Exploring perceptions of interactions
Research type
Research Study
Full title
An exploration of how Deaf people and registered nurses perceive their interactions
IRAS ID
226886
Contact name
Megan Dickson
Contact email
Sponsor organisation
Queen Margaret University
Duration of Study in the UK
2 years, 3 months, 1 days
Research summary
Research Summary
Those whose first language is British Sign Language (BSL) rarely meet healthcare professionals who share their language or who have appropriate Deaf awareness training. As a result communication exchanged between healthcare professionals and people who are Deaf is often compromised due to lack of knowledge or understanding of communication needs. The implications of resorting to inadequate methods of facilitating communication are vast including increased risk of misdiagnosis, medical error and non adherence to treatment. The National Health Service (NHS) is subsequently failing to provide effective, person-centred care to Deaf people.
Due to the gap in knowledge regarding the experiences of Deaf people interacting with nurses within Scotland this research study proposes to address the questions:
1. What are the experiences of Deaf people who have interacted and received care from nurses?
2. What are the experiences of nurses who have interacted and provided care for a person(s) who is Deaf?The first sample will include six prelingually Deaf adults, whose first language is BSL, that have received nursing care during the past six months within Scotland. Data will be generated using face-to-face semi-structured interviews. These interviews will take place at a venue of the participants' choice. Within the second research target population 20 registered nurses, who have cared for a Deaf person(s)within the past six months, will be recruited. From this group 12 nurses will take part in individual semi-structured interviews. The remaining eight nurses will take part in an hour long, in-depth focus group with the aim of further exploring themes that are generated from the semi-structured interviews. Interviews and the focus group with nurse participants will take place within a hospital setting.
The study will be conducted over a period of 2.5 years ending in Dec 2019
Summary of Results
Background: British Sign Language (BSL) is the visual-spatial language of deaf people in Scotland. For deaf, BSL users all contact with the NHS takes place in a hearing led context where spoken English is the primary mode of communication. Healthcare can therefore be challenging for deaf people to access and engage in. The implicit assumptions of the biomedical perspective, that views deafness as an illness to be ‘cured’, often underpin and shape healthcare practices. In this context, there is a lack of acknowledgement of deaf peoples’ linguistic and cultural status. There has been recognition in healthcare literature that access to healthcare is problematic for deaf people. However, the majority of this literature is informed by the biomedical perspective, privileging positivist approaches to treating deaf people. This has resulted in knowledge that does acknowledge the social world in which deaf peoples’ experiences of healthcare take place. Conceptualising healthcare as a form of social relationship, this research explored nurses’ and deaf peoples’ experiences of interacting with one another.
Approach and methods: This research is underpinned by Gadamer’s hermeneutics which enabled exploration of participants’ relational and contextual experiences of interacting. Semi-structured interviews with four deaf, BSL users and nine nurses who had provided care for a deaf person were undertaken over a period of 10 months. A focus group with three BSL/English interpreters was also carried out.
Findings: The findings revealed that nurses often articulated and embodied predominantly biomedical understandings of what it means to be deaf. Approaching care from this perspective, nurses often struggled to acknowledge or respond to deaf peoples’ visual-spatial ways of being and knowing. Healthcare environments were therefore frequently experienced by deaf people as hearing spaces in which they were disempowered due to the oppression of their visual-spatial nature and language. This created divisive boundaries between deaf people and nurses that limited the potential for an effective nursing relationship to develop. Nurses who displayed qualities of openness and curiosity developed alternative ways of thinking about deafness. These had the potential to transform their approaches to practice that enabled collaborative relationships to develop.
Conclusions and implications: This research has demonstrated that healthcare spaces are relational and therefore constructed by the social actions of the people in them. For nurses to construct spaces that are respectful of and embodied deaf culture, the significance of the whole body in developing relational practice must be recognised. Such understanding and knowledge could enable nurses to approach practice with an awareness of how both their own and deaf peoples’ embodied experiences can inform care. This necessitates reflexivity in which nurses recognise and question the assumptions that underpin their practice. Recognising the significance of deaf peoples’ visual-spatial experience and embodied understanding of the world has the potential to contribute to emancipatory and empowering approaches to caring for deaf people.REC name
South East Scotland REC 02
REC reference
17/SS/0106
Date of REC Opinion
18 Aug 2017
REC opinion
Favourable Opinion