Face mask use in healthcare settings: effects on communication, cognition, listening effort and strategies for amelioration

Aim: To investigate mask use and the difficulties it may pose during communication in healthcare settings. Methods: A survey utilizing a series of Likert scales was administered. Mask use challenges between clinicians and their patients were examined in the domains of communication, listening effort, cognition, and rehabilitation. Results: Across 243 participants, mask use significantly increased listening effort, with hearing loss having an additive effect on listening effort. Listening effort was also significantly associated with more trouble understanding conversation, decreased interest in conversation, more difficulty connecting with patients, changes in cognition for both providers and patients, and changes in the clinical efficiency of providers. Hearing loss had an additive effect for trouble understanding conversations and changes in clinical efficiency. Conclusion: These results provide information about the clinical strain introduced from mask use in healthcare settings. Overall, results show that in healthcare settings there is increased cognitive load and listening effort for both patients and providers, as well as changes in clinical efficiency for providers when utilizing masks. These effects are often greater with hearing loss. Results showed that patients reported written and visual instructions would be most beneficial to include in appointments among the other rehabilitative strategies which are discussed.