Psychometric properties of the Health Professionals and Aphasia Questionnaire (HPAQ): a new self-assessment tool for evaluating health communication with people with aphasia

Background: Communication partner training (CPT) of health professionals (HP) is recommended in several international guidelines for stroke and aphasia. The effectiveness of CPT is well established, but research and evaluation is needed for implementation of CPT in different healthcare settings. The Health Professionals and Aphasia Questionnaire (HPAQ) was developed to make available a valid and reliable outcome measure, which is feasible for use with HP working in practice settings with people with aphasia as well as in research. Aims: The aim was to investigate the test–retest reliability and underlying psychometric properties of the HPAQ when administered four weeks apart to HP in neurorehabilitation. Methods and Procedures: Participants were recruited from a CPT implementation study in Denmark. Health professionals with contact with patients with aphasia were assigned to CPT courses and asked to fill the questionnaire four weeks before and on the day of their scheduled course. In all, 270 HP responded to the HPAQ. The internal consistency, test–retest reliability, structural validity, and floor and ceiling effects of the HPAQ questions were investigated using descriptive statistics, intraclass correlation coefficient (ICC), Cronbach’s alpha, and factor analysis. Outcomes and Results: The overall test–retest reliability of HPAQ was excellent (ICC = 0.86); and ICC of the individual questions ranged between 0.80 and 0.48. Minor ceiling or flooring effects in answering questions were present. The factor analysis revealed three underlying factors. The first and strongest was a CPT-related knowledge and skill factor represented in all questions except for question 10. The second component was associated with questions probing environmental factors. Test–retest reliability was excellent for the score developed with variables used in these factors. A third factor was associated with expecting or being prepared for making an extra effort when communicating with patients with aphasia. Test–retest reliability for the variables explaining this factor was good. Regarding professions, nurses have the highest ICC on the overall HPAQ, whereas physio and occupational therapists have the lowest. The overall HPAQ showed excellent or good reliability for all healthcare professionals with six or more years of experience, and fair reliability for respondents with fewer years of experience. Conclusions: The HPAQ has good reliability and is suitable as an outcome measure in CPT studies aimed at different health professionals working in practice settings with people with aphasia.