Quantifying the effect of personal protective equipment on speech understanding

Malin, Alexander; Dooley, Andrew; Garvey, Grainne

doi:10.1016/j.bja.2021.08.005

Cited by 2 publications

(3 citation statements)

References 9 publications

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“…Similarly, the surgical mask, FFP3, and FFP3 masks plus face shield all significantly worsened speech intelligibility from the no-PPE condition and from each other (Malin et al, 2021).…”

Section: Other Face Mask Typesmentioning

confidence: 83%

“…A subgroup analysis indicated that hard‐of‐hearing participants had significantly worse hearing with surgical and N95 facemasks compared to normal‐hearing participants and that female speakers in N95 masks resulted in significantly lower word recognition for both the normal‐ and hard‐of‐hearing groups. Similarly, the surgical mask, FFP3, and FFP3 masks plus face shield all significantly worsened speech intelligibility from the no‐PPE condition and from each other (Malin et al., 2021).…”

Section: Resultsmentioning

confidence: 98%

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Best practices for communication while wearing facemasks: A scoping review

Shaw,

Lee,

Williams

et al. 2023

J of Nursing Scholarship

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IntroductionFacemasks are an important piece of personal protective equipment (PPE) to mitigate the spread of respiratory illnesses, but they can impede communication between patients and healthcare providers. The purpose of this scoping review is to identify effective communication practices while wearing facemasks.DesignScoping review using a systematic search of articles from the PubMed, CINAHL, and Embase databases.MethodsThe PEO (population, exposure, outcome) methodology was selected for this systematic scoping review. The population of interest (P) includes humans of all ages (children, adults, and older adults); the exposure of interest (E) is PPE that covers the mouth (i.e., facemasks); and the outcome of interest (O) is successful or unsuccessful communication practices. The Johns Hopkins Evidence‐Based Practice for Nurses and Healthcare Professionals appraisal guidelines were used to determine the level and quality of the research.ResultsThirty‐nine articles met the inclusion criteria. Seventeen of these were high‐ or good‐quality research studies, and the remaining 22 were non‐research articles included with separate analysis as part of the scoping review. The 17 articles encompassed 2656 participants. The highest quality evidence indicated that standard surgical masks have the least impact on speech perception compared to other non‐transparent mask types, and that recognizing emotions is less accurate with facemasks, necessitating compensatory actions (i.e., reducing extraneous noise, using a microphone to amplify voice, and employing clear speech). Evidence was contradictory regarding the use of transparent masks. Evidence was of limited quality for other non‐verbal and verbal communication strategies.ConclusionAwareness of communication challenges is crucial when wearing facemasks. More high‐quality studies are needed to evaluate communication techniques when speakers are wearing facemasks. Basic strategies such as selecting an appropriate mask type, reducing extraneous noise, using microphones, verbalizing emotions, and employing clear speech appear to be beneficial.Clinical RelevanceThe findings of this scoping review highlight the importance of considering communication challenges while wearing facemasks in the healthcare settings. The review suggests that selecting an appropriate mask type, reducing extraneous noise, verbalizing emotions, and employing clear speech are some strategies that may be effective in mitigating the impact of facemasks on communication between patients and healthcare providers.

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“…Similarly, the surgical mask, FFP3, and FFP3 masks plus face shield all significantly worsened speech intelligibility from the no-PPE condition and from each other (Malin et al, 2021).…”

Section: Other Face Mask Typesmentioning

confidence: 83%

Section: Resultsmentioning

confidence: 98%

Best practices for communication while wearing facemasks: A scoping review

Shaw,

Lee,

Williams

et al. 2023

J of Nursing Scholarship

View full text Add to dashboard Cite

show abstract

“…This effect increases with greater levels of protective wear (on the head/face) in healthcare settings (Bandaru et al, 2020; Hampton et al, 2020; Malin et al, 2021). The negative impacts of masks on communication may be especially impactful in health care, wherein communication between provider and patient is required to relay essential information and maintain rapport.…”

mentioning

confidence: 99%

Mask wearing during neuropsychological assessment negatively impacts performance on verbal tests in older patients.

Thomas,

Tranel

2023

Psychological Assessment

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Face masks are recommended to minimize the spread of COVID-19 and are required in many health care settings. Although masks have documented health advantages, they also negatively impact communication, an essential element of clinical neuropsychological assessment. Using a large clinical data set from a major academic medical center, we investigated the effect of mask wearing on neuropsychological test performance. Specifically, we examined performance on eight standard, widely used neuropsychological tests between a prepandemic (unmasked) and postpandemic (masked) group, composed of 754 and 837 adult patients, respectively. We compared performance on verbally mediated versus visually mediated tests, hypothesizing that the postpandemic group, compared to the prepandemic group, would perform significantly lower on the verbally mediated tests but not on the visually mediated tests. In partial support of the hypothesis, we found that the postpandemic group performed significantly worse on the Auditory Verbal Learning Test (AVLT; p = .001). Secondary analyses showed that age moderated the mask-related effect ( p = .038), whereby patients 65 and older had significantly worse performance on Digit Span ( p = .0027) and the AVLT ( p = .0002) with masks on, while patients younger than 65 showed no significant differences. There were no significant differences on any visually mediated tests. These findings suggest that mask wearing during neuropsychological assessment compromises performance on verbally mediated tests in older patients. These findings are particularly relevant for neuropsychologists practicing in geriatric settings. Neuropsychologists performing assessments with masks should be aware that masks may artificially deflate patient scores for reasons unrelated to cognition or clinical condition. Public Significance StatementThis study shows that older individuals are at a disadvantage when completing verbal tasks with a mask on. It may be harder for older persons to hear clearly through masked speech, and this could interfere with their performance on mental status tests that rely on precise verbal exchange. Speaking clearly and at a higher volume could improve speech perception for this population.

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Quantifying the effect of personal protective equipment on speech understanding

Cited by 2 publications

References 9 publications

Best practices for communication while wearing facemasks: A scoping review

Best practices for communication while wearing facemasks: A scoping review

Mask wearing during neuropsychological assessment negatively impacts performance on verbal tests in older patients.

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