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为沟通障碍患者提供的精神卫生保健服务:豪登省精神卫生专业人员的经验

Mental Healthcare Services for Persons With Communication Disorders: Experiences of Mental Health Professionals in Gauteng.

作者信息

Masuku Khetsiwe, Zuma Luyanda

机构信息

Department of Speech Pathology, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

Int J Lang Commun Disord. 2025 Sep-Oct;60(5):e70101. doi: 10.1111/1460-6984.70101.

Abstract

BACKGROUND

Persons with communication disorders are susceptible to mental health difficulties and often require the help of mental healthcare professionals. Mental healthcare interventions require a significant amount of communication between the mental healthcare professional and the person with communication disorders, yet not much is known about how mental healthcare professionals provide mental healthcare services to persons with communication disorders. The study, therefore, aims to explore the experiences of mental healthcare professionals in providing mental healthcare services to persons with communication disorders.

METHODS

A qualitative phenomenological research approach was employed, where 11 semi-structured interviews were conducted with mental healthcare professionals practising in the Gauteng Province of South Africa (n = 7 social workers; n = 3 psychologists; n = 1 counsellor). Participants were purposively selected for the study. Data were analysed using inductive reflexive thematic analysis.

RESULTS

The following four themes emerged from the data that were analysed: (i) lack of preparedness to provide care to persons with communication disorders, (ii) communication barriers, (iii) emotional effects and (iv) accommodations.

CONCLUSIONS

Findings suggest that communication barriers are a source of frustration, and they hinder persons with communication disorders from accessing quality mental healthcare services. There is therefore a need to include in the curriculum of mental healthcare professionals, training on communication disorders and on strategies to foster communication with this population during intervention. Conversational partner training and collaborations between mental healthcare professionals and speech language therapists could potentially be used to address the communication barriers in mental healthcare provision for persons with communication disorders.

WHAT THIS PAPER ADDS

What is already known on this subject Persons with communication disorders are susceptible to mental health difficulties because the communication impairment reduces their societal and economic inclusivity, thus placing them at a higher risk of developing mental health challenges. Unfortunately access to quality mental healthcare services is a challenge for this population for many reasons, with the most pronounced one being the fact that they do not depend on verbal language to communicate their needs (are voiceless) and require reasonable accommodation to facilitate communication, yet the techniques and methods used in mental healthcare intervention whether formal or informal are predominantly based on verbal communication. What this paper adds to existing knowledge The study advocates for the implementation of educational opportunities for mental healthcare providers through communication/conversational partner training programmes. These programmes can potentially improve their knowledge and skills on how to effectively support communication with persons with communication disorders, to mitigate communication challenges. Research has demonstrated positive effects of communication partner training. Speech language therapists, as communication brokers due to their expertise in facilitating communication, should be at the centre of developing such training programmes. Speech language therapists should also foster collaborations with mental healthcare professionals in clinical spaces when treating persons with communication disorders. What are the potential or actual clinical implications of this work? The lack of knowledge on communication disorders and the subsequent lack of knowledge and skills on appropriate communication strategies to implement when conducting mental healthcare interventions with persons with communication disorders compromises patient care and subjects persons with communication disorders to continuous substandard patient care, which is essentially an infringement on their right to healthcare. It is common knowledge that communication forms the cornerstone of all healthcare interventions, and where there are communication barriers between healthcare providers and their patients, healthcare provision becomes unsuccessful, resulting in negative patient outcomes. The study offers a potential solution to these communication challenges.

摘要

背景

有沟通障碍的人易出现心理健康问题,且常常需要精神卫生保健专业人员的帮助。精神卫生保健干预需要精神卫生保健专业人员与有沟通障碍的人之间进行大量沟通,然而,对于精神卫生保健专业人员如何为有沟通障碍的人提供精神卫生保健服务,我们了解得并不多。因此,本研究旨在探讨精神卫生保健专业人员为有沟通障碍的人提供精神卫生保健服务的经历。

方法

采用定性现象学研究方法,对在南非豪登省执业的精神卫生保健专业人员进行了11次半结构式访谈(7名社会工作者、3名心理学家、1名咨询师)。研究对象是经过有目的选择的。采用归纳反思性主题分析法对数据进行分析。

结果

分析数据后出现了以下四个主题:(i)为有沟通障碍的人提供护理的准备不足,(ii)沟通障碍,(iii)情感影响,(iv)适应性调整。

结论

研究结果表明,沟通障碍是令人沮丧的根源,它们阻碍有沟通障碍的人获得高质量的精神卫生保健服务。因此,有必要在精神卫生保健专业人员的课程中纳入关于沟通障碍以及在干预期间促进与这一人群沟通的策略的培训。对话伙伴培训以及精神卫生保健专业人员与言语语言治疗师之间的合作可能有助于解决为有沟通障碍的人提供精神卫生保健时的沟通障碍问题。

本文补充内容

关于该主题的已有知识 有沟通障碍的人易出现心理健康问题,因为沟通障碍会降低他们在社会和经济方面的包容性,从而使他们面临更高的心理健康挑战风险。不幸的是,由于多种原因,这一人群获得高质量精神卫生保健服务面临挑战,最突出的一点是他们不依赖口头语言来表达需求(无声音),需要合理的调整来促进沟通,然而精神卫生保健干预中使用的技术和方法,无论是正式的还是非正式的,主要都基于口头沟通。本文对现有知识的补充 该研究主张通过沟通/对话伙伴培训项目为精神卫生保健提供者提供教育机会。这些项目有可能提高他们在如何有效支持与有沟通障碍的人进行沟通方面的知识和技能,以减轻沟通挑战。研究已经证明了沟通伙伴培训的积极效果。言语语言治疗师作为沟通促进方面的专家,应处于制定此类培训项目的核心位置。在治疗有沟通障碍的人时,言语语言治疗师还应在临床环境中促进与精神卫生保健专业人员的合作。这项工作的潜在或实际临床意义是什么?对沟通障碍缺乏了解,以及随后在对有沟通障碍的人进行精神卫生保健干预时缺乏关于适当沟通策略的知识和技能,会损害患者护理,并使有沟通障碍的人持续接受不合格的患者护理,这实际上侵犯了他们的医疗保健权利。众所周知,沟通是所有医疗保健干预的基石,当医疗保健提供者与患者之间存在沟通障碍时,医疗保健服务就会失败,导致负面的患者结果。该研究为这些沟通挑战提供了一个潜在的解决方案。

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