From the School of Medicine, Brookfield Health Sciences Complex.
Disability Services, University College Cork, College Road, Cork, Ireland.
J Patient Saf. 2021 Apr 1;17(3):e155-e160. doi: 10.1097/PTS.0000000000000298.
Hearing loss contributes to suboptimal medical treatment. We investigated the nature and magnitude of potential health-care harm of hearing loss alone on a patient's understanding of medical consultations, investigations, and treatments of health conditions unrelated to their hearing loss.
A cross-sectional, questionnaire-based design of a convenience sample of students with hearing loss, registered with the institutional disability support service in 8 Irish and 15 UK third-level institutions. Content analysis of open-ended item responses identified and coded emergent themes. Closed-ended questionnaire items recorded demographic and clinically relevant characteristics.
Ninety-five responses were received and analyzed. Fifty-six (58.9%) indicated "yes" to mishearing a physician/nurse in a hospital. Approximately 60.7% identified this in relation to consultation content; 33.9% mishearing; and 21.4% misinterpreting what was said, including diagnosis, guidelines and advice, and matters relating to medications. Approximately 22.3% indicated physician/nurse-patient communication failures; 19.6% identified failure to initiate/maintain eye contact, turning away from the patient, speaking while wearing surgical masks, excluding the possibility of lip reading. Approximately 7.1% identified speaking in too low a volume or too fast. Concerning common words misheard or misinterpreted, 23.2% identified phonological similarity such as similar sounding words and numbers, 7.4% discrimination of unvoiced consonants. Similar findings emerged in GP clinics.
Most hearing-impaired students experienced difficulty in understanding health-care professionals in a hospital and general practice setting. This underscores the importance for health-care providers to identify hearing-impaired patients and to augment communication using visual aids, a quite environment and optimizing lip reading communication.
听力损失会导致医疗效果不佳。我们研究了听力损失单独对患者理解与听力损失无关的医疗咨询、检查和治疗的影响，以及这种影响的性质和程度。
采用横断面、基于问卷的便利样本设计，对 8 所爱尔兰和 15 所英国高等教育机构的听力损失患者注册机构的残疾支持服务的学生进行研究。对开放式项目回答内容进行分析，确定并编码出新兴主题。采用封闭式问卷项目记录人口统计学和临床相关特征。
共收到并分析了 95 份回复。56 份（58.9%）表示在医院里听错医生/护士的话。大约 60.7%的人认为这与咨询内容有关；33.9%的人听错了；21.4%的人误解了所说话的内容，包括诊断、指南和建议，以及与药物相关的问题。大约 22.3%的人表示医患沟通失败；19.6%的人认为没有进行眼神交流、扭头不看患者、戴口罩说话，使唇读变得不可能。大约 7.1%的人认为说话声音太小或太快。关于听错或误解的常见单词，23.2%的人表示发音相似，如发音相似的单词和数字；7.4%的人表示无法区分不发声的辅音。在全科医生诊所也有类似的发现。
大多数听力受损的学生在医院和全科医生诊所都难以理解医疗保健专业人员的话。这突显了医疗保健提供者识别听力受损患者并通过使用视觉辅助工具、安静的环境和优化唇读交流来增强沟通的重要性。
