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Hall S, Ballard M. Deaf patients' preferred communication in clinical settings: implications for healthcare providers. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2024; 29:170-186. [PMID: 38160399 DOI: 10.1093/deafed/enad061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024]
Abstract
Deaf patients who communicate in American Sign Language (ASL) experience communication challenges leading to medical errors, treatment delays, and health disparities. Research on Deaf patient communication preferences is sparse. Researchers conducted focus groups based on the Health Belief Model with culturally Deaf patients and interpreters. The ASL focus groups were interpreted and transcribed into written English, verified by a third-party interpreting agency, and uploaded into NVivo. Deductive coding was used to identify communication methods and inductive coding was used to identify themes within each. Writing back-and-forth introduced challenges related to English proficiency, medical terminology, poor penmanship, and tendencies of providers to abbreviate. Participants had various speechreading abilities and described challenges with mask mandates. Multiple issues were identified with family and friends as proxy interpreters, including a lack of training, confidentiality issues, emotional support, and patient autonomy. Video remote interpreter challenges included technical, environmental, and interpreter qualification concerns. Participants overwhelmingly preferred on-site interpreters for communication clarity. While there was a preference for direct care, many acknowledged this is not always feasible due to lack of providers fluent in ASL. Access to on-site interpreters is vital for many Deaf patients to provide full access to critical medical information. Budget allocation for on-call interpreters is important in emergency settings.
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Affiliation(s)
- Sarah Hall
- Department of Public Health, Utah Valley University, Orem, UT, United States
| | - Michael Ballard
- Department of Languages and Culture, Utah Valley University, Orem, UT, United States
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Mairson TM, Howe E. Addressing Structural Audism in Medicine: How Those Who are Deaf and Hard of Hearing are Marginalized in Healthcare. Psychiatry 2024; 87:2-6. [PMID: 38266212 DOI: 10.1080/00332747.2023.2286844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
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Nam HJ, Lee S, Park HN, Kim B, Yoon JY. A mixed-method systematic literature review of health literacy interventions for people with disabilities. J Adv Nurs 2023; 79:4542-4559. [PMID: 37503718 DOI: 10.1111/jan.15805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/29/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023]
Abstract
AIMS To identify the components and characteristics of health literacy interventions for people with disabilities and to explore the outcomes in terms of health literacy competencies. DESIGN A mixed-method systematic literature review. REVIEW METHODS The search results were reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. The quality appraisal was guided by the Mixed Methods Appraisal Tool. The contents of each intervention were mapped to the health literacy intervention model and the outcomes were annotated using the integrated model of health literacy. DATA SOURCES The literature search was conducted using several electronic databases, including PubMed, EMBASE, CINAHL, Cochrane library and PsycINFO in December 2022. RESULTS Ten studies were selected for this systematic literature review. Seven studies were quantitative, two were qualitative and one was a mixed-methods study. The four components of the health literacy interventions included empowering individuals with low-health literacy (n = 10), strengthening individuals' social support system (n = 3), improving communication with health professionals (n = 1) and reducing barriers to access health systems (n = 3). No intervention addressed improving health professionals' health literacy competencies. Health literacy competencies identified as outcomes in the studies included access (n = 1), understand (n = 7), appraise (n = 1) and apply (n = 9) the health information. CONCLUSIONS The significant findings of this systematic literature review provide baseline data and evidence for developing health literacy interventions for people with disabilities. However, this review demonstrates that only a handful of intervention studies have addressed the low-health literacy of people with disabilities. Further and more rigorous interventions addressing health literacy for people with diverse disabilities are warranted. IMPACT This review provides insights into how health literacy interventions can be tailored to the type of disability. Further, efforts should be expanded to comprehensively promote all the four core competencies of health literacy to reduce health disparities for individuals living with disabilities. NO PATIENT OR PUBLIC CONTRIBUTION Systematic literature review.
