Availability of specialised healthcare facilities for deaf and hard of hearing individuals

Anika S. Smeijers, Martina H. Ens-Dokkum, Beppie van den Bogaerde, Anne Marie Oudesluys-Murphy


Context: To allow a medical consultation to proceed successfully, it is essential that physicians are aware of the linguistic and cultural backgrounds of deaf and hard of hearing individuals (DHH) and related communication aspects. Some specialised healthcare facilities have emerged to respond to the specific needs of people who are DHH.

Objective: This study aims to provide insight into the various types of general healthcare facilities available for DHH individuals. By sharing and comparing experiences and results improvements can be made.

Design, Data Sources and Study selection: A systematic review of the literature on specialised healthcare for DHH people was performed. The following databases were searched: PubMed, Web of Science, PsycINFO, Academic Search Premier, CINAHL and Embase. After independent extraction per article by two readers, fifteen articles were included in the systematic review. As it appeared that not all existing locations of facilities of which we were aware were described in the literature, we expanded the data collection with internet searches, specific literature searches and unstructured interviews.

Results: Some countries have developed facilities to meet the needs DHH people Experts and patients’ groups report that the perceived quality of healthcare and health education in specialised healthcare settings is higher compared to regular healthcare settings. Two projects undertaken to improve the health related knowledge level of DHH people, proved to be effective.

Conclusion: Some facilities or combinations of facilities are used in different countries to attempt to meet the needs of DHH patients. These facilities are rarely described in the scientific literature. Further development of specialised healthcare facilities for DHH patients, which should include high quality studies on their effectiveness, is imperative to comply with medical ethical standards and respect the human rights of DHH people.

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Reference List

(1) Napier J, Kidd MR. English literacy as a barrier to healthcare information for deaf people who use Auslan. Aust Fam Physician 2012; 42, 896-899.

(2) Barnett S. Communication with deaf and hard-of-hearing people: a guide for medical education. Acad Med 2002;77(7):694-700.

(3) Steinberg AG, Barnett S, Meador HE, Wiggins EA, Zazove P. Healthcare system accessibility. Experiences and perceptions of deaf people. J Gen Intern Med 2006;21(3):260-266.

(4) Fellinger J, Holzinger D, Pollard R. mental health of deaf people. Lancet, 2012;379: 1037-1044

(5) Barnett S. Clinical and cultural issues in caring for deaf people. Fam Med 1999;31(1):17-22.

(6) Smith S.R., Kushalnager P., Hauser P.C. Deaf Adolescents' Learning of Cardiovascular Health Information: Sources and Access Challenges. Journal of Deaf Studies and Deaf Education 2014;408-418.

(7) Fitz-Gerald.D., Fitz-Gerald M. Sex education for the hearing-impaired: implications for the teacher/counselor. In: Culhane B, Williams C, editors. Social aspects of deafness.Washington DC: Gallaudet University; 1982; 263-274.

(8) Folkins A, Sadler GR, Ko C, Branz P, Marsh S, Bovee M. Improving the Deaf community's access to prostate and testicular cancer information: a survey study. BMC Public Health 2005;5:63.

(9) Tamaskar P, Malia T, Stern C, Gorenflo D, Meador H, Zazove P. Preventive attitudes and beliefs of deaf and hard-of-hearing individuals. Arch Fam Med 2000;9(6):518-25, discussion.

(10) Wood B. Deaf patients in the OR: a mile in someone else's shoes. Todays Surg Nurse 1999;21(3):34-36.

(11) Smeijers AS, Ens-Dokkum MH, van den Bogaerde B, Oudesluys-Murphy AM. Clinical practice : The approach to the deaf or hard-of-hearing paediatric patient. Eur J Pediatr 2011;170(11):1359-1363.

(12) Rodda M, Eleweke CJ. Providing accessible services to minority ethnic deaf people: insights from a study in Alberta, Canada. Am Ann Deaf 2002;147(5):45-55.

(13) Smeijers AS, Pfau R. Towards a treatment for treatment: the communication between general practitioners and their Deaf patients. The Sign Language Translator and Interpretor 2009;3(1):1-14.

(14) Schein JD, Delk MT. Survey of healthcare for deaf people. The Deaf American 1980;32(5):5-27.

(15) Bat-Chava Y, Martin D, Kosciw JG. Barriers to HIV/AIDS knowledge and prevention among deaf and hard of hearing people. AIDS Care 2005;17(5):623-634.

(16) McEwen E, Anton-Culver H. The medical communication of deaf patients. J Fam Pract 1988;26(3):289-291.

(17) Zazove P, Niemann LC, Gorenflo DW et al. The health status and healthcare utilization of deaf and hard-of-hearing persons. Arch Fam Med 1993;2(7):745-752.

(18) US Department of Justice: Communicating with people who are deaf or hard of hearing in hospital setting. https://www.ada.gov/hospcombr.htm. Retrieved 2015, Web last accesed May 2016.

