Journal of General Internal Medicine

, Volume 10, Issue 3, pp 133–137 | Cite as

Improvements in preventive care and communication for deaf patients

Results of a novel primary health care program
  • Theodore G. MacKinney
  • Donna Walters
  • Geoffrey L. Bird
  • Ann Butler Nattinger
Original Articles

Abstract

OBJECTIVE: To test the hypothesis that profoundly deaf persons would have better preventive care compliance and improved physician communication if enrolled in a primary care program providing American Sign Language (ASL) interpreters.

DESIGN: A case-cohort community-based study. The authors had ASL-fluent research assistants interview 90 randomly selected patients (the cases) enrolled in a unique primary care program for the deaf (Deaf Services Program), which provided full-tune ASL interpreters and subsidized health care costs for some patients. Eighty-five deaf controls were friends of the cases drawn from the community.

RESULTS: The cases were poorer and less often married than were the controls, but other baseline characteristics were similar. The cases were more likely (p<0.05) to report receiving within the preceding three years Pap tests (90% vs 72%), mammography (86% vs 53%), and rectal examinations (72% vs 25%), but not breast examinations (76% vs 71%, p=0.7). The cases were more likely than the controls to report receiving counseling in ASL for psychiatric and substance abuse problems (49% vs 5%, p<0.001). Although only 18% of the controls were fluent in written English, 67% of them used written notes to communicate with their physicians. Twenty percent of the controls used ASL interpreters compared with 84% of the cases (p<0.001). More cases than controls were moderately or extremely satisfied with communication with their physicians (92% vs 42%, p<0.001).

CONCLUSION: Deaf persons enrolled in a primary care program that included full-time interpreters were more likely to use ASL, were more satisfied with physician communications, and had improved preventive care outcomes.

Key words

deaf services prevention physician-patient communication patient compliance 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Schein JD, Delk MT. The deaf population of the United States. Silver Spring, MD: National Association of the Deaf. 1974.Google Scholar
  2. 2.
    Reisman G. Medical interpreting for hearing-impaired patients. JAMA. 1977;237:2397–8.PubMedCrossRefGoogle Scholar
  3. 3.
    Silverman SR. Rehabilitative audiology. In: Paparella MM, Shumrick DA. Gluckman JL, Meyerhoff WL (eds). Otolaryngology. Philadelphia: W. B. Saunders. 1991;1005–15.Google Scholar
  4. 4.
    Schein J. Delk M. Survey of health care for deaf people. Deaf Am. 1980;32:5–27.Google Scholar
  5. 5.
    Schlesselman J. Case—Control Studies. New York: Oxford Press. 1982;77.Google Scholar
  6. 6.
    Wachman S. McLaughlin JK. Silverman DT, Mandel JS. Selection of controls in case-control studies, I: Principles. Am J Epidemiol. 1992;135:1019–28.Google Scholar
  7. 7.
    Ronco G. Segnan N, Ponti A. Who has Pap tests? Variables associated with the use of Pap test in the absence of screening programmes. Int J Epidemiol. 1991;20:349–53.PubMedCrossRefGoogle Scholar
  8. 8.
    Centers for Disease Control. Use of mammography for breast cancer screening—Rhode Island. 1987. MMWR. 1988;7:357–61.Google Scholar
  9. 9.
    National Cancer Institute Breast Cancer Screening Consortium. Screening mammography: a missed clinical opportunity? JAMA. 1990;264:54–8.CrossRefGoogle Scholar
  10. 10.
    Lass L, Franklin R. Bertrand W, Baker J. Health knowledge, attitudes and practices of the deaf population in greater New Orleans-a pilot study. Am Ann Deaf. 1978;123:960–7.PubMedGoogle Scholar
  11. 11.
    Kleinig D. Mohay H. A comparison of the health knowledge of hearing-impaired and hearing high school students. Am Ann Deaf. 1990;134:246–51.Google Scholar
  12. 12.
    Nemon A. Deaf persons and their doctors. J Rehabil Deaf. 1980;14:19–23.Google Scholar
  13. 13.
    Americans with Disabilities Act of 1990. 28 CFR 36.102–36.104.Google Scholar
  14. 14.
    Sawyer J, Earp J, Fletcher R, Daye F. Wynn T. Accuracy of women’s self-report of their last Pap smear. Am J Public Health. 1989;79:1036–7.PubMedCrossRefGoogle Scholar
  15. 15.
    Walter S. Clarke E. Hatcher J, Stitt L. A comparison of physician and patient reports of Pap smear histories. J Clin Epidemiol. 1988;41:401–10.PubMedCrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 1995

Authors and Affiliations

  • Theodore G. MacKinney
    • 1
  • Donna Walters
    • 2
  • Geoffrey L. Bird
    • 3
  • Ann Butler Nattinger
    • 1
  1. 1.the Medical College of WisconsinMilwaukee
  2. 2.Baltimore Medical Services, Inc.Baltimore
  3. 3.Georgetown University Medical SchoolWashington, DC.
  4. 4.Division of General Internal MedicineMilwaukee

Personalised recommendations