Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Department of Health Education and Behavior, University of Florida, Gainesville, Florida, USA.
Health Expect. 2023 Dec;26(6):2374-2386. doi: 10.1111/hex.13842. Epub 2023 Aug 9.
Deaf and hard-of-hearing (DHH) patients are a priority population for emergency medicine health services research. DHH patients are at higher risk than non-DHH patients of using the emergency department (ED), have longer lengths of stay in the ED and report poor patient-provider communication. This qualitative study aimed to describe ED care-seeking and patient-centred care perspectives among DHH patients.
This qualitative study is the second phase of a mixed-methods study. The goal of this study was to further explain quantitative findings related to ED outcomes among DHH and non-DHH patients. We conducted semistructured interviews with 4 DHH American Sign Language (ASL)-users and 6 DHH English speakers from North Central Florida. Interviews were transcribed and analysed using a descriptive qualitative approach.
Two themes were developed: (1) DHH patients engage in a complex decision-making process to determine ED utilization and (2) patient-centred ED care differs between DHH ASL-users and DHH English speakers. The first theme describes the social-behavioural processes through which DHH patients assess their need to use the ED. The second theme focuses on the social environment within the ED: patients feeling stereotyped, involvement in the care process, pain communication, receipt of accommodations and discharge processes.
This study underscores the importance of better understanding, and intervening in, DHH patient ED care-seeking and care delivery to improve patient outcomes. Like other studies, this study also finds that DHH patients are not a monolithic group and language status is an equity-relevant indicator. We also discuss recommendations for emergency medicine.
This study convened a community advisory group made up of four DHH people to assist in developing research questions, data collection tools and validation of the analysis and interpretation of data. Community advisory group members who were interested in co-authorship are listed in the byline, with others in the acknowledgements. In addition, several academic-based co-authors are also deaf or hard of hearing.
聋人和重听（DHH）患者是急诊医学健康服务研究的重点人群。与非 DHH 患者相比，DHH 患者更有可能使用急诊部（ED），在 ED 的停留时间更长，并且报告医患沟通不佳。这项定性研究旨在描述 DHH 患者的 ED 就诊和以患者为中心的护理观点。
这项定性研究是混合方法研究的第二阶段。本研究的目的是进一步解释与 DHH 和非 DHH 患者的 ED 结局相关的定量发现。我们对来自佛罗里达州中北部的 4 名美国手语（ASL）使用者和 6 名 DHH 英语使用者进行了半结构化访谈。使用描述性定性方法对访谈进行转录和分析。
提出了两个主题：（1）DHH 患者参与复杂的决策过程，以确定 ED 的使用；（2）DHH ASL 使用者和 DHH 英语使用者之间的 ED 以患者为中心的护理存在差异。第一个主题描述了 DHH 患者评估使用 ED 的需求的社会行为过程。第二个主题侧重于 ED 内的社会环境：患者感到刻板印象、参与护理过程、疼痛沟通、获得住宿和出院过程。
这项研究强调了更好地了解和干预 DHH 患者的 ED 就诊和护理提供的重要性，以改善患者的结局。与其他研究一样，这项研究还发现，DHH 患者不是一个单一的群体，语言状况是一个与公平相关的指标。我们还讨论了对急诊医学的建议。
这项研究召集了一个由四名 DHH 人组成的社区咨询小组，以协助制定研究问题、数据收集工具以及验证数据分析和解释。有兴趣共同撰写论文的社区咨询小组成员列在作者名单中，其他成员列在致谢中。此外，还有几位学术背景的合著者也是聋人或重听。
