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

摘要

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.