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Accessible healthcare
106
ACQ
Volume 12, Number 3 2010
ACQ
uiring knowledge in speech, language and hearing
This article
has been
peer-
reviewed
Keywords
COMMUNICATION
ACCESSIBILITY
COMMUNICATION
DISABILITY
COMMUNICATIVE
ENVIRONMENT
HOSPITALS
Robyn
O’Halloran
about their health and this may compromise their immediate
healthcare and their long-term health outcomes. For
example, people with hearing impairment (Hines, 2000;
Iezzoni, O’Day, Killeen, & Harker, 2004), vision impairment
(O’Day, Killeen, & Iezzoni, 2004), complex communication
needs (Balandin, Hemsley, Sigafoos, & Green, 2007),
developmental disability (Iacono & Davis, 2003), aphasia
(Parr, Byng, Gilpin, & Ireland, 1997), and people who
experience temporary communication difficulties, such as
patients in intensive care units (Schou & Egerod, 2008),
have described having difficulty communicating with their
healthcare providers in a range of different healthcare
settings. Difficulty communicating with healthcare providers
can result in serious consequences for people with
communication disabilities, such as getting misdiagnosed
(Hines, 2000), and becoming emotionally distressed (Schou
& Egerod, 2008). Other consequences include being unable
to get basic healthcare needs met such as getting a drink or
getting help to go to the toilet (Iacono & Davis, 2003), having
difficulty following instructions during radiological procedures
(Moelker, Maas, & Pattynama, 2004), or having difficulty
reading the healthcare information they are given (Nzegwu,
2004). It is not surprising that recent studies have found that
people with communication disabilities are among those who
are at greatest risk of preventable adverse events in hospital,
such as an adverse drug reaction or hospital incurred injury
(Bartlett, Blais, Tamblyn, Clermont, & MacGibbon, 2008),
and are less satisfied overall with the healthcare they receive
(Hoffman et al., 2005).
One way speech pathologists and audiologists are
beginning to address these problems experienced by
people with communication disabilities is by helping to
create healthcare environments that are more accessible for
people with communication disabilities. The World Health
Organization’s
International Classification of Functioning,
Disability and Health
(ICF; World Health Organization, 2001)
defines the environment as a person’s immediate physical,
social, and attitudinal environment, as well as his or her
broader social environment, including the informal and formal
systems, services, laws, and ideologies of his or her society
(World Health Organization, 2001). Thus, the ICF suggests
that a communicatively accessible healthcare environment
encompasses the physical environment of the healthcare
setting, as well as the skills, knowledge and attitudes of
healthcare providers and the informal and formal systems
of the healthcare setting, such as the institution’s policies
and procedures. All these aspects of the environment may
People need to be able to communicate
effectively with their healthcare providers and
access information about their health
condition/s in a range of different ways in
order to participate in their own healthcare.
People with communication disabilities are at
risk of not being able to communicate with
their healthcare providers or to access the
information they need and this places them at
greater risk of poorer health outcomes. One
way speech pathologists and audiologists can
support people with communication
disabilities is by creating communicatively
accessible healthcare environments. The
articles in this issue of
ACQuiring Knowledge
in Speech, Language and Hearing
indicate
that creating communicatively accessible
healthcare environments requires
administrative support, ongoing research,
personal commitment, and a long-term
perspective.
A
person’s ability to communicate effectively about
his or her health is inextricably linked to his or
her overall health and well-being (Roter & Hall,
2006). The ability to communicate about health includes
how well a person can communicate directly with his or
her healthcare providers. This is associated with a range
of positive health outcomes such as enhanced patient
satisfaction with healthcare, greater patient compliance with
medical recommendations and increased adherence to
medication schedules, and with specific health outcomes
such as better emotional health, symptom resolution and
greater pain control for some health conditions (Roter & Hall,
2006). The ability to communicate about health also refers
to a person’s ability to seek out, understand and evaluate
information about a particular health condition from a range
of sources such as written information, the internet, and/or
health-related education groups. Health communication also
consists of the ability to understand health-related messages
delivered through the media (Wright, Sparks, & O’Hair,
2008).
Many people with different types of communication
disabilities experience difficulty communicating effectively
Communication
accessibility in
healthcare settings
Robyn O’Halloran