Assessment of cancers' diagnostic stage in a Deaf community - survey about 4363 Deaf patients recorded in French units

Health outcomes in Deaf signing populations: A systematic review

OBJECTIVES

(i) To identify peer reviewed publications reporting the mental and/or physical health outcomes of Deaf adults who are sign language users and to synthesise evidence; (ii) If data available, to analyse how the health of the adult Deaf population compares to that of the general population; (iii) to evaluate the quality of evidence in the identified publications; (iv) to identify limitations of the current evidence base and suggest directions for future research.

DESIGN

Systematic review.

DATA SOURCES

Medline, Embase, PsychINFO, and Web of Science.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

The inclusion criteria were Deaf adult populations who used a signed language, all study types, including methods-focused papers which also contain results in relation to health outcomes of Deaf signing populations. Full-text articles, published in peer-review journals were searched up to 13th June 2023, published in English or a signed language such as ASL (American Sign Language).

DATA EXTRACTION

Supported by the Rayyan systematic review software, two authors independently reviewed identified publications at each screening stage (primary and secondary). A third reviewer was consulted to settle any disagreements. Comprehensive data extraction included research design, study sample, methodology, findings, and a quality assessment.

RESULTS

Of the 35 included studies, the majority (25 out of 35) concerned mental health outcomes. The findings from this review highlighted the inequalities in health and mental health outcomes for Deaf signing populations in comparison with the general population, gaps in the range of conditions studied in relation to Deaf people, and the poor quality of available data.

CONCLUSIONS

Population sample definition and consistency of standards of reporting of health outcomes for Deaf people who use sign language should be improved. Further research on health outcomes not previously reported is needed to gain better understanding of Deaf people's state of health.

Communication Barriers in Oncology Care for Elderly Deaf Patients: A Daughter's Narrative and Call for Tailored Medical Services

My father is deaf. A year ago, he was diagnosed with Hodgkin lymphoma. Most patients with hearing disabilities suffer from a lack of access to health care in a form that ensures they receive a rapid diagnosis, correct and effective treatment, and medical treatment options they understand. The minimal evidence that exists is associated with the timeliness of a cancer diagnosis, therapy, and consequences for these patients. We must give them the appropriate treatment for their disease and include them in clinical trials if they will benefit from them and provide health care workers training and tools on how to communicate better with these patients.

Cancer Disparities Experienced by People with Disabilities

People with disabilities, who represent a rapidly growing and seriously disadvantaged segment of the U.S. population, face unremitting barriers to equal and accessible healthcare and a high prevalence of chronic health conditions. A slowly growing body of research suggests multiple cancer-related disparities between people with and without disabilities. This commentary identifies multiple aspects of the cancer experience and highlights ways cancer is impacted by disability. This includes vulnerabilities to risk factors, barriers to accessing healthcare, and disparities in screening, diagnosis, and treatment. The authors offer six essential pathways for reducing cancer disparities faced by people with disabilities. It is clear that reducing cancer health disparities experienced by people with disabilities will require the commitment and cooperation of a wide range of stakeholders.

Evaluation of a specialist cognitive clinic for the Deaf community

There are significant health inequalities between Deaf and hearing people, including barriers to accessing care and communication difficulties in consultations. Such problems have particularly affected Deaf people with acquired cognitive deficits, leading to late and missed diagnoses. We therefore established a specialist cognitive clinic for the Deaf community in 2011 at the National Hospital for Neurology and Neurosurgery, which to our knowledge is the first of its kind in the world. In this study, we retrospectively analysed electronic patient records to evaluate the service and its impact since inception. We found that Deaf patients who use British sign language had difficulty obtaining an accurate diagnosis before attending our specialist clinic, highlighting the importance of tailored services for Deaf people. Our results show that the clinic improved communication for patients and accessibility to specialist investigations, ensuring diagnostic accuracy and overall reducing health inequality for this population.

Breast self-examination training video with the sign language for deaf women: An interventional study

OBJECTIVE

Breast self-examination is an important component for the early detection of breast cancer. The lack of knowledge of deaf women regarding breast examination and screenings may delay diagnosis of breast cancer. The objective of the study is to examine the effect of a video prepared with the sign language giving breast self-examination (BSE) skills to deaf women.

METHODS

This study used a quantitative, quasi-experimental, comparison group research design. Participants were recruited from the Izmir Association for the Protection and Development of the Deaf, Izmir, Turkey. The research was conducted between March 2018 and March 2019. BSE training video was prepared by the researchers. One group (n = 30) watched a BSE training video with sign language. The other group (n = 30) watched a BSE training video without sign language. After the training video, the BSE Skill Assessment of all women were assessed on a female torso mannequin model using BSE Skill Assessment Form.

RESULTS

The BSE skills of the women who watched the training video with sign language were significantly different from those who watched the training video without sign language (p < 0.05).

CONCLUSION

The training video with the sign language prepared by the researchers can significantly improve the BSE skills of deaf women.

Assessing and Providing Culturally Competent Care in Radiation Oncology for Deaf Cancer Patients

Purpose

Recognition of disparities for vulnerable populations in the field of oncology is increasing, but little attention has been paid to deaf patients. At least a million Americans are culturally deaf and use American Sign Language. Poor linguistic and cultural competency among physicians is a barrier to care delivery for these patients, placing them at risk for treatment disparities. To better educate oncology practitioners, including radiation oncologists, regarding the unique needs of this cohort, we performed an evidence-based literature review of culturally competent care for deaf patients to improve patient care and delivery.

Methods and Materials

PubMed was systematically reviewed for publications reporting on deaf patients for articles regarding (1) survivorship, patterns of failure, or toxicity in treating malignancies or (2) cultural and linguistic barriers to delivery of oncological care. Publications were excluded if deafness was a side effect of treatment or barriers and outcomes were reported on nonmalignant conditions.

Results

Barriers to care were poor health literacy, accessibility to providers or resources in preferred language (ie, American Sign Language), and limited cultural and linguistic proficiency of providers. Deaf patients may have a delay in cancer diagnosis, but no articles reported on treatment outcomes for malignancies in deaf patients. Currently, no oncology-specific guidelines exist on care delivery for deaf patients with cancer. We propose the need for a care model that provides guidelines on creating effective and total communication accessibility for deaf patients and improves cultural and linguistic competency among providers. Guidance should be provided on implementation of resources and training for oncology practitioners and how their respective institutions and staff can help create inclusive care environments.

Conclusions

Clinical outcomes of deaf patients with cancer remain poorly characterized, highlighting the need for a care model to promote provision of linguistically and culturally competent oncological care for deaf patients.