Características del clima laboral

1. Brief name: Provide the name or phrase that describes the intervention

This item was assessed as addressed in the study if the author outlined a name or phrase in a succinct sentence or title where the category of intervention was clearly outlined. A brief name allows readers of the study to identify and link topics efficiently. This item was reported in 74% of included studies.

Speech and language therapies for aphasia with a functional outcome fell into the following categories: music-based (Sparks et al., 1974; Schlaug, 2008; Jungblut et al., 2009; Stahl et al., 2013); conversational coaching and communication partner training (Hopper et al., 2002; Lyon, 2007; Cherney, 2008; Szaflarski, 2008; Fridriksson, 2012; Marangolo, 2013; Blom-Johansson, 2013; Ruiter, 2010), verb strengthening (Edmonds et al., 2014); constraint-induced therapies (Szaflarski, 2008; Sickert et al, 2014); computer-based rehabilitation (Doesborgh, 2004; Tessier et al., 2007; Weill-Chounlamountry, 2013); sign language or symbol exchange (Moody, 1982; Johnannsen-Horbach et al., 1985); writing therapies (Beeson et al., 2010; Panton & Marshall, 2008) and combination interventions (Rodriquez et al., 2013; Cherney, 2012; Morris, 2011). A brief name or phrase also outlined whether priming was involved in the intervention, such as transcranial Direct Current Stimulation (tDCS) (Marangolo, 2013), epidural cortical stimulation (Cherney, 2012) and pharmacological (Galling, 2014).

2. Why: Describe any rationale, theory or goal of the elements essential to the intervention

The goal and theory behind the intervention was made explicit in all of the included studies. The articles provided clear rationales for the interventions that were implemented. The goals differed from those that aimed to assess whether a certain intervention worked, e.g. tested using an outcome measure (e.g. Sparks et al, 1974; Moody, 1982, Hopper et al 2002; Lyon, 2007; Cherney et. al 2008; Szaflarski et al, 2008; Edmonds et al., 2014). Studies also compared group and individual therapy (Wertz et al., 1981), comparing the influence of who implemented intervention on outcome (David et al., 1982), speech and language therapy treatment compared to no treatment (Lincoln et al., 1984; Doesborgh et al., 2004), timing of intervention (Laska et al., 2011; Sickert et al., 2014) and intensity of treatment (Godecke et al., 2012; Rodriquez et al. 2013).

3. What (materials): Describe any physical or informational materials used in the intervention, including those provided to participants or used in intervention delivery or in training intervention providers.

Studies were assessed as adhering to this item if the author made reference to, or provided a description of, the intervention materials. For controlled studies, adherence was assessed as present if the materials were described for either the case or control arm. Information on the therapy materials used was provided in 79% of studies. Descriptions of materials varied from broad categories, such as ‘low and high frequency words’ (Beeson et al., 2010) and ‘concrete objects’ (Moody, 1982) to more specific lists of words which were provided in appendices (Edmonds et al., 2014). Studies also used computers and computer programs (Doesborgh, 2004; Fridriksson, 2012; Cherney et al, 2012). Materials could be prescribed, such as ‘twenty items from the Pyscholinguistic Assessment of Language Processing in Aphasia’ (PALPA), (Galling et al, 2014), or tailored to the client, such as ‘sixty words chosen that were related to the client’s work’ (Panton & Marshall, 2008).

4. What (procedures): Describe each of the procedures, activities and/or processes used in the intervention, including any enabling or support activities

This item was assessed as present if the procedures of the intervention were outlined explicitly or if the reader was directed to an article where full information on the procedures could be obtained. The procedures needed to be replicable to be counted and these were made explicit in 85% of the included articles. Procedures were outlined in step or tabular format. Edmonds et al. (2014) and Stark et al. (2010) included protocols in the appendices of the articles, with supplementary information. Terms such as ‘standard therapy’ (Sickert et al., 2014) and ‘usual care’ (Lincoln et al, 1984) were used to describe the procedure of some interventions.

Feedback was provided either on the outcome of the intervention activity or on the performance in half of included studies, with the other half not specifying feedback.

