Masked: study highlights communication awareness

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Closeup of young woman doctor with gloves puts on medical mask.

Face masks are making it harder to communicate – especially with pharmacists, doctors and nurses, a study shows

A new study by researchers from the University of Manchester has found that masks, despite being a key tool in the fight against the spread of COVID-19, have some drawbacks.

Their use has “far-reaching” impacts on everyone, the researchers concluded, but particularly people with hearing loss.

However, the researchers acknowledge that “the benefit of face coverings in reducing particle spread and thus virus transmission has been established” and say their findings show a need for communication-friendly face coverings, and the need to be aware of how we communicate when wearing them.

The researchers recruited 460 members of the general public for the study, intentionally over-sampling people with hearing loss.

The study was conducted earlier this year, when wearing masks in public was becoming common in the UK, but was not yet mandatory.

At the time the survey was completed, 62% of participants had encountered a situation in which they had worn a face covering while communicating.

“With few exceptions, participants reported that face coverings negatively impacted hearing, understanding, engagement, and feelings of connection with the speaker,” they found.

“Impacts were greatest when communicating in medical situations.

“People with hearing loss were significantly more impacted than those without hearing loss.

“Face coverings impacted communication content, interpersonal connectedness, and willingness to engage in conversation; they increased anxiety and stress, and made communication fatiguing, frustrating and embarrassing – both as a speaker wearing a face covering, and when listening to someone else who is wearing one.”

The researchers noted that various types of mask can damp sound to differing degrees, as well as removing visible cues for speechreading and blocking facial expressions.

They also cited one study which showed that, “About 60% reported that they had misheard or misinterpreted information during a medical appointment because of their hearing loss”.

Pharmacists were found to be harder to hear by most people, as well as harder to understand; as were doctors and workers at hospital appointments.

“A comparison of the red bars across listening situations suggests that the negative impacts of face coverings are greater when communicating in medical situations (doctor, pharmacist, hospital visits) than when communicating with family/friends, shop assistants and at work,” the researchers said.

Sixty per cent of them said they communicated differently as a result of wearing a face covering, and 46% said the nature of the conversation had differed, with a further 17% and 25% respectively saying ‘maybe’.

“Although face coverings are an essential weapons in the fight to contain Covid-19, we were surprised by the depth of feeling they generated,” said Principal Investigator Dr Gabrielle H. Saunders, a Senior Research Fellow at The University of Manchester

“It was clear that though the problems associated with face coverings were particularly relevant to people with hearing loss, people without hearing loss were also affected.”

Over time, the researchers hope some of the problems people reported in the study, like feeling socially awkward, embarrassed and unsure how to cope, will decrease as people adjust to wearing face coverings.

Dr Saunders added: “Already many individuals said they used gestures, facial expressions and their eyes to enhance communication when they were wearing a face covering.

“This perhaps suggests with guidance and instruction, non-verbal cues might help us to improve the way we communicate while wearing a mask.

“But there is no doubt these findings represent a call to action to acousticians and industrial designers to develop communication-friendly face coverings, to healthcare providers to ensure they address the communication needs of their patients, and to the public to use good communication tactics.”

The study is published in the International Journal of Audiology.

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