Kaitiaki Research and Evaluation, Wellington 6012, New Zealand.
Te Kura Tapuhi Hauora-School of Nursing, Midwifery, and Health Practice, Wellington Faculty of Health, Te Herenga Waka-Victoria University of Wellington, Wellington 6140, New Zealand.
Int J Environ Res Public Health. 2022 Dec 18;19(24):17007. doi: 10.3390/ijerph192417007.
The COVID-19 pandemic significantly affected global healthcare access and exacerbated pre-pandemic structural barriers. Literature on disabled people's experiences accessing healthcare is limited, with even less framing healthcare access as a human rights issue. This study documents and critically analyses Deaf people's healthcare access experiences in Aotearoa New Zealand during the COVID-19 pandemic. Eleven self-identified Deaf individuals participated in semi-structured videoconferencing interviews. Discourse analysis was applied to participant narratives with discourses juxtaposed against a human rights analysis. Barriers influencing healthcare access included: (1) the inability of healthcare providers to communicate appropriately, including a rigid adherence to face mask use; (2) cultural insensitivity and limited awareness of Deaf people's unique needs; and (3) the impact of ableist assumptions and healthcare delaying care. Barriers to healthcare access represent consecutive breaches of rights guaranteed under the United Nations Convention on the Rights of Persons with Disabilities (CRPD). Such breaches delay appropriate healthcare access and risk creating future compounding effects. Action is required to address identified breaches: (1) The CRPD should also underpin all health policy and practice development, inclusive of pandemic and disaster management responsiveness. (2) Health professionals and support staff should be trained, and demonstrate competency, in Deaf cultural awareness and sensitivity.
新冠疫情大流行严重影响了全球的医疗保健可及性，并加剧了大流行前存在的结构性障碍。关于残疾人获得医疗保健的经验的文献有限，将获得医疗保健作为人权问题的框架甚至更少。本研究记录并批判性分析了新西兰奥特亚罗瓦的聋人在新冠疫情大流行期间获得医疗保健的经验。11 名自我认同的聋人参加了半结构式视频会议访谈。对参与者的叙述进行了话语分析，将话语与人权分析并列。影响医疗保健可及性的障碍包括：（1）医疗保健提供者无法进行适当沟通，包括对戴口罩的严格遵守；（2）文化敏感性差，对聋人独特需求的认识有限；以及（3）对残疾歧视假设和医疗保健延误护理的影响。医疗保健可及性障碍代表了对《联合国残疾人权利公约》（CRPD）保障的权利的连续侵犯。这些侵犯会延迟获得适当的医疗保健，并有可能造成未来的累积影响。需要采取行动来解决已确定的侵犯行为：（1）《残疾人权利公约》还应作为所有卫生政策和实践发展的基础，包括大流行和灾害管理应对措施。（2）应培训医疗保健专业人员和支持人员，并使其具备聋人文化意识和敏感性方面的能力。
