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.

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.

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.

Sensitive care for the deaf: a cultural challenge.

Of the more than 36 million American adults who have some degree of hearing loss (Centers for Disease Control and Prevention [CDC], 2008), 500,000 are acculturated into the culturally Deaf community who share behavioral norms, values, customs, educational institutions, and organizations. This article discusses the Deaf community, their culturally based health care needs, and health care providers' (HCPs) lack of understanding and recognition of Deafness as a distinct culture, which individually or cumulatively result in barriers to culturally sensitive care that can lead to disparities in care. It suggests transcultural methods HCPs can use to narrow the cultural divide.

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.

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 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)

Communication strategies for nurses interacting with deaf patients.

Nurses play a pivotal role in promoting access to culturally competent health care services for those who experience linguistic and cultural barriers. Nursing strategies to facilitate and enhance the deaf community's access to health care services are provided.

Perception of persons with severe or profound deafness about the communication process during health care.

This study describes a qualitative approach with the objective of characterizing the perceptions of people with severe or profound deafness about the communication process in the context of health care services. Study participants were 11 people with severe and/or profound deafness, who were interviewed using Brazilian sign language (LIBRAS). The interactions were videotaped and then transcribed. Care was taken to maintain the grammatical construction which was characteristic in the expression of each person. Three categories emerged from thematic analysis: Understanding, Need for Mediation, Feelings. Deaf persons do not achieve effective communication in health care, during which they experience negative feelings. Hence, the presence of a professional interpreter is needed.

Communicating effectively with deaf patients.

This article explores the communication needs of deaf patients who use British Sign Language as their first or preferred language. It would appear that these needs are not being met, particularly in acute hospital settings. Practical advice is provided for nurses to improve the quality of care that deaf patients receive.

Adapting de-escalation techniques with deaf service users.

This article discusses the reasons why deaf patients might become angry and outlines de-escalation techniques that could be used by nurses when caring for these patients.