Abstract
Background
Patients with speech disabilities can present with challenges when communicating during primary-care clinical encounters. Little is known about the healthcare communication experiences of patients with severe speech disabilities.
Methods
Twelve participants took part in open-ended, in-person interviews. All participants had either acquired or developmental, severe speech disabilities but were not limited by cognitive and language disabilities. A multi-disciplinary team conducted a thematic analysis that included reading the transcripts and then developing and applying a list of codes through consensus.
Results
Participants discussed provider behaviors that affected communication during clinical encounters. They wanted providers to acknowledge their competence by speaking directly to them and using age-appropriate language. Additionally, participants appreciated when providers adapted to their communication style by maintaining eye contact, asking the patient how to best communicate with them, providing time for the patient to communicate, not interrupting the patient, and admitting when they do not understand the patient.
Conclusion
Primary-care providers need to be cognizant of the communication needs of patients with communication disabilities. While the needs might be similar to other patient populations, patients with communication disabilities present with unique challenges. With accommodations, patients with speech disabilities can potentially be more engaged in their healthcare conversations.
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Acknowledgements
The authors would like to thank Drs. Sharan Brown, Kurt Johnson, and Brian Dudgeon for their guidance and assistance throughout the project, Anjali Truitt for her detailed coding of the data, and finally the participants for sharing their stories and insights with us.
Megan Morris and Kathryn Yorkston contributed to the study concept, design and data collection. All authors, Megan Morris, Kathryn Yorkston, and Marla Clayman, contributed to data analysis, interpretation and manuscript preparation and review. Megan Morris will act as the overall guarantor of this manuscript.
Conflict of interest statement
To the best of our knowledge, none of the authors have any conflicts of interest, financial or otherwise.
Grant Support
This work was supported by NIH (NICHD) Training Grant (T32HD007424).
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Morris, M.A., Yorkston, K. & Clayman, M.L. Improving Communication in the Primary Care Setting: Perspectives of Patients with Speech Disabilities. Patient 7, 397–401 (2014). https://doi.org/10.1007/s40271-014-0067-y
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DOI: https://doi.org/10.1007/s40271-014-0067-y