title: The role of the physical environment in conversations between people who are communication vulnerable and health-care professionals: a scoping review.
abstract: OBJECTIVE
  The role of the physical environment in communication between health-care professionals and persons with communication problems is a neglected area. This study provides an overview of factors in the physical environment that play a role in communication during conversations between people who are communication vulnerable and health-care professionals.
  
  
  METHODS
  A scoping review was conducted using the methodological framework of Arksey and O'Malley. The PubMed, PsycINFO, CINAHL and Cochrane Library databases were screened, and a descriptive and thematic analysis was completed.
  
  
  RESULTS
  Sixteen publications were included. Six factors in the physical environment play a role in conversations between people who are communication vulnerable and health-care professionals: (1) lighting, (2) acoustic environment, (3) humidity and temperature, (4) setting and furniture placement, (5) written information, and (6) availability of augmentative and alternative communication (AAC) tools. These factors indicated barriers and strategies related to the quality of these conversations.
  
  
  CONCLUSIONS
  Relatively small and simple strategies to adjust the physical environment (such as adequate lighting, quiet environment, providing pen and paper) can support people who are communication vulnerable to be more involved in conversations. It is recommended that health-care professionals have an overall awareness of the potential influence of environmental elements on conversations. Implications for rehabilitation The physical environment is an important feature in the success or disturbance of communication. Small adjustments to the physical environment in rehabilitation can contribute to a communication-friendly environment for conversations with people who are communication vulnerable. Professionals should consider adjustments with regard to the following factors in the physical environment during conversations with people who are communication vulnerable: lighting, acoustic environment, humidity and temperature, setting and furniture placement, written information, and availability of AAC (augmentative and alternative communication tools).
authors.affiliation: a Faculty of Health , Zuyd University of Applied Sciences , Heerlen , the Netherlands.|b Research School CAPHRI, Maastricht University , Maastricht , the Netherlands.
authors.forename: Steffy E A
authors.initials: SEA
authors.lastname: Stans
authors.affiliation: a Faculty of Health , Zuyd University of Applied Sciences , Heerlen , the Netherlands.
authors.forename: Ruth J P
authors.initials: RJP
authors.lastname: Dalemans
authors.affiliation: a Faculty of Health , Zuyd University of Applied Sciences , Heerlen , the Netherlands.|b Research School CAPHRI, Maastricht University , Maastricht , the Netherlands.
authors.forename: Luc P
authors.initials: LP
authors.lastname: de Witte
authors.affiliation: a Faculty of Health , Zuyd University of Applied Sciences , Heerlen , the Netherlands.
authors.forename: Hester W H
authors.initials: HWH
authors.lastname: Smeets
authors.affiliation: a Faculty of Health , Zuyd University of Applied Sciences , Heerlen , the Netherlands.|b Research School CAPHRI, Maastricht University , Maastricht , the Netherlands.
authors.forename: Anna J
authors.initials: AJ
authors.lastname: Beurskens
mesh_terms: D003144:Communication Barriers; D004777:Environment; D006801:Humans; D011369:Professional-Patient Relations; D000066768:Rehabilitation Research
keywords: Communication; conversations; neurological disorders; physical environment