Challenges experienced by healthcare workers in managing patients with hearing impairment at a primary health care setting: a descriptive case study

Abstract

Background: There has been little research on the experiences of healthcare workers (HCWs) with deaf/hearing impaired (HI) clients. Anecdotal evidence suggests that HCWs experience challenges, but little is reported on how they manage these challenges. Interactions with and care of deaf/Deaf and HI patients by clinicians has yielded several questions around communication and assessment strategies, as well as comparative quality of health care for deaf/Deaf and HI clients. This research was intended to further the understanding and knowledge of these aspects of health care of deaf/Deaf and HI clients.Methods: The study design is a qualitative, descriptive case study. Data were collected using semi-structured interviews with individual HCWs and focus-group discussions with groups of participants. Participants were invited staff members at Retreat Community Health Centre (RCHC) in Cape Town. Convenience sampling was used to select participants, and interviews were conducted until saturation was reached. Data were studied and analysed using the phenomenological method.Results: HCWs reported that they serve very few Deaf or HI clients. However, themes of language barriers, resilience, preconceptions, improvisation and innovation, interpreters and recommendations emerged. Difficulties in communication were acknowledged, but HCWs insisted that these barriers are not insurmountable.Discussion and conclusion: A few preconceptions and gaps in knowledge and awareness were revealed. HCWs also tended to rely on escorts and other interpreters. The dominant recommendations are that HCWs should receive training in sign language (SL) and/or that SL interpreters be available at facilities. Despite using words and phrases such as ‘frustrating’ and ‘more effort’, participants’ concluding remarks reiterate that their experiences are positive, suggesting a notable resilience.

Knowledge, Attitudes, and Practices Toward Deaf Patients Among Healthcare Workers in Saudi Arabia: 2020-2021

“…This is consistent with the study of Velonaki et al [6], which indicated that nurses lacked knowledge about Deaf people, suggesting that only 5.8% were aware that Deaf patients were not conversant about their health issues. Supporting these reports, a qualitative report done by Orrie and Motsohi [13] revealed that HCWs had preconceptions and gaps in knowledge and awareness. They identified themes such as language barriers, improvisation and innovation, interpreters, resilience, and recommendations as the point of concern, adding that communication is a challenge, but HCWs claimed this barrier is not insurmountable.…”

“…Although interpreters help overcome language barriers, inappropriate use of escorts as interpreters may steal patients' independence and confidentiality rights [4]. In the absence of communication assistance, HCWs usually communicate in writing [12], despite knowing the disadvantages of this method, such as patient literacy-level dependency and time consumption [13]. According to one study, only 20% of deaf people have fluency in written English [14].…”

Social determinants of health in non-communicable diseases prevention policies in South Africa

“…Inequities and disparities in health care and economics are factors impeding the successful implementation of EHDI programmes in African countries (Engelman 2014;. Inequalities within the African context often disadvantage families in accessing health care, including both structural and procedural access, that is, physical access, funding, transport and communication barriers, as well as attitudes and beliefs of health care providers Orrie & Motsohi 2018). Late-identified hearing impairment poses additional financial stress to the resource-constrained African health care systems, as it is estimated that the cost of severe-profound hearing impairment to society is approximately $300,000 over the lifetime of the hearing-impaired individual (Hear-It.org 2021).…”

“…The authors of this chapter argue for the acknowledgement and incorporation of cultural beliefs and practices, where appropriate, in ECI programmes planning and implementation, particularly because evidence demonstrates that parental beliefs and perceptions influence the outcomes of the therapeutic approach adopted (Majid et al 2017). It is, therefore, important for African audiologists to explore the challenges encountered in the African context while rendering communication interventions with the aim of improving their quality of care and addressing the capacity versus demand challenges so that more children with hearing impairment can have access to evidence-based ECI services (Harmer 1999;Orrie & Motsohi 2018). Chapter 10 comprehensively deliberates on complexities presented by context, particularly linguistic and cultural diversity challenges in preventive audiology in South Africa, with ECI being part of tertiary preventive audiology.…”

Complexities with context: Cultural and linguistic diversity challenges in preventive audiology in Africa

“…The authors of this chapter argue for the acknowledgement and incorporation of cultural beliefs and practices, where appropriate, in ECI programmes planning and implementation, particularly because evidence demonstrates that parental beliefs and perceptions influence the outcomes of the therapeutic approach adopted (Majid et al 2017). It is, therefore, important for African audiologists to explore the challenges encountered in the African context while rendering communication interventions with the aim of improving their quality of care and addressing the capacity versus demand challenges so that more children with hearing impairment can have access to evidence-based ECI services (Harmer 1999;Orrie & Motsohi 2018). Chapter 10 comprehensively deliberates on complexities presented by context, particularly linguistic and cultural diversity challenges in preventive audiology in South Africa, with ECI being part of tertiary preventive audiology.…”