“My Dream Is To Be Understood”: an Analysis of the Doctor-Deaf Patient Interaction during Health Care

Abstract:

Introduction:

The deaf community represents a significant portion of the Brazilian population that faces numerous barriers in access to health care. Communication failures increase the chances of misdiagnosis, errors in medical records, embarrassment, non-adherence to treatment, suffering and user dissatisfaction. The study aimed to characterize health care for deaf people from the perspective of medical professionals, medical interns and the patients themselves, discussing the strategies developed in the dialogue and physician-patient interaction, and the tools for the improvement of medical practice.

Method:

An observational, descriptive study based on integrated content analysis. A sample of 181 participants divided into three groups: medical professionals (n=46), medical students from the fifth and sixth year (n=54) and deaf individuals (n=81). Two semi-structured instruments were used, one for doctors and interns and one for the deaf. Descriptive analysis of the quantitative variables was performed with percentage distributions for categorical variables and measure of central tendency and dispersion for numerical variables. The answers to the essay questions were organized into three groups of texts and the material was submitted to lexicographic analysis with the support of IRaMuTeQ software.

Results:

76% of doctors and academics said they had already treated a patient with severe or partial deafness. Although 49% reported discomfort, but also feeling secure when treating deaf patients, 55.5% of the deaf said they had already stopped going to the doctor, or reporting any problems, such as pain, discomfort or anguish, for fear of not being understood. The participation of caregivers as mediators of the doctor-patient relationship was the most frequent communicational strategy pointed out by all participants. Other frequent strategies identified by the deaf interviewees were lip reading and LIBRAS; by the doctors, mime and writing; and by the interns, lip reading and writing; all of which are non-resolving strategies.

Conclusions:

The perceptions of the different actors of the doctor-patient interaction analyzed showed differences in satisfaction with the service and health risks for the deaf, lacking multimodal planning with effective communication strategies.

Keywords:
Health Services Accessibility; Health Care; Health Communication; Teaching; Sign Language; Physician-Patient Relations; Deafness