Witko Joanne, Boyles Pauline, Smiler Kirsten, McKee Rachel
Project Lead for the 'NZSL in Health' project, Office of Disability Strategy and Performance 3DHB, Wairarapa, Hutt Valley and Capital and Coast District Health Board and Psychotherapist, Te-Upoko-me-te-Whatu-o-Te-Ika, Mental Health, Addictions & Intellectual Disability Service.
Director of Disability Strategy and Performance, Wairarapa, Hutt Valley and Capital and Coast District Health Boards.
N Z Med J. 2017 Dec 1;130(1466):53-61.
The research described was undertaken as part of a Sub-Regional Disability Strategy 2017-2022 across the Wairarapa, Hutt Valley and Capital and Coast District Health Boards (DHBs). The aim was to investigate deaf New Zealand Sign Language (NZSL) users' quality of access to health services. Findings have formed the basis for developing a 'NZSL plan' for DHBs in the Wellington sub-region.
Qualitative data was collected from 56 deaf participants and family members about their experiences of healthcare services via focus group, individual interviews and online survey, which were thematically analysed. Contextual perspective was gained from 57 healthcare professionals at five meetings. Two professionals were interviewed, and 65 staff responded to an online survey. A deaf steering group co-designed the framework and methods, and validated findings.
Key issues reported across the health system include: inconsistent interpreter provision; lack of informed consent for treatment via communication in NZSL; limited access to general health information in NZSL and the reduced ability of deaf patients to understand and comply with treatment options. This problematic communication with NZSL users echoes international evidence and other documented local evidence for patients with limited English proficiency.
Deaf NZSL users face multiple barriers to equitable healthcare, stemming from linguistic and educational factors and inaccessible service delivery. These need to be addressed through policy and training for healthcare personnel that enable effective systemic responses to NZSL users. Deaf participants emphasise that recognition of their identity as members of a language community is central to improving their healthcare experiences.
本研究是2017 - 2022年怀拉拉帕、哈特谷以及首都与海岸地区卫生委员会（DHBs）次区域残疾战略的一部分。目的是调查新西兰手语（NZSL）聋人使用者获得医疗服务的质量。研究结果已成为为惠灵顿次区域的DHBs制定“NZSL计划”的基础。
通过焦点小组、个人访谈和在线调查，从56名聋人参与者及其家庭成员那里收集了关于他们医疗服务体验的定性数据，并进行了主题分析。通过五次会议从57名医疗专业人员那里获得了背景观点。对两名专业人员进行了访谈，65名工作人员回复了在线调查。一个聋人指导小组共同设计了框架和方法，并对研究结果进行了验证。
整个卫生系统报告的关键问题包括：口译服务提供不一致；缺乏通过NZSL交流获得治疗的知情同意；以NZSL获取一般健康信息的机会有限，以及聋人患者理解和遵守治疗方案的能力下降。与NZSL使用者的这种有问题的沟通与国际证据以及其他记录在案的针对英语水平有限患者的本地证据相呼应。
NZSL聋人使用者在获得公平医疗服务方面面临多重障碍，这些障碍源于语言和教育因素以及难以获得的服务提供。需要通过针对医疗人员的政策和培训来解决这些问题，从而实现对NZSL使用者的有效系统应对。聋人参与者强调，承认他们作为语言社区成员的身份对于改善他们的医疗体验至关重要。