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Affiliation(s)
- Hye Jin Nam
- College of Nursing, Seoul National University, Seoul, South Korea
| | - Sujin Lee
- College of Nursing, Seoul National University, Seoul, South Korea
| | - Han Nah Park
- College of Nursing, Seoul National University, Seoul, South Korea
| | - Bohye Kim
- College of Nursing, Seoul National University, Seoul, South Korea
| | - Ju Young Yoon
- College of Nursing, Seoul National University, Seoul, South Korea
- Research Institute of Nursing Science, Seoul National University, Seoul, South Korea
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Seoul National University, Seoul, South Korea
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Piao Z, Lee H, Mun Y, Lee H, Han E. Exploring the health literacy status of people with hearing impairment: a systematic review. Arch Public Health 2023; 81:206. [PMID: 37993969 PMCID: PMC10664265 DOI: 10.1186/s13690-023-01216-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 11/08/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND People with hearing impairment have many problems with healthcare use, which is associated with health literacy. Research on health literacy is less focused on people with hearing impairments. This research aimed to explore the levels of health literacy in people with hearing impairment, find the barriers to health literacy, and summarize methods for improving health literacy. METHODS A systematic review was conducted using three databases (PubMed, Cochrane, and Embase) to search the relevant articles and analyze them. The studies were selected using pre-defined inclusion/exclusion criteria in two steps: first, selection by examining the title and abstract; and second, after reading the study in full. The Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS) was used to assess the quality of the articles. RESULTS Twenty-nine studies were synthesized qualitatively. Individuals with hearing impairment were found to have lower health literacy, when compared to those without impairment, which can lead to a higher medical cost. Most of the people with hearing impairment faced barriers to obtaining health-related information and found it difficult to communicate with healthcare providers. To improve their health literacy, it is essential to explore new ways of accessing health information and improving the relationship between patients and healthcare providers. CONCLUSIONS Our findings show that people with hearing impairment have lower health literacy than those without. This suggests that developing new technology and policies for people with hearing impairment is necessary not to mention promoting provision of information via sign language. TRIAL REGISTRATION OSF: https://doi.org/10.17605/OSF.IO/V6UGW . PROSPERO ID CRD42023395556.
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Affiliation(s)
- Zhaoyan Piao
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, 162-1 Songdo-Dong, Yeonsu-Gu, Incheon, Republic of Korea
| | - Hanbin Lee
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, 162-1 Songdo-Dong, Yeonsu-Gu, Incheon, Republic of Korea
| | - Yeongrok Mun
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, 162-1 Songdo-Dong, Yeonsu-Gu, Incheon, Republic of Korea
| | - Hankil Lee
- College of Pharmacy, Ajou University, Suwon, Gyeonggi-Do, Republic of Korea
| | - Euna Han
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, 162-1 Songdo-Dong, Yeonsu-Gu, Incheon, Republic of Korea.
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Sarhan MBA, Fujiya R, Kiriya J, Htay ZW, Nakajima K, Fuse R, Wakabayashi N, Jimba M. Health literacy among adolescents and young adults in the Eastern Mediterranean region: a scoping review. BMJ Open 2023; 13:e072787. [PMID: 37290942 PMCID: PMC10255069 DOI: 10.1136/bmjopen-2023-072787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/25/2023] [Indexed: 06/10/2023] Open
Abstract
OBJECTIVES For adolescents and young adults, most health literacy research has been conducted in Western countries, but few studies have been conducted in the Eastern Mediterranean region (EMR). This review aimed to explore the existing health literacy research in the EMR in addition to the levels of health literacy and its associated factors among adolescents and young adults. METHODS The search, conducted using the PubMed/MEDLINE, EBSCOhost/CINAHL plus, Web of Science and J-STAGE databases, was initially performed on 16 June 2022 and later updated on 1 October 2022. Studies that targeted 10-25 years old persons, conducted in any of the EMR countries and that used the health literacy concept and/or described its levels or predictors were included in the review. Content analysis was used for data extraction and analysis. Data related to the study methods, participants, outcome variables and health literacy were extracted. RESULTS The review included 82 studies, most of which were conducted in Iran and Turkey and adopted a cross-sectional design. Half of the studies showed that more than half of adolescents and young adults had low or moderate health literacy. Nine studies applied university-based or school-based health education interventions to improve health literacy, which was also predicted by demographic and socioeconomic factors and internet usage. Little attention was paid to assessing the health literacy of vulnerable people, such as refugees and those with a disability and exposed to violence. Finally, various health literacy topics were investigated, including nutrition, non-communicable diseases, media and depression. CONCLUSION Health literacy levels were low-to-moderate in adolescents and young adults in the EMR. To promote health literacy, it is recommended to use school-based health education and attempt to reach adolescents and young adults through social media platforms. More attention should be paid to refugees, people with disabilities and those exposed to violence.
