Communication and Communication Support in Primary Care: A Survey of Deaf Patients

Abstract

Modern disability discrimination legislation puts a duty on health providers to facilitate access for patients with disabilities. Deaf people – those whose first language is sign language – can have difficulties accessing health care due to problems communicating with health professionals. Ninety-eight Deaf adults living in north-west England were interviewed about their experiences of consulting in primary care, and their preferences for, and use of, communication support. Over half the sample expressed a preference for professional sign interpreter support, but only 17% had an interpreter at their last consultation; just 11% preferred to consult alone, yet more than 50% actually consulted alone. On all questions for which comparative results were available for the general population, Deaf patients as a group reported substantially less communication and less satisfaction with their primary health care provider (p<0.001 in all cases). Around one in three left their last consultation uncertain if the doctor had managed their case correctly, gained no better understanding of their illness, and did not fully understand the doctor's advice on what to do next. One in four had at some time been prescribed medication without adequate information, or that they believed to be incorrect, and two people had been seriously ill after consuming a medicine intended for external application. Patients who consulted using their preferred form of communication support reported significantly fuller communication than those who did not (p<0.05). For many patients without preferred support, communication was so limited that patient safety was put at risk. The one change that would produce the greater benefit for the largest number of Deaf patients is routine provision of sign interpreters for all who desire them. However, a shortage of qualified interpreters is a major barrier. Other approaches that could substantially reduce the scale of the problem are mandatory deaf/disability awareness training for medical staff and the use of electronic aids to communication.

• access
• disability
• hearing impairment
• general practice