Reading material on improving patient communication, cross-cultural aspect

A person with a disability is a person who has a sensory, communication, physical, intellectual or psychosocial impairment, or a combination of these, which, in interaction with environmental, social and other significant barriers, limits or prevents effective and equal participation in society (Act XXVI of 1998 on the Rights of Persons with Disabilities and Ensuring their Equal Opportunities).  

Hungary was the second country in the world to ratify the UN Convention on the Rights of Persons with Disabilities and the first to accede to its Optional Protocol. The Convention contains a number of provisions to ensure equal access and recognises that disability is an evolving concept and that disability is the result of the interaction between persons with disabilities and attitudinal and environmental barriers that prevent them from participating fully and effectively in society on an equal basis with others. (Act XCII of 2007 on the Proclamation of the Convention on the Rights of Persons with Disabilities and its Optional Protocol) 

Disability is not a disease, but a condition that can result from a congenital or acquired impairment/disease that prevents a person with a disability from participating in society. It is necessary to ensure that people with disabilities can be equal members of society with equal dignity and equal rights. Independence is a way of life which ensures that all persons with disabilities have the opportunity to participate in society and play an active role as citizens, and which excludes any discrimination or restriction in political, economic, social, cultural, civic or any other field. 

A visually impaired person is a person whose impairment or lack of visual function (visual acuity, adaptation, contrast, colour vision, visual field) and/or processing and interpretation (acquired visual impairment in the perception of visual stimuli due to brain damage), alone or in combination with other disabilities, prevents him or her from living an independent and safe life and from participating fully and effectively in society on an equal basis with others. 

Visual impairment can be hereditary or acquired, organic or functional. Three groups of people are distinguished according to the severity of their visual impairment: visually impaired, partially sighted and blind. 

The lack of sight severely limits direct cognition and the content of images and concepts is different from that of the sighted. Their mobility is restricted and this can affect the development of movement patterns. Stereotyped movements may also develop. Problems with personality development and socialisation can also occur as a result of blindness. 

Psychological aspects of blindness 

Acceptance of one’s own condition:  

The blind person is not a type. We must get to know the blind person as a person and not judge his personality and behaviour in advance on the basis of blindness. A blind person can be happy and sad, balanced and confused. He has his own problems to deal with. Perhaps the most important of these is acceptance of one’s condition. This acceptance is perhaps best determined by the time of onset of visual impairment. 

A person who is blind from birth or has early onset blindness will live a completely different life. He or she will look at the world differently, form different ideas, define things differently. His or her development will be different both mentally and physically because of blindness. His or her movements will be characteristically different from those of sighted peers, a kind of stereotyped movement called “blindism”. He may have difficulty in self-fulfilment, in carrying out his daily routine. The many individual situations can cause psychological strain, resulting in a withdrawn, lonely, withdrawn, insecure personality. Or, on the contrary, just as a mother may overestimate her child’s abilities, the blind child may overestimate himself, becoming selfish and arrogant towards his environment. A child who is blinded at an early age is only affected by such consequences of his lack of sight, the lack of sight itself is usually not manifested, because he has never seen, he does not know what he has lost. In contrast, the personality of a child or young adult who becomes blind later in life is already established, so there is less chance of maldevelopment. Trauma, on the other hand, has an even greater impact on the personality, as the whole life has to be reassessed, habits and daily routines have to be changed. In adolescence, the loss of sight and the realisation of a disability can easily lead to a state of “blindness crisis”. The trauma of this condition can cause the young person to rethink his or her life and habits, which must now be adapted to blindness. Often he or she will also break away from his or her old communities, seeking out new groups and joining new communities. The trauma of blindness can also cause problems with self-identity. A blind person does not know what to do with his life, does not know what to do with himself. Often they do not even know who they are or why they were born. The self-identity crisis is complicated by the fact that blindness is a kind of borderline situation. 

General rules of communication 

The basic rules of verbal and non-verbal communication and their congruence are also essential when communicating with a blind person. We must express our attention and openness to the patient not only verbally, but also non-verbally, even when he or she cannot see us. 

The rules of active and empathic listening 

(“SZENYIHASZER” in Hungarian) 

• Face to face 
• Open posture 
• Leaning towards the client 
• Eye contact (!!!) 
• Relaxation (comfort) 

Special rules of communication with a blind person 

ASSISTANCE RULES 

ACCOMPANYING A VISUALLY IMPAIRED PERSON 

• Driver’s posture 
• Recording the first contact when driving  
• General movement 
• Turning 
• Level differences (stairs, kerb approach) 
• Planting (in the case of chairs, examination beds) 

GETTING TO KNOW AN UNFAMILIAR PLACE WITH A VISUALLY IMPAIRED PERSON 

ASSISTANCE UNDER SIGNATURE 

HOW WE CAN REPLACE VISUAL DEMONSTRATION TOOLS IN OUR EXPLANATIONS, USEFUL TOOLS 

Additional materials in the above-mentioned topics are available in the e-manual.  

Sensitisation of visually impaired people through activities that can be done at home, life situations and personal experiences to show the obstacles and perception disorders caused by visual impairment. “The black book of colours”