JCPSLP Vol 21 No 3 2019

categorisation included dementia and cognitive change without physical impairment, functional decline related to physical +/– cognitive decline and medical included any other acute illness. Patients requiring assistance to communicate were identified in all diagnoses. Self-perceived communication abilities were not a reliable indicator of successful participation in health care conversations. Of the patients scored as independent, 3 out of 31 felt that they needed assistance. Of the patients scored as needing assistance, 20 rated themselves as having no difficulty, 17 felt they needed support and 8 were

Overall 38.2% of patients screened were identified as benefiting from a speech pathology referral. This was based on the clinical judgement of a speech pathologist that there was a need for further assessment or an identifiable rehabilitation goal. Data was not collected on the number of referrals currently in place. Cognitive change was the most prevalent communication impairment evident in 46% of the acute medical and 43% of the GEM population (see Table 2a, 2b). All participants were asked about their hearing, vision and literacy. Table 3 showed high levels of self-reported hearing and visual impairment. Literacy status was a self- reported response to the question: “Are you able to read and write in English?” All patients were categorised by admission diagnosis (see Table 4). Neurological categorisation included new stroke, TIA, TBI, and progressive neurological conditions, Cognitive

unable to answer. Discussion

Effective communication between health care providers and patients is a critical component of patient-centred care, patient safety, patient outcomes and patient satisfaction. It

Table 2a. Presence of communication impairment as per CDS scales

No impairment n (%)

Impairment n (%)

Unknown n (%)

Total n (%)

Speech impairment Acute

48 (100) 28 (100) 76 (100)

2 (4.1) 0 (0) 2 (2.6)

8 (16.7) 4 (14.3)

38 (79.2) 24 (85.7) 62 (82)

GEM Total

12 (16)

Language impairment Acute

48 (100) 28 (100) 76 (100)

6 (12.5) 0 (0) 7 (9.2)

8 (16.7) 2 (7.1) 10 (13.2)

34 (70.8) 26 (92.9) 60 (78.9)

GEM Total

Cognitive impairment Acute

48 (100) 28 (100) 76 (100)

7 (14.6) 1 (3.6) 8 (10.5)

22 (45.8) 11 (39.3) 33 (43.4)

19 (39.6) 16 (57.1) 35 (46.1)

GEM cognitive impairment Total

Table 2b. Severity of communication impairment as per CDS scales *

Acute (n = 48)

GEM (n = 28)

Total (n = 76)

Mild n

Moderate n Severe n

Mild n

Moderate n Severe n

n

Speech impairment

5

1

2

3

1

0

12

Language impairment

7

1

0

1

0

0

9

Cognitive impairment

14

7

1

4

3

4

33

*an individual patient may present with all three impairments.

Table 3. Self-reported hearing, vision and English literacy status

Reported difficulty n (%)

Unknown n (%)

Total n (%)

No reported difficulty n (% )

Hearing impairment Acute

48 (100) 28 (100) 76 (100)

5 (10.4) 0 (0) 5 (6.6)

14 (29.2) 14 (50) 28 (36.8)

29 (60.4) 14 (50) 43 (56.6)

GEM Total

Vision impairment Acute

48 (100) 28 (100) 76 (100)

4 (8.3) 0 (0) 4 (5.2)

32 (66.7) 22 (78.6) 54 (71.1)

12 (25)

6 (21.4) 18 (23.7)

GEM Total

Literacy (English) Acute

48 (100) 28 (100) 76 (100)

4 (8.3) 0 (0) 4 (5.2)

3 (6.3) 2 (7.1) 5 (6.6)

41 (85.4) 26 (92.9) 67 (88.2)

GEM Total

151

JCPSLP Volume 21, Number 3 2019

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