Environmental factors that influence communication between patients and their healthcare providers in acute hospital stroke units: an observational study

There was NO communication from my stroke doctors, nothing on how rehab and recovery would go. Nothing on what my brain damage was. NOTHING! I'd have to say this is all because there are NO protocols out there anywhere that can be used to get you recovered. Better to say nothing or just give you platitudes that hard work and exercise will get you recovered, even though your doctor knows that is false. 
http://www.tandfonline.com/doi/abs/10.3109/13682821003660380?src=recsys&journalCode=ilcd20#.WeYm5DFCUD4.twitter

Robyn O'Halloran, Linda Worrall & Louise Hickson

Pages 1-18 | Received 11 Jun 2009, Accepted 24 Jan 2010, Published online: 26 Mar 2010

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Abstract

Background: Many people have communication-related impairments when they are patients in acute hospital stroke units. One way to improve a person's ability to communicate is by providing a supportive communicative environment.
Aims: Using the World Health Organisation's (WHO) International Classification of Functioning, Disability and Health (ICF) framework, this research sought to identify the environmental factors that either create barriers to and/or facilitate communication between patients and their healthcare providers in acute hospital stroke units.
Methods & Procedures: A qualitative research methodology was used. Sixty-five patients were observed communicating with their healthcare providers in healthcare events. Interactions were transcribed and analysed to identify any environmental factors that may have influenced the interaction.
Outcomes & Results: In total, 126 environmental factors were identified, which were grouped into 89 subcategories, 28 categories, and seven overall themes. Four themes related to the healthcare provider's knowledge, communication skills, attitudes and individual characteristics. The other three themes included the presence of family, the physical environment, and hospital systems.
Conclusions & Implications: There are many environmental factors that influence communication between patients and their healthcare providers in the acute stroke unit. Removing barriers and maintaining factors that facilitate communication may contribute towards the development of communicatively accessible stroke units.

Original Article