Nurses provide healthcare services to patients in clinics, homes, schools, the military, churches, communities, and emergency medical helicopters. Most patients expect nurses to communicate effectively, be culturally competent, and provide quality and safe care. However, when nurses are assigned to care for deaf patients, the issue of cultural incompetence becomes more apparent (Pendergrass et al., 2017). The problem is that some nurses could be unfamiliar with ASL culture. Also, communication is a crucial nursing skill that all nurses are expected to learn in nursing school.
On the contrary, the nursing programs’ course content rarely educates nurses on effective communication with deaf patients. The relationship between a nurse and a patient largely depends on effective communication. Unfortunately, most nurses are not effectively prepared and trained on the issues of cultural competency, thus making it difficult for them to handle deaf patients. Consequently, because of this cultural incompetence, deaf patients cannot access quality healthcare services that would otherwise improve their health outcomes.
In contrast, registered nurses (RNs) trained using educational tool kits are in a better position to understand the needs of deaf patients. They thus can communicate effectively, improving their health outcomes. The deaf community can be termed as cultural-linguistic minorities affected by similar health disparities mainly because the community of healthcare professionals fails to understand their ASL culture. Regardless of race, sexual orientation, ethnicity, gender, physical disabilities, language, or education should not impede effective communication between nurses and their patients (Richardson, 2014). Notably, it has been identified that most nurses are often anxious when handling deaf patients, mainly because they have not familiarized themselves with the culture. Surprisingly, nurses are the first care respondents, especially in healthcare emergencies in a healthcare facility. In addition, some nurses are biased toward deaf patients, which significantly affects the quality of patient care because of the misunderstanding of the American sign language (ASL) culture.
Prevalent Healthcare Beliefs and Needs of ASL Culture
ASL culture comprises a diverse community with many needs and beliefs. Although it is essential to recognize and understand that individual needs and beliefs may differ, several prevalent healthcare needs and beliefs are associated with ASL culture. One of the basic needs is visual communication. It is crucial to recognize that deaf individuals depend heavily on visual communication, such as sign language, body language, and facial expressions (Wright & Reese, 2015). Deaf patients prefer healthcare providers with significant skills in sign language or those capable of enhancing communication with the help of visual aids. In addition, deaf patients value language access, which promotes effective communication in healthcare settings. In most cases, deaf patients may require the assistance of a qualified sign language interpreter or other means of communication support, including remote video interpreting or video relay services to facilitate communication with their nurses. Adequate language access allows deaf individuals to understand their diagnosis, preventive measures, treatment options, disease management, and healthcare instructions.
Moreover, it is essential to be culturally sensitive because the deaf culture has unique traditions, customs, and norms. It is crucial that nurses demonstrate some sense of cultural sensitivity and always respect the ASL culture. In essence, nurses are expected to value and recognize ASL language as a distinct culture and understand the significance of the deaf community and identity. Also, the deaf community constantly advocates for accessibility and inclusion in healthcare settings (Lesch et al., 2019). Healthcare facilities should ensure they are well equipped with visual notifications, alarms, clear signage, sign language interpretation, videos with captions, and clearly written materials. In addition, nurses should respect deaf autonomy and identity because some deaf patients do not consider their deafness as a disability but as a cultural identity. They may prioritize independent decision-making and autonomy regarding their healthcare, including issues related to treatment, medical interventions, and communication preferences.
Furthermore, it is crucial to prioritize health literacy because deaf patients may possess varying understanding levels, just like any population. Therefore, nurses should provide health information in formats that are easily accessible to deaf patients depending on their literacy levels. Clear explanations, visual aids, clearly written materials, and ASL interpretation can play a crucial role in helping deaf patients understand their health and empowering them to participate in matters of their health actively (Sirch et al., 2017). Finally, community support is crucial as most deaf individuals find support and empowerment within their deaf community. Some deaf patients may prefer the support of individuals who are familiar with and understand ASL culture. Having a better grasp of these healthcare needs and beliefs can encourage nurses to provide patient-centered care aimed at improving the healthcare experience of deaf patients.
How ASL culture s Lifestyle Affects Their Health
ASL culture and lifestyle can significantly impact the health and life of deaf individuals. For example, communication barriers can deny deaf patients access to quality and safe healthcare services. Communication difficulties with nurses can lead to misdiagnosis, misunderstandings, and inadequate treatment. Also, limited access to educational resources and health information can impact preventive measures and understanding of health issues (Emond et al., 2015). Secondly is the issue of health disparities.
In most cases, deaf patients experience health disparities such as lower health literacy rates, reduced access to quality and safe healthcare services, and higher chronic condition rates. These outcomes can be associated with a lack of linguistically and culturally appropriate healthcare, financial barriers, reduced staffing of sign language interpreters, and discriminatory practices. In addition, deaf patients often experience more mental health challenges primarily associated with communication and language barriers, inadequate mental health services, and social isolation. As such, compared to the general population, deaf patients have a prevalence of mental health disorders such as anxiety and depression. They also experience limited health promotion because ASL culture influences health behaviors and practices.