5. Who provided: For each category of intervention provider (for example psychologist or nursing assistant), describe their expertise, background and any specific training given

This item was assessed as present if authors made any reference to who delivered the intervention, for example a Speech and Language Pathologist (‘SLP’), clinician, therapist or volunteer. Authors made reference to an intervention provider in 88% of the included

studies. However, details regarding their years of experience, background, role in the study or training were made explicit in only 18% of articles (Edmonds et al., 2014; Lyon et al, 2007; Stahl et al., 2013; Ruiter et al, 2010; Blom-Johansson, 2013; Laska et al, 2011). The most detailed description was found in Edmonds et al. (2014 p.320), where it is stated that ‘three speech and language pathologists with extensive clinical (8-30 years) and research experience with aphasia conducted the research’.

6. How: Describe the modes of delivery (e.g. face-to-face, internet or telephone) of the intervention and whether it was provided individually or in a group

The modes of intervention were face-to-face (patient and therapist), face-to-face (patient, communication partner or family member and therapist), computer-based with an avatar or via Skype and individual and group intervention (including choirs). These modes were discussed in 90% of the included studies. Studies had one mode such as individual, face-to- face intervention, for example (Edmonds et al., 2014), a combination of modes such as computer-based and with a therapist, for example (e.g. Galling et al, 2014), or individual and group intervention, for example (Morris et. al, 2011).

7. Where: Describe the type(s) of location(s) where the intervention occurred, including any necessary infrastructure or relevant features

Therapy was provided in a variety of settings such as: rehabilitation centres; sub-acute hospital setting or outpatient; at home or a combination. The setting of the intervention was made explicit in 49% of included studies.

8. When and how much: Describe the number of times the intervention was delivered and over what period of time, including the number of sessions, their schedule and their duration, intensity or dose

All articles outlined the amount of time per session, the number of sessions per week and the duration of the intervention block. For example, in Cherney (2008), the amount of practice differed between patients with averages reported. From the information provided, the reader would be able to obtain the dosage and intensity of the intervention.

9. Tailoring: If the intervention was planned to be personalised, titrated or adapted, then describe what, why, when and how

This item was counted if the author reported whether the intervention or goal was tailored in order for these to be salient and meaningful for the patient. Of the included articles, 36% made this explicit using terms such as ‘collaborative goal setting’ (Morris et al, 2011),

choosing meaningful targets for the patient (Galling et al, 2014; Panton & Marshall, 2008) or whether individualised communication training was provided (Lyon, 2007).

2.6.3 Data synthesis

The learning processes involved in (re)learning in aphasia rehabilitation were extracted and applied to the the items from the TIDieR checklist (Hoffmann et al, 2014); relating to learning processes. The most frequently reported items were: the rationale underlying the intervention (item 2), located in the background and introduction of the article; and the dosage and intensity of the intervention (item 8). Both item two and eight were made explicit in all of the included articles. Information on feedback provided (item 4), the setting of intervention (item 7) and how the intervention was tailored (saliency of

intervention) (item 9) were the least reported learning processes, with 50%, 49% and 36% respectively of studies reporting these items.

Seven articles reported all items of the TIDieR checklist: (Lyon et al, 2007; Cherney et al., 2008; Panton & Marshall, 2008; Morris et al., 2011; Sickert et al., 2014; Blom Johansson et al., 2013; Weill-Chounlamountry et al., 2013). These articles include intervention studies, case studies and a controlled trial. The controlled trial, however, did not outline all the items of the TIDieR checklist for both arms of the trial, with the ‘standard therapy’ being described as ‘guided by standard aphasia treatment focusing on training specific deficits examples’ (Sickert et al., 2014 p.52).

Some studies directed the reader to relevant articles where additional information on the interventions could be obtained, such as: Laska (2011), Stark (2010), Rodriquez et al. (2013), Jungblut et al. (2009), Ruitier, (2010), Stahl et al. (2013) and Godecke (2012). Edmonds et al. (2014) and Beeson et al. (2010), who provided additional intervention information, such as the protocol and/or word lists in the appendices of the article.