Communication Strategies for Nurses Interacting With Patients Who Are Deaf

Christine Chong-hee Lieu, BA; Georgia Robins Sadler, PhD, MBA, BSN; Judith T. Fullerton, PhD, CNM, FACNM; Paulette Deyo Stohlmann, MSN, RN, OCN


Dermatology Nursing. 2007;19(6):541-544; 549-55. 

In This Article

Deaf Culture and Its Relationship to Health Care Access and Utilization

The nurse must first become knowledgeable about the differences between being deaf and being a member of the Deaf community. Deaf persons generally deem themselves to be members of the Deaf community (upper-case D), using a unique language (ASL) and adherence to certain social and cultural behaviors. Further more, this community defines itself as a linguistic minority because of its use of ASL (Phillips, 1996). English language proficiency levels may vary because English frequently is learned as a second language and never aurally reinforced following the onset of deafness. On the other hand, deaf (lower-case d) refers to persons with an audiological inability to hear (Barnett, 1999; Meador & Zazove, 2005; Phillips, 1996; Stein berg et al., 2006; Ubido, Hunting ton, & Warburton, 2002). Deafness often is defined medically as a disability for which there should be a cure (Phillips, 1996). Contrarily, members of the Deaf community see their deafness as a natural characteristic.

Research from focus groups conducted with the Deaf community delineated the difficulties of accessing health care information and services. Some deaf patients believed their physicians were culturally insensitive, explaining that doctors too often failed to maintain face-to-face contact and to enunciate clearly when communicating with people who were deaf (Ubido et al., 2002). Also, health service staff often assumed that ASL is a direct translation of the English language, even though ASL has a unique syntax, structure, and cultural context. In these cases, when medical jargon was utilized, the assumption was made that terms, such as glaucoma, bowel, smear, and penicillin were meaningful to a deaf patient. However, for those whose first language is ASL, these terms held little value (Iezzoni, O'Day, Killeen, & Harker, 2004).

Another misconception and consequent barrier to care for members of the Deaf community was providers' perceptions of deaf persons' ability to understand health information. Participants in one focus group noted that some physicians "do not adequately respect patients' intelligence, motivation, and desire to understand and participate in their health care" (Iezzoni et al., 2004, p. 357). Others in the Deaf community reported a decreased likelihood of having numerous health maintenance procedures performed at their most recent physical examination, such as having their blood pressure checked, being asked or advised about smoking, or having an annual mammogram (Barnett & Franks, 2002; Ubido et al., 2002).


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