Availability of specialized healthcare facilities for deaf and hard of hearing individuals.

Context: To allow a medical consultation to proceed successfully, it is essential that physicians are aware of the linguistic and cultural backgrounds of deaf and hard of hearing individuals (DHH) and related communication aspects. Some specialised healthcare facilities have emerged to respond to the specific needs of people who are DHH. Objective: This study aims to provide insight into the various types of general healthcare facilities available for DHH individuals. By sharing and comparing experiences and results improvements can be made. Design, Data Sources and Study selection: A systematic review of the literature on specialised healthcare for DHH people was performed. The following databases were searched: PubMed, Web of Science, PsycINFO, Academic Search Premier, CINAHL and Embase. After independent extraction per article by two readers, fifteen articles were included in the systematic review. As it appeared that not all existing locations of facilities of which we were aware were described in the literature, we expanded the data collection with internet searches, specific literature searches and unstructured interviews. Results: Some countries have developed facilities to meet the needs DHH people Experts and patients’ groups report that the perceived quality of healthcare and health education in specialised healthcare settings is higher compared to regular healthcare settings. Two projects undertaken to improve the health related knowledge level of DHH people, proved to be effective. Conclusion: Some facilities or combinations of facilities are used in different countries to attempt to meet the needs of DHH patients. These facilities are rarely described in the scientific literature. Further development of specialised healthcare facilities for DHH patients, which should include high quality studies on their effectiveness, is imperative to comply with medical ethical standards and respect the human rights of DHH people

Availability and accessibility of healthcare for deaf and hard of hearing patients

It is well documented that both ethnic/cultural differences as well as language differences complicate a satisfying and effective doctor-patient relationship. Although these differences are also present during communication between Deaf patients and their hearing physicians, the volume and quality of research on healthcare facilities for deaf and hard of hearing (DHH) people has not kept up with research on hearing people. This thesis studied the barriers experienced by this patient group, their nature and impact, and possible (cost-effective) solutions to tackle these barriers. The theoretical background, development and use of a guideline to translate and validate standardized questionnaires into sign language is described. The barriers in providing healthcare for severely DHH patients can be classed as follows: 1) communication barriers, 2) barriers due to limited health knowledge and 3) barriers due to deaf cultural features. The results of these studies indicate that DHH people in the Netherlands experience a significantly lower physical, and often also psychological quality of life compared to the rest of the population. Several countries provide specialized facilities to improve healthcare access for this patient group. Though most of these services are likely to be cost-effective, no scientific data are available to support this assumption. </table

Availability and accessibility of healthcare for deaf and hard of hearing patients

It is well documented that both ethnic/cultural differences as well as language differences complicate a satisfying and effective doctor-patient relationship. Although these differences are also present during communication between Deaf patients and their hearing physicians, the volume and quality of research on healthcare facilities for deaf and hard of hearing (DHH) people has not kept up with research on hearing people. This thesis studied the barriers experienced by this patient group, their nature and impact, and possible (cost-effective) solutions to tackle these barriers. The theoretical background, development and use of a guideline to translate and validate standardized questionnaires into sign language is described. The barriers in providing healthcare for severely DHH patients can be classed as follows: 1) communication barriers, 2) barriers due to limited health knowledge and 3) barriers due to deaf cultural features. The results of these studies indicate that DHH people in the Netherlands experience a significantly lower physical, and often also psychological quality of life compared to the rest of the population. Several countries provide specialized facilities to improve healthcare access for this patient group. Though most of these services are likely to be cost-effective, no scientific data are available to support this assumption. NSGK voor het Gehandicapte Kind Stichting HandgebaarLUMC / Geneeskund

Specialized outpatient clinic for deaf and hard of hearing patients in the Netherlands: Lessons learned in an attempt to improve healthcare

In 2013 a group of organizations and individuals in the Netherlands got together to attempt to improve access to healthcare and health education for deaf and hard of hearing (DHH) patients in the country. The result was the start of a specialized outpatient clinic named PoliDOSH. An independent research group was set up to evaluate the effect of this specialized clinic. Even though the initiative did not succeed and was closed after only two years, an extensive analysis of the start-up and functioning of the whole process was made. The findings are reported in this paper and advice concerning setting up a similar facility in the future in the Netherlands or elsewhere is given. Data collection: structured and non-structured questionnaires and structured interviews. Outcomes: Only a small group of DHH patients indicated that they felt a need for consultations at the PoliDOSH. However, to ensure that DHH patients are provided with the opportunity to access optimal medical care it is essential that the possibility to visit specialized healthcare facilities exists. There is a great need for facilities to collect and disseminate information to and about DHH patients. The information should be aimed at providing psycho-education for 1) the DHH persons themselves and 2) healthcare professionals, concerning the specific needs and problems of this patient group. To ensure successful functioning of a specialized facility the team members should include a representative group of DHH members. All key functions should be filled by top experts in the relevant fields as well as an expert in communication and needs of the target group. It is essential that regular healthcare workers who look after the target group are frequently informed about the existence and possibilities of these facilities. Thorough market research prior to start up is needed to enable the facility to connect with the needs of patients. The start-up period should allow sufficient time for the project to become known and for patients to become familiar with it and trust it. Charting the availability of medical and paramedical care available for DHH people in the whole country can help to concentrate the care in various regions and strengthen the already present expertise