Tannenbaum-Baruchi Carolina, Feder-Bubis Paula, Aharonson-Daniel Limor
School of Nursing Science, The Academic College Tel Aviv-Yaffo, Tel Aviv, Israel.
PREPARED Center for Emergency Response Research, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Acad Emerg Med. 2025 Mar;32(3):246-259. doi: 10.1111/acem.15037. Epub 2024 Oct 31.
This study aimed to identify communication barriers between health care workers (HCWs) and deaf and hard-of-hearing (DHH) patients. Both perspectives are offered to provide a comprehensive understanding.
Two consecutive studies were conducted from 2018 to 2021. Study 1 comprised mixed methods, employing a cross-sectional survey (n = 288) and in-depth interviews (n = 9) with DHH participants, utilizing accessible tools including sign language. Study 2 involved a cross-sectional survey of health care emergency workers without hearing loss (N = 391).
The perceived self-efficacy of DHH patients, and not their hearing loss, was linked with their ability to communicate independently with HCWs. No significant differences in successful communication with these providers were found vis-à-vis mode of communication utilized (sign language, writing, interpreter, etc.). In the qualitative findings, DHH patients noted two urgent care barriers: HCWs' communication unfamiliarity and patients' communication accessibility issues. Quantitative findings indicated a main barrier: difficulties in communicating with HCWs in general (57%) and specifically in the emergency room (ER; 65%). Only 28.8% reported being able to independently communicate with ER staff. Health care providers were not familiar with effective communication strategies when treating these patients. Respondents indicating that communication was not a barrier to care were mainly administrative staff (54.55%), compared to nurses (32.74%) and physicians (22.58%).
Communication solutions are needed to improve access to health services, especially in emergencies. Providing medical staff training on effective communication strategies with these patients could simplify interactions and reduce the reliance on hearing family members, potentially improving medical care. Implementing a communication policy for frontline staff, along with the use of visual aids, is crucial. Health care professionals may not realize that small changes can greatly improve communication with DHH patients.
本研究旨在确定医护人员与聋哑及听力障碍（DHH）患者之间的沟通障碍。提供双方的观点以达成全面理解。
在2018年至2021年期间进行了两项连续研究。研究1采用混合方法，对DHH参与者进行横断面调查（n = 288）和深入访谈（n = 9），使用包括手语在内的无障碍工具。研究2涉及对无听力损失的医护急救人员进行横断面调查（N = 391）。
DHH患者感知到的自我效能感，而非其听力损失，与他们独立与医护人员沟通的能力相关。在与这些医护人员的成功沟通方面，未发现所采用的沟通方式（手语、书写、口译等）存在显著差异。在定性研究结果中，DHH患者指出了两个紧急护理障碍：医护人员沟通不熟悉和患者沟通无障碍问题。定量研究结果表明一个主要障碍：总体上与医护人员沟通困难（57%），在急诊室（ER）尤其如此（65%）。只有28.8%的人报告能够独立与急诊室工作人员沟通。医护人员在治疗这些患者时不熟悉有效的沟通策略。表示沟通不是护理障碍的受访者主要是行政人员（54.55%），相比之下护士为（32.74%），医生为（22.58%）。
需要沟通解决方案来改善医疗服务的可及性，尤其是在紧急情况下。为医护人员提供与这些患者有效沟通策略的培训可以简化互动并减少对有听力的家庭成员的依赖，有可能改善医疗护理。为一线工作人员实施沟通政策以及使用视觉辅助工具至关重要。医护专业人员可能没有意识到小的改变可以极大地改善与DHH患者的沟通。
