Communication barriers to optimal access to emergency rooms according to deaf and hard-of-hearing patients and health care workers: A mixed-methods study

Abstract

Background: 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. Methods: 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). Results: 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%). Conclusions: 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.