口罩會影響醫病溝通嗎？相關文獻回顧

Do Masks Affect Provider-Patient Communication? A Review of Relevant Literature

鄭臻貞(Chen-chen Cheng) ； 蔡子培(Tzu-pei Tsai)

《台灣聽力語言學會雜誌》 45期 (2021/12) Pp. 77-98

https://doi.org/10.6143/JSLHAT.202112_(45).0005

摘要

新型冠狀病毒疫情肆虐，研究顯示口罩可以有效阻斷病毒傳播。國際公衛組織建議在公共場所戴上口罩，各國政府也頒布口罩規定。由於普遍戴上口罩是歐美最近的日常，聽力語言學者及醫護相關人員對於口罩是否會影響溝通的研究很有興趣，在2020～2021年之間發表的相關研究數量大增。在台灣，口罩早已經是生活必需品，不過對口罩和溝通的研究不多，現在正是借鏡其他國家相關研究的好時機，來反思國內醫護人員在配戴口罩的情況下如何透過良好溝通，與病患建立正面關係。本文首先回顧13篇國外對於口罩和口語溝通相關研究，以研究設計類別分成3組，一是由聆聽者複述或打字出研究者播放有無口罩及有無噪音情況下的詞彙或句子錄音檔，比較不同錄音情況的言語清晰度；二是分析戴上口罩和沒有口罩時製作的錄音檔的聲學資料；三是自陳的問卷調查，利用嗓音量表或自製問卷詢問醫療人員是否在疫情期間察覺到嗓音問題。接著，我們回顧5篇醫療人員或是病患對於配戴口罩意義方面的研究結果，瞭解配戴口罩這件事在不同的社會文化裡代表的意義，以及意義改變的過程，以反映出口罩對醫病關係的影響。最後，我們運用擴大及替代溝通理論，提出具體溝通策略，讓醫療人員即使戴著口罩，也可提升與病患的溝通效能。

關鍵字

口罩 ； 新冠病毒 ； 醫病溝通 ； 醫病關係 ； 擴大及替代溝通（AAC）

並列摘要

The coronavirus disease 2019 (COVID-19) pandemic is raging globally and mask wearing has been proven effective to prevent the spread of the virus to a certain degree. International public health organizations have recommended people wear masks in public, prompting governments around the world to issue mask mandates. Universal mask wearing has become the new normal in most western countries. This new phenomenon of masking is of great interest of scholars from the speech language pathology, audiology, and other medically related fields as donning a mask presumably would interfere with verbal and nonverbal communication. During 2020-2021, a large number of studies on mask and communication have been published. In Taiwan, while masks are part of our daily necessities even before the pandemic, studies on how masks affect communication remain scarce. It is high time that we reviewed what scholars outside Taiwan have found so we can reflect on how masked medical professional can better communicate and build rapport with their patients. We first reviewed 13 studies on mask and verbal communication that were divided into 3 groups according to their research design. The first group are studies with listeners repeating or typing single words or sentences from the audio recordings made with speakers with masks, with no masks, in noise or in quiet to compare the listener's speech reception in different situations. The second group is studies of acoustic analyses of the recordings made with speakers wearing masks, with no masks, in noise or in quiet. The third group is self-reported perception survey about mask users' voice conditions in the time of pandemic. Next, we reviewed 5 articles on the change of social and cultural meanings of masks to understand how masks play a part in medical professional-patient communication and relationships. Lastly, we offer medical professionals practical communication strategies based on augmentative and alternative communication principles so they can communicate with their patients when they need to wear masks.

並列關鍵字

Mask ； COVID-19 ； Provider-patient communication ； Doctor-patient rapport building ； Augmentative and alternative communication (AAC)

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