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American Sign Language Interpreters Perceptions of Barriers to Healthcare Communication in Deaf and Hard of Hearing Patients

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Abstract

Communication barriers between healthcare providers and patients contribute to health disparities and the effectiveness of health promotion messages. This is especially true regarding communication between providers and deaf and hard of hearing (HOH) patients due to lack of understanding of cultural and linguistic differences, ineffectiveness of various means of communication and level of health literacy within that population. This research aimed to identify American Sign Language (ASL) interpreters’ perceptions of barriers to effective communication between deaf and HOH patients and healthcare providers. We conducted a survey of ASL interpreters attending the 2015 National Symposium on Healthcare Interpreting with an overall response rate of 25%. Results indicated a significant difference (p < 0.05) in all areas of preferred communication between providers and deaf/HOH patients as perceived by interpreters. ASL interpreters observed that patients did not understand provider instructions in nearly half of appointments. Eighty-one percent of interpreters said that providers “hardly ever” use “teach-back” methods with patients to ensure understanding. A focus on improving health care and health promotion efforts in the deaf/HOH community depends on improving communication, health literacy, and patient empowerment and involves holding health care organizations accountable for assuring adequate staffing of ASL interpreters and communication resources in order to reduce health disparities in this population.

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References

  1. Oates, J., Weston, W. W., & Jordan, J. (2000). The impact of patient-centered care on outcomes. Family Practice, 49, 796–804.

    Google Scholar 

  2. Committee on Quality Health Care in America, Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st Century. Washington, D.C.: National Academy Press.

    Google Scholar 

  3. Scheier, D. (2009). Barriers to health care for people with hearing loss: A review of the literature. Journal of the New York Nurses Association, 40(1), 4–10.

    Google Scholar 

  4. Centers for Disease Control and Prevention. (2008). Health disparities among adults with hearing loss: United States, 2000–2006. Accessed March 17, 2015, from http://www.cdc.gov/nchs/data/hestat/hearing00-06/hearing00-06.pdf.

  5. Barnett, S., & Franks, P. (2002). Health care utilization and adults who are deaf: Relationship with age at onset of deafness. Health Services Research, 37(1), 105–120.

    PubMed  Google Scholar 

  6. Stewart, M. A. (1995). Effective physician-patient communication and health outcomes: A review. CMAJ: Canadian Medical Association Journal, 152(9), 1423–1433.

    PubMed  CAS  Google Scholar 

  7. Tamaskar, P., Malia, T., Stern, C., et al. (2000). Preventive attitudes and beliefs of deaf and hard-of-hearing individuals. Archives of Family Medicine, 9(6), 518–525.

    Article  PubMed  CAS  Google Scholar 

  8. McKee, M. M., Barnett, S. L., Block, R. C., et al. (2011). Impact of communication on preventive services among Deaf American Sign Language users. American Journal of Preventive Medicine, 41(1), 75–79.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Shuler, G. K., Mistler, L. A., Torrey, K., et al. (2013). Bridging communication gaps with the deaf. Nursing, 43(11), 24–30.

    Article  PubMed  Google Scholar 

  10. Iezzoni, L., O’Day, B., Killeen, M., et al. (2004). Communicating about health care: Observations from persons who are deaf or hard of hearing. Annals of Internal Medicine, 140, 356–362.

    Article  PubMed  Google Scholar 

  11. Brown, H. L., Hughes-Bell, A., & McDuffie, A. W. (2015). Caring for patients who are deaf or hard of hearing. JAAPA, 28(12), 50–55.

    PubMed  Google Scholar 

  12. Barnett, S. (1999). Clinical and cultural issues in caring for deaf people. Family Medicine, 31, 17–22.

    PubMed  CAS  Google Scholar 

  13. Barnett, S. (2002) Cross-cultural communication with patients who use American Sign Language. Family Medicine, 34(5), 376–382.

    PubMed  Google Scholar 

  14. Andrade Pereira, P., & De Carvalho Fortes, P. (2010). Communication and information barriers to health assistance for Deaf patients. American Annals of the Deaf, 155(1), 31–37.

    Article  Google Scholar 

  15. Reeves, D., & Kokoruwe, B. (2005). Communication and communication support in primary care: A survey of deaf patients. Audiological Medicine, 3(2), 95–107.

    Article  Google Scholar 

  16. Ebert, D. A., & Heckerling, P. S. (1995). Communication with deaf patients: Knowledge, beliefs and practices of physicians. JAMA, 273, 227–229.

    Article  PubMed  CAS  Google Scholar 

  17. Flores, G. (2005). The impact of medical interpreter services on the quality of health care: A systematic review. Medical Care Research and Review, 62(3), 255–299.

    Article  PubMed  Google Scholar 

  18. King, J. F. (2005). Practical considerations for accommodating the deaf patient. Patient Care, 39(1), 17–23.

    Google Scholar 

  19. Nicodemus, B., Swabey, L., & Moreland, C. (2014) Conveying medication prescription in American Sign Language: Use of emphasis in translations by interpreters and deaf physicians. Translation & Interpreting, 6(1), 1–22.

    Google Scholar 

  20. Tamura-Lis, W. (2013). Teach-back for quality education and patient safety. Urologic Nursing, 33(6), 267–271.

    Article  PubMed  Google Scholar 

  21. MacDougall, D. (2012). Gendered discourse and ASL-to-English interpreting: A poststructuralist approach to gendered discourse and the ASL-to-English interpretive process. Journal of Interpretation, 19(1), 33–69.

    Google Scholar 

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Acknowledgements

We would like to thank the St. Catherine University CATIE Center, Richard Laurion, and Erica Alley for their aid in coordination and inspiration for this research.

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Correspondence to Kari Hartwig.

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The authors declare they have no conflict of interest.

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This study was reviewed and approved by the St. Catherine University Institutional Review Board. All participants read a consent form before participating in the survey.

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Hommes, R.E., Borash, A.I., Hartwig, K. et al. American Sign Language Interpreters Perceptions of Barriers to Healthcare Communication in Deaf and Hard of Hearing Patients. J Community Health 43, 956–961 (2018). https://doi.org/10.1007/s10900-018-0511-3

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  • DOI: https://doi.org/10.1007/s10900-018-0511-3

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