Developing a capacity-building intervention for healthcare workers to improve communication skills and awareness of hard of hearing and D/deaf patients: results from a participatory action research study.

BACKGROUND: Healthcare workers (HCWs) are commonly not prepared to properly communicate with D/deaf and hard of hearing (HoH) patients. The resulting communication challenges reinforce the existing barriers to accessing and benefiting from quality of care in these populations. In response, this study aimed to develop and evaluate a capacity-building intervention for HCWs to raise their awareness of D/deaf and HoH individuals' experiences in healthcare and improve their capacity to communicate with these populations. METHODS: This study featured a participatory action research design using qualitative and quantitative methods. The intervention was developed and tested through 4 iterative phases. Reactions (i.e., satisfaction and perception of the intervention content, quality, appropriateness and usefulness) were assessed quantitatively and qualitatively after the intervention, whereas perceived knowledge and self-efficacy in communicating with D/deaf and HoH patients and organizational payoffs (use frequency of basic rules and tools improving communication) were quantitatively assessed before, after and 6-month post-intervention. RESULTS: Main qualitative and quantitative findings showed that the final version of the intervention reached high levels of satisfaction among participants. Next, perceived knowledge and self-efficacy scores obtained after receiving the intervention and 6 months later were significantly higher than those yielded in the initial assessment, although both scores significantly decreased at 6 months (compared to the scores obtained just after the intervention). Finally, findings showed no significant changes in organizational payoffs after receiving the intervention. Echoing these results, main qualitative findings documented that after receiving the intervention, participants felt more confident yet not more equipped to communicate with D/deaf and HoH patients. CONCLUSIONS: Findings suggest that the capacity-building intervention is a promising means to sustainably increase HCWs' perceived knowledge and self-efficacy on how communicating with D/deaf and HoH patients, although complementary approaches and follow-up intervention reminders may be necessary to enable practice changes in the working environment.

[Equity of care in gynecology-obstetrics for the deaf and hard of hearing†: issues]. / Équité des soins en gynécologie-obstétrique pour les personnes sourdes et malentendantes†: enjeux.

The deaf and hard of hearing population suffers from difficulties in accessing the health care system due to communication barriers with health care and administrative personnel who are often insufficiently trained in deafness issues. Gynecology-obstetrics consultations represent a gateway to the health system. Since 2011, there is a gynecology and obstetrics consultation dedicated to deaf people at the CHUV. This article presents the means of communication support put in place within the context of this specific consultation as well as the experience of a group of patients. Awareness of deafness among all staff in contact with patients as well as the use of professional interpreters are the key elements of care that respects the needs and rights of deaf people.

La population sourde et malentendante souffre de difficultés d'accès au système de santé en raison de barrières de communication avec le personnel soignant et administratif, souvent insuffisamment formé aux enjeux de la surdité. Les consultations de gynécologie-obstétrique représentent une porte d'entrée dans le système de santé. Depuis 2011, une consultation de gynécologie-obstétrique dédiée aux personnes sourdes existe au CHUV. Cet article présente les moyens d'aide à la communication mis en place dans le cadre de cette consultation spécialisée ainsi que le vécu d'un collectif de patientes. Une sensibilisation à la surdité de l'ensemble du personnel au contact des patient·e·s ainsi que la sollicitation d'interprètes professionnel·le·s sont les piliers d'une prise en charge respectueuse des besoins et des droits des personnes sourdes.

Developing and Evaluating a Capacity-Building Intervention for Healthcare Providers to Improve Communication Skills and Awareness of Hard of Hearing and D/deaf Populations: Protocol for a Participative Action Research-Based Study.

Background: D/deaf and hard of hearing populations are at higher risk for experiencing physical and mental health problems compared to hearing populations. In addition, they commonly encounter barriers to accessing and benefiting from health services, which largely stem from challenges they face in communicating with healthcare providers. Healthcare providers commonly lack tailored communication skills in caring for D/deaf and hard of hearing populations, which lead to difficulties and dissatisfaction for both staff and D/deaf and hard of hearing communities. This research project aims to develop and evaluate a capacity-building intervention for healthcare providers with the goal of increasing their awareness of D/deaf and hard of hearing individuals' experiences with the healthcare system, their distinct needs, and improving their capacity to communicate effectively with this patient population. Methods: This research project features a participative action research design using qualitative and quantitative methods. Consistent with participative action research, the study will actively involve the target populations, key stakeholders and representative associations. The intervention will be developed and tested through iterative phases. The Integrated Model of Training Evaluation and Effectiveness will guide prospective evaluation of the intervention. The latter will involve qualitative and quantitative assessments in participants before and after the intervention and at 6-months follow-up. Discussion: Results will contribute to research aimed at decreasing barriers to accessing and benefiting from healthcare services for D/deaf and hard of hearing individuals. Findings will be presented to representative associations and political authorities, as well as disseminated at research conferences and in peer-reviewed journals.

[Health issues in deaf and hearing-impaired patients†: a challenge to take up]. / Prise en charge de la patientèle sourde et malentendante†: un défi à relever.

In Switzerland, one person out of a hundred suffers from serious hearing impairment or complete hearing loss, whereas 13 % of the population is hard of hearing. Scientific literature shows that the global health of the hearing-impaired population is also an issue (psychological distress, sexual health, chronic diseases, access to messages of prevention). It is a little-known fact that deaf people form a real community, with a complete and proper system of communication ; they share cultural norms and values. The difficult access to care for this population calls for adaptations in the socio-sanitary world, thus enabling an effective level of communication and an appropriate handling of deaf patients.

En Suisse, une personne sur cent présente une limitation importante ou complète de l'ouïe, alors que 13 % de la population est malentendante. La littérature révèle de fortes inégalités de santé entre populations entendante et sourde et malentendante (détresse psychologique, santé sexuelle, maladies chroniques, accès aux messages de prévention, etc.). Une réalité largement méconnue : les personnes dites sourdes forment une véritable communauté, au bénéfice d'un système de communication complet et partageant un ensemble de normes et de valeurs culturelles. La difficulté d'accès aux soins pour cette population commande la mise en place, pour l'heure balbutiante, d'adaptations au sein du monde socio-sanitaire permettant une communication efficiente et une prise en charge adéquate.