Estrategias comunicativas entre profesionales sanitarios y personas con pérdida de audición / Communication strategies between health professionals and people with hearing loss

Caso: Hombre de 30 años con pérdida de audición bilateral progresiva y percepción de vulnerabilidad ante el riesgo de dependencia para la comunicación con los demás. Objetivo principal: Conocer las diferentes estrategias comunicativas, basadas en la evidencia, para mejorar la calidad asistencial entre el personal sanitario y las personas con pérdida de audición. Metodología: Búsqueda de evidencias siguiendo el modelo PRAXIS. Resultados principales: Recomendaciones de buena práctica: (a) adquirir conocimientos sobre el método de comunicación más apropiado para el paciente; (b) facilitar el acceso a las personas en los centros sanitarios y consultas; (c) buscar apoyo en otros recursos para evitar su exclusión; (d) conocer las competencias lingüísticas para comunicarse con personas sordas; (e) emplear intérpretes en las unidades de salud; y (f) asegurarse de la comprensión de la información aportada. Prácticas de autocuidado: Concienciarse de que la sordera es una discapacidad que tiene ciertas soluciones, conocer los derechos y recursos de los que dispone y pedir ayuda siempre que la necesite debido al desconocimiento por parte de los profesionales sanitarios sobre la comunicación con las personas sordas.(AU)

Case: 30-year-old man with progressive bilateral hearing loss and perceived vulnerability to the risk of dependence for communication with others. Objective: To know the different communication strategies, based on evidence, to improve the quality of care among health personnel and people with hearing loss. Methods: searching for evidence following the PRAXIS model. Results: Good practice recommendations: (a) acquire knowledge about the most appropriate method of communication for the patient; (b) facilitate access to people in health centers and consultations; (c) seek support from other resources to avoid exclusion; (d) know the linguistic skills to communicate with deaf people; (e) employ interpreters in health units; and (f) ensure that the information provided is understood. Self-care practices: become aware that deafness is a disability that has certain solutions, know your rights and available resources and ask for help whenever you need it due to the lack of knowledge on the part of health professionals about communication with deaf people(AU)

Development and Validation of an Instrument to Measure Nurses' Beliefs Toward Deaf and Hard of Hearing Interaction.

BACKGROUND AND PURPOSE: Nurse-patient communication has a significant effect on health outcomes and quality of care. The purpose of this research was to develop and validate an instrument to measure nurses' beliefs toward interacting with Deaf signers, non-signing deaf, and hard of hearing (DdHH) patients. METHODS: Initial pool items created based on literature review. Content validated by DdHH and hearing registered nurses (RNs) and certified interpreters working in healthcare. Resulting D/deaf and Hard of Hearing Interaction Beliefs Scale for Registered Nurses (DdHH-IBS/RN) administered to two groups of RNs. Two validation studies conducted. RESULTS: Analyses demonstrated high inter-item reliability, internal consistency reliability, and stability reliability of a 25-item DdHH-IBS/RN. Confirmatory factor analysis supported hypothesized structure of the scale. CONCLUSION: The DdHH-IBS/RN is a reliable and valid scale to measure nurses' beliefs towards DdHH interaction.

Estrategias de comunicación de los profesionales de enfermería con personas sordas o ciegas / Nurses’ communication strategies used with deaf/blind people

Objetivo principal: Explorar estrategias de comunicación de los profesionales de enfermería con personas sordas o ciegas en la atención sanitaria. Metodología: Revisión bibliográfica con búsqueda en 16 bases de datos de la producción científica relacionada. Resultados principales: Los profesionales no emplean estrategias exitosas de comunicación porque carecen de conocimientos y habilidades pertinentes, pudiendo llegar a sentir miedo, ansiedad, impotencia, frustración, vergüenza y negación. Esto interfiere en la calidad de la atención, dando lugar a malentendidos, errores en la toma de decisiones y en desconfianza. Conclusión principal: El acceso de las personas sordas o ciegas a los servicios de salud está limitado por una deficiente comunicación asistencial que exigiría una urgente formación de sus profesionales

Objective: To explore nurses' communication strategies used with deaf/blind people in healthcare. Methods: Literature review, searching into 16 data bases in order to find related scientific production. Results: Nurses do not use successful communication strategies because they lack relevant knowledge and skills regarding this matter; they can feel fear, anxiety, powerlessness, frustration, embarrassment and denial. This interferes with care quality, leading to misunderstandings, mistakes in decision making and lack of confidence. Conclusions: Deaf/blind people’s access to healthcare is constrained by a poor care communication that needs an urgent professional’s training

Improving the experience of pregnancy and childbirth for deaf people and their families.

Deafness is unique in that it crosses barriers of age, gender, economic status and ethnicity. It is particularly complex in the context of the 'disabled/abled binary'. Generalisation is unhelpful since impairment is individualised and manifests itself in emotional, psychological, social and physical dimensions of a person's life. The 'Deaf Nest' project aims to improve deaf users' personal experience, equality of access, choice and control over maternity care. The implementation of clear guidance, an early assessment form, effective referrals, deaf awareness study days and 'Deaf Nest' support packs will result in improved deaf access to information, the ongoing assessment of need, improved health and lifestyle choices and greater family involvement.

Deaf culture: competencies and best practices.

