ACQ Vol 12 No 3 2010

Accessible healthcare

Communication accessibility in healthcare settings Robyn O’Halloran

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

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

This article has been peer- reviewed Keywords COMMUNICATION ACCESSIBILITY COMMUNICATION DISABILITY COMMUNICATIVE ENVIRONMENT HOSPITALS

Robyn O’Halloran

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ACQ Volume 12, Number 3 2010

ACQ uiring knowledge in speech, language and hearing