(19) Barnett S, Franks P. Healthcare utilization and adults who are deaf: relationship with age at onset of deafness. Health Serv Res 2002;37(1):105-120.

(20) Fellinger J, Holzinger D, Schoberberger R, Lenz G. [Psychosocial characteristics of deaf people: evaluation of data from a special outpatient clinic for the deaf]. Nervenarzt 2005;76(1):43-51.

(21) Kaskowitz SR, III, Nakaji MC, Clark KL, Gunsauls DC, Sadler GR. Bringing prostate cancer education to deaf men. Cancer Detect Prev 2006;30(5):439-448.

(22) Choe S, Lim RS, Clark K, Wang R, Branz P, Sadler GR. The impact of cervical cancer education for deaf women using a video educational tool employing American sign language, open captioning, and graphics. J Cancer Educ 2009;24(1):10-15.

(23) Jones EG, Renger R, Firestone R. Deaf community analysis for health education priorities. Public Health Nurs 2005;22(1):27-35.

(24) Jensen LG, Nakaji MC, Gallegos N, Malcarne VL, Sadler GR. Ovarian cancer: Deaf and hearing women's knowledge before and after an educational video. J.Cancer Educ. 2012; 28, 647-655.

(25) Hickey S, Merz EL, Malcarne VL, Gunsauls DC, Huang J, Sadler GR. Breast cancer education for the Deaf community in American Sign Language. Oncol Nurs Forum 40, 2012; E86-E91.

(26) Harry KM, Malcarne VL, Branz P, Garcia BD, Sadler GR. Evaluating a skin cancer education program for the Deaf community. J.Cancer Educ. 2012; 27, 501-506.

(27) Yao CS, Merz EL, Nakaji MC, Harry KM, Malcarne VL, Sadler GR. Cervical cancer control: deaf and hearing women's response to an educational video. J.Cancer Educ. 2012; 27, 62-66.

(28) Sacks L, Nakaji MC, Harry KM, Oen M, Malcarne VL, Sadler GR. Testicular cancer knowledge among deaf and hearing men. J.Cancer Educ. 2013; 28, 503-508.

(29) MacKinney TG, Walters D, Bird GL, Nattinger AB. Improvements in preventive care and communication for deaf patients: results of a novel primary healthcare program. J Gen Intern Med 1995;10(3):133-137.

(30) Equy DA, et. all. Evaluation of Measures to Facilitate Access to Care for Pregnant Deaf Patients: Use of Interpreters and Training of Caregivers in Sign Language Communication Disorders, Deaf Studies & Hearing Aids. 2012;1(1):1-4.

(31) Sporek P.E. Improving the experience of pregnancy and childbirth for deaf people and their families. Pract Midwife 2014;17(4):12-14.

(32) Thew D, Smith SR, Chang C, Starr M. The deaf strong hospital program: a model of diversity and inclusion training for first-year medical students. Acad.Med. 87, 2012; 1496-1500.

(33) Kuenburg A, Fellinger P, Fellinger J. Health Care Access Among Deaf People. Journal of Deaf Studies and Deaf Education. 2016;21(1):1-10.

(34) European Union of the Deaf. http://www.eud.eu. Retrieved 2011, Web last accesed May 2015.

(35) de Wit M. Sign Language Interpreting in Europe. Self-pubished. Printed by Create Space, Baarn, 2008. Available at Amozone.com

(36) World Association of Sign Language Interpreters. http://www.wasli.org/links-p55.aspx. Retrieved 2011, Web last accesed May 2016.

(37) Departement of Human Services, Victoria. http://www.dhs.vic.gov.au/for-individuals/disability/community-life-and-jobs/video-relay-interpreting-service/auslan-video-relay-interpreting-service-links. Retrieved 2015, Web last accesed May 2016.

(38) Swanson L. New mental health services for deaf patients. CMAJ 2007;176(2):160.

(39) Canadian Association of the Deaf. http://www.cad.ca/health_care.php. Retrieved 2011, Web last accesed May 2016.

(40) Kuurojen liitto ry (The Finnish Association of the Deaf). http://www.kl-deaf.fi. Retrieved 2015, Web last accesed May 2016.

(41) Kokko J, Kepmpainen E, Rautavaara A. Technology and Regional Social Structures: Evaluation of Remote Sign Language Interpretation in Finland. Lecture Notes in Computer Science 4554, 2007; 716-721.

(42) Laubreton J., Morvan R., Roblot P. Développons les consultations hospitalières pour les sourds. Press Med 2013;(42):1427-1429.

(43) Deafhear, Services for Deaf & Hard of Hearing People (Ireland). http://www.deafhear.ie. Retrieved 2015, Web last accesed May 2016

(44) Deaf japan News. http://www.dhs.vic.gov.au/disability/improving_support/cultural_and_linguistic_diversity/auslan-video-relay-interpreting-service/key-vri-providers#contact. Retrieved 2015, Web last accesed May 2016.

