title: Perceptions of communication between people with communication disability and general practice staff.
abstract: OBJECTIVE
  To explore consultation between people with communication disability and General Practice (GP) staff from the perspectives of both patients and staff.
  
  
  BACKGROUND
  Communication disability causes a particular problem in primary care. This issue has not yet been investigated from the perspective of both patients and GP staff.
  
  
  METHODS
  Eight focus groups were held - four with GP practices, two with people with intellectual disability and two with people who had had a stroke. Picture symbols and Talking Mats, a visual communication framework, were used to assist the participants with communication disability. Discussions were audio recorded and analysed thematically.
  
  
  METHODS
  Twenty GP staff, 12 people with aphasia and six people with learning disability were interviewed.
  
  
  RESULTS
  GP staff expressed frustration with not being understood and not understanding but there was a lack of awareness of the reasons behind these difficulties. They all said they mainly relied on carers. They recognized the significance of poor communication in terms of access to health services and agreed that the extent of the problem was greater than they had previously believed. People with communication disability described significant problems before, during and after the consultation. Although some acknowledged that they needed help from their carer, most objected to staff speaking to the carer and not to them.
  
  
  CONCLUSIONS
  The main priorities for GP staff were the need for relevant training and simple resources. The main priorities for people with communication difficulty were continuity of staff, trust, better GP staff communication skills, and less reliance on carers.
authors.affiliation: AAC Research Unit, University of Stirling, Stirling, UK. joan.murphy@stir.ac.uk
authors.forename: Joan
authors.initials: J
authors.lastname: Murphy
mesh_terms: D003142:Communication; D005194:Family Practice; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D008503:Medical Staff; D016743:Mental Competency; D011369:Professional-Patient Relations; D012017:Referral and Consultation; D006113:United Kingdom