australia's vast geography and limited trainer availability. It must include outcome measures reflecting the perspectives of communication support partners-older Australians in aged care with communication challenges. To tackle the health, personal and environmental communication barriers in aged care, a fit-for-purpose CPT program, co-designed with key stakeholders, is essential to ensure the training is both feasible and acceptable to meet the unmet needs of intended end-users.
在老年护理机构中，直接护理人员在为有沟通需求的老年人提供支持方面发挥着关键作用。然而，许多直接护理人员在人际、跨文化和代际沟通方面存在未得到满足的技能需求。沟通伙伴培训（CPT）提供了一种潜在的解决方案。然而，尚不清楚现有的项目是否能满足老年护理机构中遇到的多样化沟通需求。我们试图确定现有CPT项目的关键特征，以确定它们是否适合澳大利亚的老年护理环境。
识别与老年护理机构相关的现有CPT项目，并描述其内容和形式。
根据乔安娜·布里格斯循证综合手册以及系统评价与Meta分析扩展版的首选报告项目（PRISMA-ScR）报告指南进行范围综述。通过系统检索，我们从五个电子数据库中识别出同行评审的文章：PubMed、PsycINFO、Embase、Cochrane和CINAHL。所有检索到的文章均通过标题和摘要进行筛选；20%由第二位评审员独立筛选。所有全文文章由两位评审员独立评估。使用干预分类法和作者开发的工具提取描述已识别CPT项目内容和形式的数据。
本综述突出了现有老年护理机构CPT项目中的关键差距。已识别的项目主要针对特定疾病（79%），绝大多数聚焦于痴呆症或失语症等病症，未能解决个人、社会和环境因素导致的更广泛沟通需求。值得注意的是，尽管在澳大利亚等国，老年护理工作者和接受者中存在已知的文化和语言多样性，但没有项目涉及跨文化沟通。此外，很少有项目（9%）考虑代际沟通因素。大多数项目依赖面对面授课方式（67%），通常由卫生专业人员主导（71%），这对于资源有限且地理位置分散的老年护理服务可能不切实际。此外，报告的结果测量方法各不相同（90篇文章中有187种），很少有项目同时评估学员和服务对象（“二元组”）的结果。这些发现强调需要全面、可扩展且与实际情况相关的CPT项目，以应对老年护理机构中复杂的沟通挑战。
需要一个适合老年护理机构直接护理人员用途的全面CPT项目。该项目应满足老年护理接受者多方面且相互交织的沟通支持需求，包括跨文化和代际沟通差异。该项目还应采用资源可行的授课方式，并评估二元沟通结果。弥合这些差距对于提高老年护理机构中老年人的护理质量和生活质量至关重要。
关于该主题已知的信息 许多澳大利亚老年人有复杂且未得到满足的沟通支持需求。在老年护理机构中，直接护理人员在支持老年人沟通方面发挥着关键作用。然而，许多老年护理工作者在人际、跨文化和代际沟通方面自身的技能需求也未得到满足。沟通伙伴培训（CPT）提供了一种潜在的解决方案。然而，尚不清楚现有项目是否能满足老年护理机构中遇到的多样化沟通支持需求。本文对现有知识的补充 使用范围综述方法，我们识别并描述了针对与老年人一起工作的直接支持人员的CPT项目。大多数CPT项目是针对特定疾病的，针对痴呆症或失语症的沟通需求。由于老年护理接受者有多方面、复杂且相互交织的沟通支持需求，这些项目可能无法满足老年护理工作者的培训需求。培训授课方式主要是面对面且由卫生专业人员主导。鉴于澳大利亚老年护理部门的资源限制，这种授课方式可能不支持项目实施。需要能够在老年护理机构中切实可行地实施以满足复杂且相互交织的沟通支持需求的CPT。这项工作的潜在或实际临床意义是什么？我们的分析强调需要为老年护理人员量身定制全面的、不针对特定疾病的CPT，以满足多样化的沟通支持需求。这种CPT应考虑在澳大利亚广阔地域和培训人员有限的情况下有效的可扩展授课方式。它必须包括反映沟通支持伙伴（有沟通挑战的老年护理澳大利亚人）观点的结果测量方法。为解决老年护理中的健康、个人和环境沟通障碍，与关键利益相关者共同设计的适合用途的CPT项目对于确保培训既可行又能被接受以满足目标最终用户未满足的需求至关重要。