To successfully navigate in the hearing world, deaf individuals must be able to read and write to bridge the gap when others do not know American Sign Language. Unfortunately, 90% of deaf children are born to hearing parents and do not develop language skills early on, which negatively impacts their ability to access health information and healthcare. Healthcare providers must ensure they provide culturally competent care and their practices accommodate the needs of deaf patients to mitigate communication barriers and ensure equitable care with positive health outcomes.

Meeting deaf patients' communication needs.

Effective communication between nurses and patients is a vital part of safe and effective nursing care. However, few health professionals receive training in how to communicate with Deaf people; as a result, attempts to communicate with Deaf patients is often inappropriate and undertaken without knowledge or understanding of their communication needs. This article examines the literature on ways in which Deaf patients experience communicating with, and receive care from, nurses.

Deafness, pregnancy and sexual health.

This article exposes the need for support for midwives, to ensure that they are equipped to meet the needs of deaf parents to be. It uncovers research which demonstrates the urgent need for an increase in awareness, education and resources; and the reasons that deaf people have higher rates of teenage pregnancy and sexually transmitted infections than the general population. With stories from midwives at a loss as to how to communicate with deaf mothers in labour, and stories from deaf women who can't understand their health professionals, nor read the literature that has been given to them--this is thought provoking reading.

Patients with cochlear implants in the OR--issues and concerns.

Safety standards for patients with cochlear implants are difficult to find. Safety standards are, in fact, constantly evolving as more information becomes available. This article provides an overview of current philosophies and guidelines for most medical/surgical interventions, with emphasis on the operating room environment, as indicated by the three manufacturers authorized to market cochlear implants in Canada.

One-dimensional scales for pain evaluation adopted in Italian nursing practice: giving preference to deaf patients.

Despite the increasing attention given to pain, little is known about how deaf patients communicate their pain and which pain scales they prefer to use. Studies of the validity of various scales often specify conditions that exclude them. With the aim to explore the preferred pain evaluation scale and the method of administration when evaluating deaf patients, a descriptive phenomenology of qualitative research study was undertaken and articulated in two phases. In the first phase, a purposeful sample of 10 nurses with experience in the care of deaf clients was studied using focus groups to collect data regarding which pain scale they used and the methods they used to administer the scales in clinical settings during care to deaf patients. In the second phase, a purposeful sample of 16 deaf people was engaged in multiple focus groups to analyze a set of one-dimension scales that emerged from the first phase of the study with nurses and to discuss their preferences for pain scales. Nurses who participated in the focus group reported using the numerical rating scale, visual analogue scale, Faces Pain Scale, and the Iowa Pain Thermometer (IPT) scale when caring for deaf people. Deaf patients involved in the second phase of this study preferred the IPT scale. Participants also noted the interference of environmental factors such as dimly lit rooms or glaring lights in situations that required lipreading for communication of pain such as in operating rooms. It was concluded that decisions regarding how to administer pain scales to deaf persons need to consider the preferences and the values of the patients. To avoid the risk of misunderstanding the pain of deaf patients, practice guidelines and strategies related to measuring pain in deaf persons should be specified by deaf associations at international, national, and local levels. Utilization of a simple sign language even at an international level could guarantee security in the communication of the pain between patients and health care workers and may help in the assessment of acute pain even in emergency conditions.

Summary of lessons learned when working with translators and interpreters in research.

This is a response to the articles in the special section written by Jones & Boyle, Baird, Siaki, and Sheppard.

Working with translators and interpreters in research: lessons learned.

The purpose of this special section is to describe culturally competent approaches for working with translators or interpreters who participate in transcultural studies. This article provides background for three exemplars of lessons learned in working with translators in transcultural studies: (a) the resettlement transition experiences of women from the Dinka tribe of Southern Sudan (Baird), (b) Samoans' risk for heart disease (Siaki), and (c) culturally Deaf adults' perceptions about depression (Sheppard).Capitalizing the word "Deaf" has gained wide acceptance to indicate a linguistic minority of people who have a hearing loss and use American Sign Language, a hallmark of Deaf culture. In each case, the individual researcher made adaptations to the usual processes of translation/back-translation when appropriate to the cultural context and the specific situations of the translators. Although these lessons were learned during research-related activities, they may apply to other circumstances when nurses work with bilingual/bicultural translators (e.g., translating consent forms or communicating with persons who have limited literacy in their native language).

Using American sign language interpreters to facilitate research among deaf adults: lessons learned.

BACKGROUND: Health care providers commonly discuss depressive symptoms with clients, enabling earlier intervention. Such discussions rarely occur between providers and Deaf clients. Most culturally Deaf adults experience early-onset hearing loss, self-identify as part of a unique culture, and communicate in the visual language of American Sign Language (ASL). Communication barriers abound, and depression screening instruments may be unreliable. PURPOSE: To train and use ASL interpreters for a qualitative study describing depressive symptoms among Deaf adults. METHOD: Training included research versus community interpreting. During data collection, interpreters translated to and from voiced English and ASL. RESULTS: Training eliminated potential problems during data collection. Unexpected issues included participants asking for "my interpreter" and worrying about confidentiality or friendship in a small community. CONCLUSIONS: Lessons learned included the value of careful training of interpreters prior to initiating data collection, including resolution of possible role conflicts and ensuring conceptual equivalence in real-time interpreting.