Communication methods between physicians and Deaf patients: A scoping review.

OBJECTIVE: Deaf individuals often face communication challenges within healthcare settings. Given the importance of the role played by physicians in shaping patients' health outcomes, it is paramount to explore Deaf patient-physician interactions. This research aims to explore (1) the existing communication support and (2) the factors influencing its usage in medical consultations with Deaf patients. METHODS: A scoping review was carried out and adhered to the Preferred Reporting System for Meta-Analysis. A comprehensive search strategy of four databases; PubMed, Medline, CINAHL Plus and Scopus, from January 2011 to June 2021 was applied. Thematic analysis was used to analyse the data. RESULTS: Ten journal articles were included, and four themes were identified; patient experiences using communication methods, practitioners' cultural competence in Deaf culture, inherent challenges of communication methods, and extrinsic factors. Professional interpreters are often regarded as the preferred modality of communication but writing and lip-reading were commonly used in healthcare settings, with video remote interpreting the least common. CONCLUSION: Healthcare professionals need to appreciate the heterogeneity of Deaf patients and their communication methods and adopt a more person-centred approach. PRACTICE IMPLICATIONS: This review provides up-to-date insight on Deaf patient-physician interactions and provisional recommendations for practice, education and policy.

A qualitative exploration of the healthcare challenges and pharmaceutical care needs of people with Parkinson's and their caregivers.

Background People with Parkinson's are at higher risk of healthcare and pharmaceutical care issues. Objective To determine the healthcare challenges, pharmaceutical care needs, and perceived need of a pharmacist-run clinic by people with Parkinson's and their caregivers. Setting Malaysian Parkinson's Disease Association. Method A focus group discussion adopting a descriptive qualitative approach was conducted involving people with Parkinson's and their caregivers. A semi-structured interview guide was used to determine the challenges they faced with their medications and healthcare system, their pharmaceutical care needs, and their views on a pharmacist-run clinic. Data was thematically analysed. Main outcome measure: Healthcare challenges faced by people with Parkinson's and caregivers along with their pharmaceutical care needs and perceived need of a pharmacist-run clinic. Results Nine people with Parkinson's and four caregivers participated. Six themes were developed: (1) "It's very personalised": the need for self-experimentation, (2) "Managing it is quite difficult": challenges with medication, (3) "The doctor has no time for you": challenges with healthcare providers, (4) "Nobody can do it except me": challenges faced by caregivers, (5) "It becomes a burden": impact on quality of life, and (6) "Lack of consistency could be counterproductive": views on pharmacist-run clinic. Conclusion The provision of pharmaceutical care services by pharmacists could help overcome issues people with Parkinson's face, however there is a need for them to first see pharmacists in their expanded roles and change their limited perception of pharmacists. This can be achieved through integration of pharmacists within multidisciplinary teams in specialist clinics which they frequent.

Health Care Needs of Deaf Signers: The Case for Culturally Competent Health Care Providers.

There is a need for culturally competent health care providers (HCPs) to provide care to deaf signers, who are members of a linguistic and cultural minority group. Many deaf signers have lower health literacy levels due to deprivation of incidental learning opportunities and inaccessibility of health-related materials, increasing their risk for poorer health outcomes. Communication barriers arise because HCPs are ill-prepared to serve this population, with deaf signers reporting poor-quality interactions. This has translated to errors in diagnosis, patient nonadherence, and ineffective health information, resulting in mistrust of the health care system and reluctance to seek treatment. Sign language interpreters have often not received in-depth medical training, compounding the dynamic process of medical interpreting. HCPs should thus become more culturally competent, empowering them to provide cultural- and language-concordant services to deaf signers. HCPs who received training in cultural competency showed increased knowledge and confidence in interacting with deaf signers. Similarly, deaf signers reported more positive experiences when interacting with medically certified interpreters, HCPs with sign language skills, and practitioners who made an effort to improve communication. However, cultural competency programs within health care education remain inconsistent. Caring for deaf signers requires complex, integrated competencies that need explicit attention and practice repeatedly in realistic, authentic learning tasks ordered from simple to complex. Attention to the needs of deaf signers can start early in the curriculum, using examples of deaf signers in lectures and case discussions, followed by explicit discussions of Deaf cultural norms and the potential risks of low written and spoken language literacy. Students can subsequently engage in role plays with each other or representatives of the local signing deaf community. This would likely ensure that future HCPs are equipped with the knowledge and skills necessary to provide appropriate care and ensure equitable health care access for deaf signers.

Design suggestions for an mHealth app to facilitate communication between pharmacists and the Deaf: perspective of the Deaf community (HEARD Project).

BACKGROUND: Deaf and hard-of-hearing (DHH) patients have trouble communicating with community pharmacists and accessing the healthcare system. This study explored the views on a proposed mobile health (mHealth) app in terms of design and features, that will be able to bridge the communication gap between community pharmacists and DHH patients. METHODS: A community-based participatory research method was utilized. Two focus group discussions (FGDs) were conducted in Malaysian sign language (BIM) with a total of 10 DHH individuals. Respondents were recruited using purposive sampling. Video-recordings were transcribed and analyzed using a thematic approach. RESULTS: Two themes emerged: (I) challenges and scepticism of the healthcare system; and (II) features of the mHealth app. Respondents expressed fears and concerns about accessing healthcare services, and stressed on the need for sign language interpreters. There were also concerns about data privacy and security. With regard to app features, the majority preferred videos instead of text to convey information about their disease and medication, due to their lower literacy levels. CONCLUSIONS: For an mHealth app to be effective, app designers must ensure the app is individualised according to the cultural and linguistic diversity of the target audience. Pharmacists should also educate patients on the potential benefits of the app in terms of assisting patients with their medicine-taking.

A qualitative study on the design and development of an mHealth app to facilitate communication with the Deaf community: perspective of community pharmacists.

PURPOSE: This study prepares the groundwork on the potential design and development of a mobile health (mHealth) app that will be able to bridge the communication gap between pharmacists and patients who are Deaf and Hard of Hearing (DHoH). PATIENTS AND METHODS: A focus group discussion was conducted with 12 community pharmacists. Participants were recruited using snowball sampling. Audio-recordings were transcribed verbatim, and analyzed using a thematic approach. RESULTS: Three themes were apparent: 1) suggestions for app design and content, 2) perceived benefits of the app, and 3) potential challenges related to the app. Participants believed the app would be able to facilitate and improve communication, and hence relationship, between pharmacists and the DHoH. Potential challenges of the app were highlighted, such as the need for manpower to manage the app, and its cost to this group of economically disadvantaged people. There were also concerns about privacy and security. CONCLUSIONS: This study allowed community pharmacists, one of the end-users of the app, to provide feedback on the contents and design of the app, which would allow them to provide pharmaceutical care services to patients who are DHoH, and better serve them. Potential benefits and challenges of the app were also identified. Undoubtedly, through the mHealth app, community pharmacists will be better equipped to serve and communicate with the DHoH, and this will hopefully translate to improved health outcomes in these patients.