Communicating about health care: Observations from persons who are deaf or hard of hearing
Communicating about health care: Observations from persons who are deaf or hard of hearing
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DOI：
10.7326/0003-4819-140-5-200403020-00011
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发表时间：
2004-03-02
影响因子：
39.2
通讯作者：
Harker, H
中科院分区：
文献类型：
--
作者：
Iezzoni, LI;O'Day, BL;Harker, H
背景：实现以患者为中心的护理需要医生和患者之间的有效沟通。聋人或听力障碍的人面临着相当大的障碍，以沟通与physics.Objective：了解的看法，医疗保健的经验和建议，以改善照顾聋人或听力障碍individual.Design：4个半结构化的小组访谈，2个进行美国手语（聋人）和2个使用通信访问实时翻译（听力障碍的个人）。男性和女性分别接受采访。研究地点：大波士顿、马萨诸塞州和华盛顿，2001年，参与者：14名成年聋人（23至51岁）和12名重听成人（30至74岁）。测量：围绕沟通维度组织的共同表达的主题或观点。结果：围绕6大主题合并的关注：医生和患者对失聪或听力障碍的不同看法;对有效沟通的不同看法（如唇读阅读、写笔记和手语翻译）;用药安全和沟通不足造成的其他风险;体检和程序期间的沟通问题;难以与办公室工作人员互动，包括在等候室;电话通信问题，如信息菜单过长。参与者提供了广泛的改进建议，从临床医生询问患者他们首选的沟通方法开始。让患者重复关键的健康信息（如药物说明）可以识别潜在的危险miscommunication.Conclusions：随着人口老龄化，医生会遇到更多的人与听力限制。医生提供一些便利，如雇用手语翻译，是不报销的。然而，确保有效的沟通对于安全，及时，高效和以患者为中心的护理至关重要。
Background: Achieving patient-centered care requires effective communication between physicians and patients. Persons who are deaf or hard of hearing face considerable barriers to communicating with physicians.Objective: To understand perceptions of health care experiences and suggestions for improving care among deaf or hard-of-hearing individuals.Design: 4 semistructured group interviews, 2 conducted in American Sign Language (for deaf individuals) and 2 using Communication Access Realtime Translation (for hard-of-hearing individuals). Men and women were interviewed separately. Tapes of interviews were transcribed verbatim for analysis.Setting: Greater Boston, Massachusetts, and Washington, DC, in 2001.Participants: 14 deaf adults (23 to 51 years of age) and 12 hard-of-hearing adults (30 to 74 years of age).Measurements: Commonly expressed themes or views organized around dimensions of communication.Results: concerns coalesced around 6 broad themes: conflicting views between physicians and patients about being deaf or hard of hearing; different perceptions about what constitutes effective communication (such as lip reading, writing notes, and sign language interpreter); medication safety and other risks posed by inadequate communication; communication problems during physical examinations and procedures; difficulties interacting with office staff, including in waiting rooms; and problems with telephone communication, such as lengthy message menus. Participants offered extensive suggestions for improvements, starting with clinicians' asking patients about their preferred communication approach. Having patients repeat critical health information (such as medication instructions) can identify potentially dangerous miscommunication.Conclusions: As the population ages, physicians will encounter many more persons with hearing limitations. Physicians are not reimbursed for making some accommodations, such as hiring sign language interpreters. However, ensuring effective communication is essential to safe, timely, efficient, and patient-centered care.