(45) New Zeeland. http://wasli.org/wp-content/uploads/2014/01/Fiji-2014-Final-Report-Zane-Hema.pdf. Retrieved 2016, Web last accesed September 2016.

(46) Norges Døveforbund (Norwegian Deaf league). Retrieved 2015, Web last accesed May 2015. http://www.deafnet.no

(47) Sveriges Dövas Riksförbund (Swedisch Deaf League). http://www.sdr.org. Retrieved 2011, Web last accesed May 2015.

(48) Thailand. http://wasli.org/training. Retrieved 2016, Web last accesed May 2016.

(49) Coghen C., Cokely D. Preparing Interpreters for Tomorrow:Reprot of a Study of Eemerging Trends in Interpreting and Implications for Interpreter Education. Boston, Massachusetts: National Interpreter Education center; Jan 2015.

(50) Royal National Institute for Deaf people. Working with BSL/ English Interpreter. Fact Sheet. London, RNID, 2005.

(51) Carrico L, Mirri S. Evaluation of real-time captioning by machine recognition with human support. New York: ACM; 2015.

(52) Gournaris MJ. Preparation for the delivery of telemental health services with individuals who are deaf: Informed consent and provider procedure guidelines. Journal of the American Deafness and Rehabilitation Association 2009;43(1):34-51.

(53) Cohn ER, Cason J. Telepractice: A wide-angle view for persons with hearing loss. The Volta Review 2012; 112, 207-226.

(54) McKee MM, Paasche-Orlow MK, et.all. Assessing Health Literacy in Deaf American Sign Language Users. J Health Commun 2015;2:92-100.

(55) Goldstein MF, Eckhardt EA, Joyner-Creamer P, Berry R, Paradise H, Cleland CM. What do deaf high school students know about HIV? AIDS Educ Prev 2010;22(6):523-537.

(56) Peinkofer JR. HIV education for the deaf, a vulnerable minority. Public Health Rep 1994;109(3):390-396.

(57) Wollin J, Elder R. Mammograms and Pap smears for Australian deaf women. Cancer Nurs 2003;26(5):405-409.

(58) Orsi JM, Margellos-Anast H, Perlman TS, Giloth BE, Whitman S. Cancer screening knowledge, attitudes, and behaviors among culturally Deaf adults: implications for informed decision making. Cancer Detect Prev 2007;31(6):474-479.

(59) Joseph JM. Peer education and the deaf community. J Am Coll Health 1993;41(6):264-266.

(60) Berman BA, Guthmann DS, Crespi CM, Liu W. Development and testing of an antitobacco school-based curriculum for deaf and hard of hearing youth. Am Ann Deaf 2011;155(5):592-604.

(61) Munoz-Baell IM, Alvarez-Dardet C, Ruiz MT, Ferreiro-Lago E, Aroca-Fernandez E. Setting the stage for school health-promoting programmes for deaf children in Spain. Health Promot Int 2008;23(4):311-327.

(62) Arunakul M, Kuphasuk Y, Boonyathanasit R. Effectiveness of oral hygiene instruction media on periodontal health among hearing impaired children. Southeast Asian J Trop Med Public Health 43, 2012; 1297-1303.

(63) Shabaik S, LaHousse SF, Branz P, Gandhi V, Khan AM, Sadler GR. Colorectal cancer video for the deaf community: a randomized control trial. J Cancer Educ 2010;25(4):518-523.

(64) Medisigns. http://www.medisignsproject.eu/MEDISIGNS/About_MEDISIGNS.html. Retrieved 2016, Web last accesed September 2016.

(65) Deafnest. http://www.deafnest.com. Retrieved 2016, Web last accesed September 2016.

(66) Stein LK, Jabaley T, Mindel ED. Deafness and Mental health. New York: Grune & Stratton Inc; 1981.

(67) Pollard R. Public mental health services and diagnostic trends regarding individuals who are deaf or hard of hearing. Rehabil Psychol 1994;39(3).

(68) Ladd P., John M. Deaf People as a Minority Group: The Political Process. Free educational projects supported by The Open University, 2016.

(69) Flores G. The impact of medical interpreter services on the quality of healthcare: a systematic review. Med Care Res Rev 2005;62(3):255-299.

(70) Zazove P, Meador H, Reed BD, Sen A, Gorenflo D. Effectiveness of videos improving cancer prevention knowledge in people with profound hearing loss. J.Cancer Educ. 2012; 27: 327-337.

(71) Kushalnager P., Smith S.R., Hopper M., Ryan C., Rinkevich M., Kushalnager R. Making Cancer Health Text on the Internet Easier to Read for Deaf People Who Use American Sign Language. J Cancer educ 2016; Epub ahead of print.


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