Improving Communication with Patients with MTBI

Content Source: National Center for Injury Prevention and Control, Division of Injury Response Heads Up! Concussion Information for Physicians Centers for Disease Control and Prevention

Patients with MTBI, particularly during the early post-injury phase, may have difficulties communicating with a physician. Obtaining an accurate report from the patient about the injury and its symptoms with tools such as the ACE is critical to proper management. The following provides a summary of types of communication problems related to expression and comprehension that individuals with MTBI may experience, and what physicians can do to improve communication with their patients.

Problem Area Problem Description What Physicians Can Do
Expression
  • May have trouble thinking of specific words (wordfinding problems) or expressing the specifics of their symptoms or functional difficulties
  • Allow patients time to express themselves
  • Ask questions about specific symptoms and problems (i.e., are you having headaches?)
Comprehension Spoken:
  • May become confused if too much information is presented at once or too quickly
  • Need extra time to understand what others are saying
  • Have trouble following complex multi-step directions.
  • May take longer than expected to respond to a question
   
  • Speak slowly and clearly
  • Use short sentences
  • Allow time for patients to comprehend
  • Provide both spoken and written instructions and directions
Written:
  • Read slowly
  • Have trouble reading material in complex formats or with small print
  • Have trouble filling out forms
   
  • Allow patients extra time to read and complete forms
  • Provide written material in simple formats and large print when possible
  • For patients who have trouble filling out forms themselves, have someone read the items and fill out the forms for them

In addition to the communications problems listed above, it is also important note that patients may be sensitive to environmental stimuli. In particular, patients may become disoriented or confused when exposed to:

  • Bright lights
  • Complex visual stimuli such as busy carpet patterns
  • Noise, including from radio or TV

To address this, physicians should consider offering patients access to a quiet, low-stimulation waiting area if needed.

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