Abstract Background and aims Shared decision-making is a collaborative, person-centred process that integrates research evidence, clinician expertise, and client preferences. Aphasia, often resulting from a cerebrovascular accident (CVA), can hinder participation in this process. However, existing research on shared decision-making involving persons with aphasia after a CVA is limited and fragmented, highlighting the need for a synthesis of current knowledge. Methods The review followed the Arksey and O’Malley framework and the PRISMA-ScR reporting guidelines. Five electronic databases (PubMed, EBSCOhost, Web of Science, SCOPUS, and Taylor and Francis) were searched for studies published between 2000 and 2025. Data was then charted and analysed thematically. A stakeholder consultation with persons with aphasia themselves, as well as speech-language therapists, was conducted to socially validate the findings. Results A total of 15 sources of evidence were included. The findings reveal that persons with aphasia can make informed decisions and participate in shared decision-making after a stroke if provided with appropriate strategies and supports. However, the predominance of clinician-led decision-making and the exclusion of persons with aphasia from involvement in shared decision-making processes is still evident. This exclusion is evident across all clinical contexts in which persons with aphasia interact and is particularly exacerbated in acute and subacute healthcare settings. Conclusions Persons with aphasia are notably excluded from shared decision-making after a stroke. As such, the use of communication supports and a person-centred approach is imperative in allowing persons with aphasia to be involved in processes pertaining to their healthcare, such as shared decision-making. Conflict of interest Bahale Mehale: nothing to disclose
Bahale Mehale (Fri,) studied this question.