Ask and ye shall not receive: Interpreter-related access barriers reported by Deaf users of American sign language

Schniedewind, Elizabeth; Lindsay, Ryan; Snow, Steven G.

doi:10.1016/j.dhjo.2020.100932

Cited by 19 publications

(12 citation statements)

References 16 publications

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“…Working-age persons with disabilities in Trinidad identified solutions similar to those in the literature such as more doctors, medical equipment and highly competent staff, materials in alternative formats, and sign languages interpreters (Alborz et al, 2005;Dassah et al, 2018;Jeamwatthanachai et al, 2019;Schniedewind et al, 2020;Vergunst et al, 2015;Withers & Speight, 2017). More contextualized solutions included the improvement of the chronic disease assistance programme and the provision of counselling services and more customer service representatives.…”

Section: Increasing Consultations With Persons With Disabilitiesmentioning

confidence: 84%

“…Persons with disabilities engaged in self-medication (Munthali et al, 2019) and relatives’ willingness to support them was based on misperceptions of the urgency and severity of the issue (Alborz et al, 2005). Regarding environmental barriers, the issue went beyond physical access (Parey, 2020a) with the literature reporting on uneven pathways, narrow doorways, inadequate bathroom facilities, the absence of appropriate signage, inadequate medical equipment, and insufficient communication mechanisms for people with sensory disabilities (Iezzoni, 2011; Jeamwatthanachai et al, 2019; Moscoso-Porras et al, 2019; Munthali et al, 2019; Schniedewind et al, 2020; Vergunst et al, 2015; Withers & Speight, 2017). Long queues at the health facilities (Dassah et al, 2018; Munthali et al, 2019), insufficient legislative and policy frameworks, low funding, and the non-involvement of persons with disabilities in decision-making were also barriers (Krahn et al, 2015; World Health Organization, 2015).…”

Section: Introductionmentioning

confidence: 99%

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Healthcare Barriers Among Working-Age Persons with Disabilities in Trinidad

Parey

Sinanan

2021

Qual Health Res

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Even though easily accessible and cost-effective healthcare is a fundamental human right, many persons with disabilities experience healthcare barriers and poor health outcomes. We explore the healthcare barriers among working-age persons with disabilities in Trinidad using a qualitative descriptive approach. Semi-structured interviews with 26 participants reveal barriers at the personal, healthcare facility, and societal levels. The findings indicate the need for a nation-wide integrated digitalized system and increased intersectoral collaborations to support adequate healthcare among persons with disabilities in Trinidad. Increased consultation with persons with disabilities and transformation of the disability discourses within the healthcare system and at the national level are also recommended as part of the humanisation of their care.

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Section: Increasing Consultations With Persons With Disabilitiesmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Healthcare Barriers Among Working-Age Persons with Disabilities in Trinidad

Parey

Sinanan

2021

Qual Health Res

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“…However, this is not consistent with the findings of a previous study that indicated interpreter JAMA Network Open | Health Policy services were frequently promised to patients who were deaf but were not provided at the appointment. 29 It has been suggested that, although communication problems are the most significant factor affecting access to health care services for patients who are deaf, these patients need to increase their demands for access. 30 Training has been provided to deaf community members to selfadvocate for accommodations in health care and other settings, 31 yet the more contacts the SPs who were deaf had with the clinic, the less likely they were to receive a new patient appointment.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Access to Primary Care Medical and Dental Appointments Between Simulated Patients Who Were Deaf and Patients Who Could Hear

2021

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IMPORTANCE Primary medical and dental clinics may accept fewer people who are deaf as patients than persons who can hear, and clinics may deny requests by patients who are deaf for American Sign Language (ASL) interpretation at appointments when necessary, creating diminished access to primary medical and dental care. OBJECTIVE To compare the rate at which patients who are deaf are offered primary care medical or dental appointments with the rate at which appointments are offered to patients who can hear in a real-world context. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study used a simulated patient (SP) call audit method. Simulated patients (4 who could hear and 4 who were deaf) followed a call script in which an adult sought to establish care, requesting new patient appointments from a statewide stratified random sample of clinicians listed in the Idaho Medical and Dental Associations member databases at 445 clinics (334 primary care and 111 general dentistry) throughout Idaho. Simulated patients who were deaf also requested interpreting services at the appointment. Calls were made between June 7 and December 6, 2018. Data analysis was conducted from December 2019 to April 2020. EXPOSURES Simulated patients who were deaf or could hear called primary care medical or dental clinics from the sampling frame and requested an appointment, supplying the same basic information. In addition, SPs who were deaf requested that an ASL interpreter be provided by the clinic for the appointment. MAIN OUTCOMES AND MEASURESRates of new appointments offered and, for SPs who were deaf, whether ASL interpreter services were confirmed for the appointment.RESULTS Two male and 2 female SPs who could hear were successful on 210 occasions (64.4%) when requesting a new patient appointment compared with 2 male and 2 female SPs who were deaf who were successful on 161 occasions (49.1%) (P < .001). Simulated patients who could hear were nearly 2 times more likely to secure appointments than were SPs who were deaf (adjusted odds ratio, 1.88; 95% CI, 1.27-2.79). For SPs who were deaf, 80 unsuccessful appointment requests (48.2%) were associated with a request for interpretation. CONCLUSIONS AND RELEVANCEThe findings suggest that in a statewide representative sample, access to primary medical and dental care for patients who are deaf is significantly reduced. Patients who are deaf may not receive an appointment if they request interpreter services, even when such services are required to provide effective communication.

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“…Interpreters, where needed, should be qualified, registered (such as with the UK National Registers of Communication Professionals Working with Deaf and Deafblind People (NRCPD)), and booked in advance of the appointment 32. Surveys show that 68% of patients in the UK requesting a BSL interpreter had not been provided with one,20 and there are similar findings from the US 33. The use of family members to provide interpretation is inappropriate and compromises privacy and patient autonomy 34…”

Section: How Can We Improve Communication With D/deaf Patients?mentioning

confidence: 99%