Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Lausanne, Switzerland.
Psychiatric Liaison Service, Lausanne University Hospital, Les Allières, Lausanne, 1011, Switzerland.
BMC Health Serv Res. 2024 Mar 6;24(1):301. doi: 10.1186/s12913-024-10574-3.
Healthcare workers (HCWs) are commonly not prepared to properly communicate with D/deaf and hard of hearing (HoH) patients. The resulting communication challenges reinforce the existing barriers to accessing and benefiting from quality of care in these populations. In response, this study aimed to develop and evaluate a capacity-building intervention for HCWs to raise their awareness of D/deaf and HoH individuals' experiences in healthcare and improve their capacity to communicate with these populations.
This study featured a participatory action research design using qualitative and quantitative methods. The intervention was developed and tested through 4 iterative phases. Reactions (i.e., satisfaction and perception of the intervention content, quality, appropriateness and usefulness) were assessed quantitatively and qualitatively after the intervention, whereas perceived knowledge and self-efficacy in communicating with D/deaf and HoH patients and organizational payoffs (use frequency of basic rules and tools improving communication) were quantitatively assessed before, after and 6-month post-intervention.
Main qualitative and quantitative findings showed that the final version of the intervention reached high levels of satisfaction among participants. Next, perceived knowledge and self-efficacy scores obtained after receiving the intervention and 6 months later were significantly higher than those yielded in the initial assessment, although both scores significantly decreased at 6 months (compared to the scores obtained just after the intervention). Finally, findings showed no significant changes in organizational payoffs after receiving the intervention. Echoing these results, main qualitative findings documented that after receiving the intervention, participants felt more confident yet not more equipped to communicate with D/deaf and HoH patients.
Findings suggest that the capacity-building intervention is a promising means to sustainably increase HCWs' perceived knowledge and self-efficacy on how communicating with D/deaf and HoH patients, although complementary approaches and follow-up intervention reminders may be necessary to enable practice changes in the working environment.
医疗保健工作者（HCWs）通常无法做好与聋人和重听（HoH）患者的有效沟通。由此产生的沟通挑战加剧了这些人群在获得和受益于高质量医疗服务方面的现有障碍。有鉴于此，本研究旨在为 HCWs 开发和评估一项能力建设干预措施，以提高他们对聋人和 HoH 个体在医疗保健中的体验的认识，并提高他们与这些人群沟通的能力。
本研究采用参与式行动研究设计，使用定性和定量方法。该干预措施通过 4 个迭代阶段进行开发和测试。干预后，从定量和定性两方面评估反应（即对干预内容、质量、适宜性和有用性的满意度和看法），而在干预前、干预后和 6 个月后，从定量角度评估对与聋人和 HoH 患者沟通的感知知识和自我效能以及组织回报（使用改进沟通的基本规则和工具的频率）。
主要的定性和定量发现表明，干预措施的最终版本在参与者中获得了很高的满意度。其次，接受干预后和 6 个月后的感知知识和自我效能得分明显高于初始评估的得分，尽管这两个得分在 6 个月后（与干预后立即获得的得分相比）显著下降。最后，在接受干预后，组织回报没有显著变化。与这些结果相呼应的主要定性发现表明，在接受干预后，参与者感到更有信心，但在与聋人和 HoH 患者沟通方面，他们感觉自己的装备并没有增强。
研究结果表明，能力建设干预措施是一种有前途的方法，可以持续提高 HCWs 对与聋人和 HoH 患者沟通的感知知识和自我效能，尽管可能需要补充方法和后续干预提醒，以促使工作环境中的实践发生变化。
