How Face Masks Affect Communication in a Healthcare Setting

The Eyes Have It – How Face Masks Affect Communication in a Healthcare Setting

“The first time I wore a mask at work I was surprised by how isolated it made me feel. There was a whole new language to learn in order to communicate effectively with patients and colleagues.”

The use of face coverings in the UK is now required in all indoor public spaces, and in domestic environments where social distancing is required, but not possible. Since the beginning of June, face coverings have also been mandated in healthcare settings. All healthcare professionals, patients, auxiliary workers and visitors are now need to wear a mask, or face covering unless exempted.


Key Features of Effective Communication in a Healthcare Setting

No doubt the next few years will produce countless studies into how face masks affect communication in a healthcare setting. For the present though, the evidence remains anecdotal and sketchy as we’re all still learning to adapt our ‘pre-mask’ communication strategies.

Healthcare professionals depend, more than most, on effective oral communication because without it a patient’s recovery can be compromised. Accurate diagnosis, and clear medical instructions are vital to successful care, and are often determined by verbal interactions.  There are 5 key components required to achieve clear oral communication:

  1. Attention. Healthcare interactions often occur in a busy environment. Gaining the attention of your patient prior to speaking is key to effective communication.
  2. Vocal Projection. Hospital, or care home wards can have a good deal of background noise going on. A projected, or focused voice, helps the patent to hear clearly.
  3. Eye Contact. Using regular eye contact signals that the patient has your full attention and that their participation in the conversation is important.
  4. Mouth Movements. Most communication involves the observation of mouth movements, whether or not the patient suffers from hearing loss.
  5. Tempo. The speed at which information is relayed will determine the amount of information that is retained – especially if it is new information, or includes unfamiliar words.

“Everyone has more difficulty hearing you when you wear a mask, and that makes communication more tiring. It really is exhausting making the adjustments.”

Adjusting to a New Communications Reality

The LDA Research team has been talking to nurses, professional carers and an occupational therapist to find out how they are coping with adapting their communication strategies to the new normal. Most of them talk about how tiring the process of communication becomes, when you take away the old shortcuts. All of them have experienced a range of colleague responses to the problems encountered:

“Lots of colleagues immediately started to adapt the way they were communicating. Others haven’t shifted at all, which makes it difficult for everyone – including patients who tend to get embarrassed about having to keep asking for stuff to be repeated. So they just give up.”

6 Tips for Effective Communication

Everyone we spoke to was eager to share their new discoveries, and we were quickly able to put together a list of tips based on professional experience over the past 6 months:

  • Keep It Concise Listening is tiring for patients because they’re working harder than usual. Put plenty of full stops into what you’re saying. And pause between separate pieces of information.
  • Slow Down. If you can’t see the mouth of the person who’s speaking it’s harder to process what they’re saying. Speak slowly and clearly to take this into account.
  • Masks Can Be Scary. Children, or patients with autism, can feel frightened when surrounded with people in masks. Drawing a smile on can help, and silly moustaches lighten the mood.
  • Projection, Not Shouting. Shouting ‘feels’ aggressive if you’re on the receiving end. A projected voice is better. You simply focus on the recipient and direct your voice specifically to them.
  • Attention. Take care that you’ve got your patient’s attention before you start speaking. And use intermittent, regular eye contact to let them know that you’re listening carefully.
  • Gestures. Use anything that helps to clarify the communication; gestures where appropriate, pointing, or writing down unfamiliar words.

Specialist Communication

For those with hearing loss, dementia or autism, communication via a mask can be extremely difficult and disorientating. The loss of communicative anchors may lead to an increase in feelings of anxiety or alienation. At the beginning of September the UK government announced the delivery of 250,000 transparent face masks in order to facilitate effective communication. Alternative specialist techniques we heard discussed include the use of written communications, or an alphabet chart.


About LDA Research

LDA Research was set up in 2011 by Lucy Doorbar. The close-knit, core team now works with a global network of trusted associates. LDA carries out qualitative research for medical and pharmaceutical clients, medical comms agencies, health market research agencies, management consultants and advertising agencies.


When it comes to fieldwork, the LDA Reasearch team is made up of experts in the provision of pharmaceutical and medical qualitative research. Give us a call to find out more – 01525 861436