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Assessment and Communication for People with Disorders of Consciousness
Published on: August 1, 2017
Communication needs and support for children and adolescents with complex communication needs requiring
Lucia Tsang1, Lorinda Lam1, Elaine Siu1
1Department of Health, Hong Kong SAR Government, Kowloon, Hong Kong, China.
Insights
Hospitalized children with complex communication needs often have unmet needs due to communication barriers. Improving communication requires system-level changes in healthcare, education, and community support.
Area of Science:
- Pediatric Healthcare
- Communication Sciences
- Health Systems Research
Background:
- Children with complex communication needs (CCN) experience significant challenges during hospitalization.
- Effective communication is crucial for addressing the physical and emotional needs of hospitalized children.
Purpose of the Study:
- To investigate the communication challenges faced by hospitalized Hong Kong Chinese children with CCN.
- To identify barriers and facilitators for effective communication in pediatric hospital settings.
Main Methods:
- Conducted six group interviews with 23 participants.
- Participants included healthcare providers, parents, adolescents with acquired brain injury, and community therapists.
Main Results:
- Parents and children reported unmet needs stemming from communication difficulties.
- Healthcare providers perceived direct child communication as non-essential, relying on parental proxies.
- Parental interaction styles and hospital environments limited direct child-provider communication opportunities.
Conclusions:
- Systemic changes are needed in healthcare, education, and community sectors to improve communication.
- Recommendations include empowering children and parents, implementing communication protocols and tools, allocating staff time, providing training, and enhancing community collaboration.
Purpose:
Children with complex communication needs face particular challenges during hospitalization. This study aimed to understand the situation for hospitalized Hong Kong Chinese children with complex communication needs.
Methods:
Six group interviews were conducted with 23 participants, including nurses, doctors, adolescents with acquired brain injury, parents of children with acquired brain injury or cerebral palsy, and community-based therapists.
Results:
Parents and children reported unmet physical and emotional needs due to lack of communication. Healthcare providers felt that direct communication with children was not essential, expecting that parents serve as proxy in conveying needs. The passive interaction mode of Chinese parents, and their increased vigilance in protecting their children, further reduced opportunities for direct child-healthcare provider interaction. Limited patient communication protocols were reported, while tight hospital space discouraged bedside communication activities and tools. Community therapists who knew these children were not involved in pre-admission handover.
Conclusion:
To address the communication barriers, changes in the healthcare, education, and community systems are proposed. Empowerment of the children and parents to promote direct patient-healthcare provider communication, dissemination of simple protocols and bedside communication tools, time allowance for staff to interact with the children, pre-/in-service staff training, and collaboration with community healthcare providers are recommended.
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