title: Improving communication in the primary care setting: perspectives of patients with speech disabilities.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA, morris.megan@mayo.edu.
authors.forename: Megan A
authors.initials: MA
authors.lastname: Morris
authors.forename: Kathryn
authors.initials: K
authors.lastname: Yorkston
authors.forename: Marla L
authors.initials: ML
authors.lastname: Clayman
mesh_terms: D000328:Adult; D000368:Aged; D003142:Communication; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009633:Nonverbal Communication; D011320:Primary Health Care; D011369:Professional-Patient Relations; D012720:Severity of Illness Index; D013064:Speech Disorders / Q000523:psychology*