Deaf patients lack quality exposure to health promotion forums, workshops, campaigns, and resources due to issues associated with accessibility and inadequate information specifically targeting the deaf community. Consequently, these aspects negatively impact their engagement and knowledge of healthy lifestyle choices and preventive measures. Moreover, deaf individuals have a strong self-advocacy and cultural identity that enables them to prioritize autonomy in healthcare settings. Therefore, they are more influenced by their treatment choices, healthcare decisions, engagement, and association with healthcare providers (Mahdavi et al., 2017). As such, most prefer assistance from nurses who respect their communication preferences and cultural identity and those knowledgeable about ASL culture. In addition, ASL culture places greater emphasis on community solidarity and support. Supportive communities are essential because they link deaf patients to access to information, social connections, and resources, thus improving their overall health and well-being.
Cultural And Communication Considerations That Should Be Taken When Caring for Individuals from ASL Culture
ASL culture emphasizes effective communication and vital culturally sensitive care when caring for deaf individuals. Cultural considerations demand respecting and recognizing the deaf identity, as some deaf patients do not consider their deafness a disability but rather a cultural and linguistic difference. It is, therefore, essential to avoid focusing on correcting and fixing their deafness (Hommes et al., 2018). Nurses are expected to demonstrate some level of cultural sensitivity and be open-minded. As such, nurses should value ASL culture, norms, and customs and be willing to learn the language, culture, and communication preferences.
In addition, it is crucial to involve deaf patients in discussions regarding their treatment options, supporting their decisions, and obtaining informed consent. Moreover, nurses should appreciate community involvement, facilitate, and encourage connections of deaf patients to community resources and support groups that can provide helpful additional and supportive information. Furthermore, nurses must consider communication and accessibility considerations. Nurses proficient in sign language should use it when communicating with deaf patients (Kuenburg et al., 2016). While communicating, minimizing visual distractions, maintaining good lighting, and maintaining eye contact with the patient is good. Also, nurses must remain respectful, attentive, and patient during communication. Avoid unnecessary interruptions and allow patients time to express themselves accordingly. It is equally important to note the cultural differences and communication styles, such as body language and eye contact.
Health Disparities That Should Be Considered for The ASL Culture Related to Communication
Deaf individuals may be subjected to significant limitations when accessing communication. Communication barriers may need to be clarified for effective communication with healthcare providers. These barriers may emanate from insufficient nurses who can communicate fluently using sign language or must be aware of ASL culture. The need for qualified personnel to interpret or provide supportive communication can result in misdiagnosis, inadequate medical information, and suboptimal care (Emond et al., 2015). In addition, communication barriers can lead to incomplete or delayed diagnosis of deaf patients. Difficulties in effectively giving a medical history, conveying symptoms, and other concerns can lead to understanding or missing information, resulting in accurate diagnosis and appropriate treatment and preventive planning.
Moreover, deaf individuals have limited health literacy levels, which, coupled with communication barriers, can limit access to health information. The effects could be better comprehension of medical procedures, terminologies, and health-promoting practices and behaviors. Limited levels of health literacy significantly contribute to difficulties associated with managing chronic illnesses, following treatment plans, and making poor healthcare decisions.
Furthermore, communication challenges can cause reduced preventive care among deaf patients. Besides, limited information about preventive measures, like vaccinations, screenings, and health promotion campaigns, can all result in reduced preventive care. Additionally, deaf individuals could face challenges when giving informed consent because of communication barriers (Sirch et al., 2017). The lack of practical communication disadvantages deaf patients because they cannot fully grasp the benefits and risks of alternative medical treatment and procedures. More understanding of informed consent can be needed when making informed decisions regarding their health, resulting in better healthcare services.
How ASL Culture Communicates with Their Healthcare Providers and Whether It Impacts Their Care
Deaf individuals often communicate with healthcare providers through various methods, primarily counting on visual communication. ASL is the primary communication method deaf patients use to communicate with their healthcare providers. It becomes more effective if healthcare providers are conversant with ASL or have qualified ASL interpreters (Lesch et al., 2019). Effective communication in ASL allows nuanced and precise discussions regarding the symptoms, treatment options, medical history, and follow-up of healthcare instructions. Deaf patients who can communicate directly and comfortably in their preferred language positively impact their health and overall well-being. Nurses and deaf patients can also communicate through written communication. Healthcare providers can use medical forms, written instructions, and notes to convey information.
However, it is imperative to note that this mode of communication cannot be sufficient because deaf individuals have different literacy levels, and some may struggle to understand complex medical terminology. Likewise, clarifications may not be possible, as in the case of ASL interaction. Finally, deaf patients and healthcare providers can use assistive communication technologies. Assistive technologies are crucial in enhancing communication. A good example is remote video interpreting (VPI) and video relay services (VRS) which use real-time communication and thus can be interpreted via video calls (Wright & Reese, 2015). Although assistive communication technologies are essential in bridging communication between healthcare providers and deaf individuals, particularly those who do not have sign language skills, their reliability and availability may vary or be readily available, or their suitability may not support all healthcare interactions.
Nurses provide for patients in clinics, homes, schools, the military, churches, communities, and emergency medical helicopters. Most patients expect nurses to communicate effectively, to be culturally competent, and to offer high-quality, safe care. When nurses are assigned to care for deaf patients, however, the issue of cultural ineptitude becomes more apparent. The issue is that some nurses may need to be more familiar with ASL culture. Furthermore, communication is a critical nursing skill that all nurses must master in nursing school. The deaf population is a cultural-linguistic minority that suffers from similar health inequities, partly because the healthcare community does not comprehend their ASL culture. Regardless of race, sexual orientation, ethnicity, gender, physical impairments, language, or education, nurses and their patients should be able to communicate effectively.
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