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Affiliation(s)
- Mohammed B A Sarhan
- Graduate School of Health Management, Keio University, Fujisawa, Kanagawa, Japan
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Rika Fujiya
- Graduate School of Health Management, Keio University, Fujisawa, Kanagawa, Japan
- Faculty of Nursing and Medical Care, Keio University, Fujisawa, Kanagawa, Japan
| | - Junko Kiriya
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Zin Wai Htay
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Kayono Nakajima
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Rie Fuse
- Graduate School of Health Management, Keio University, Fujisawa, Kanagawa, Japan
| | - Nao Wakabayashi
- Graduate School of Health Management, Keio University, Fujisawa, Kanagawa, Japan
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Bulun MA, Çepni S, Ermez Y. Turkish Sign Language Adaptation of the Turkish Health Literacy Scale-32. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2022; 27:443-452. [PMID: 35914243 DOI: 10.1093/deafed/enac025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
Sign language speakers are at a disadvantage in terms of health literacy due to the lack of health education materials in sign languages. Deaf and hard of hearing (DHH) individuals are excluded from health literacy research due to the lack of measurement tools in their language of excellent fluency. This study aims to provide the literature with a tool that allows the measurement of health literacy among DHH individuals. The Turkish Health Literacy Scale (THLS)-32 was translated into Turkish Sign Language (TSL). After the THLS-32 was translated into TSL in video format, it was tested for validity and reliability. The translated version of the scale was administered to participants from a DHH association in Turkey who are fluent in TSL. Subsequently, a study was conducted with 207 DHH individuals. The study group was assessed in terms of their mean index scores and evaluated to have "limited health literacy" according to the THLS-32 classification. We conclude that the THLS-32 in TSL is suitable to measure health literacy in DHH individuals and to assess the impact of the health education system.
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Anderson ML, Glickman NS, Craig KSW, Crane AKS, Wilkins AM, Najavits LM. Developing Signs of Safety: A Deaf-accessible counselling toolkit for trauma and addiction. Clin Psychol Psychother 2021; 28:1562-1573. [PMID: 33847426 PMCID: PMC8511355 DOI: 10.1002/cpp.2596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 04/06/2021] [Indexed: 11/09/2022]
Abstract
The U.S. Deaf community-more than half a million Americans who communicate using American Sign Language (ASL)-experiences higher rates of trauma exposure and substance use disorder (SUD) than the general population. Yet there are no evidence-based treatments for any behavioural health condition that have been evaluated for use with Deaf people. The driving aim of our work, therefore, has been to develop and formally evaluate a Deaf-accessible trauma/SUD counselling approach. Here we describe our initial intervention development work and a single-arm pilot that evaluated the feasibility, acceptability, and preliminary clinical efficacy of Signs of Safety-a Deaf-accessible toolkit to be used with an existing, widely adopted protocol for trauma and addiction (Seeking Safety). Preliminary efficacy results indicated clinically significant reductions in PTSD symptoms and frequency of alcohol use for the Seeking Safety/Signs of Safety model. Frequency of drug use did not change significantly-likely attributable to the mid-study legalization of recreational marijuana in our state. Next steps include the redesign and refilming of Signs of Safety based on pilot participant feedback, again using a Deaf-engaged development and production process. This new toolkit will be tested via a pilot randomized controlled trial designed based on present methodological lessons learned.
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Affiliation(s)
- Melissa L. Anderson
- University of Massachusetts Medical School (UMMS), Implementation Science and Practice Advances Research Center (iSPARC), 222 Maple Avenue, Chang Building, Shrewsbury, MA 01545, USA
| | - Neil S. Glickman
- University of Massachusetts Medical School (UMMS), Implementation Science and Practice Advances Research Center (iSPARC), 222 Maple Avenue, Chang Building, Shrewsbury, MA 01545, USA
- Advocates, 1881 Worcester Road, Framingham, MA 01701, USA
| | - Kelly S. Wolf Craig
- University of Massachusetts Medical School (UMMS), Implementation Science and Practice Advances Research Center (iSPARC), 222 Maple Avenue, Chang Building, Shrewsbury, MA 01545, USA
| | | | - Alexander M. Wilkins
- University of Massachusetts Medical School (UMMS), Implementation Science and Practice Advances Research Center (iSPARC), 222 Maple Avenue, Chang Building, Shrewsbury, MA 01545, USA
| | - Lisa M. Najavits
- University of Massachusetts Medical School (UMMS), Implementation Science and Practice Advances Research Center (iSPARC), 222 Maple Avenue, Chang Building, Shrewsbury, MA 01545, USA
- Treatment Innovations, 28 Westbourne Road, Newton Centre, MA 02459, USA
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Affiliation(s)
- Helen Grote
- Chelsea and Westminster Hospital NHS Foundation Trust, London SW10 9NH, UK
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