Biomedical subjects
Steven Barnett
Publications and source records attributed to Steven Barnett.
Communication with deaf and hard-of-hearing people: a guide for medical education.
Some physicians may be insufficiently prepared to work with the many patients who have hearing loss. People with hearing loss constitute approximately 9% of the U.S. population, and the prevalence is increasing. Patients with hearing loss and their physicians report communication difficulties; physicians also report feeling less comfortable with these patients. Although communication with patients plays a major role in determining diagnoses and management, little attention is given to teaching medical students and residents the skills necessary to facilitate communication when hearing loss is involved. The need for these skills will increase with the expected rise in the number of such patients. The author presents the rationale for including information about hearing loss in curricula on patient-doctor communication, and suggests curricular content, including background regarding hearing loss and techniques that can enhance the physician's ability to listen to (that is, "hear") and learn about the stories of these patients.
Health care utilization and adults who are deaf: relationship with age at onset of deafness.
OBJECTIVES: To evaluate the health care utilization of a nationally representative sample of U.S. deaf adults while accounting for the age at onset of deafness, an indicator of linguistic and sociocultural group affiliation. DATA SOURCES/STUDY SETTING: Data from the 1990 to 1991 National Health Interview Surveys the most recent years the Hearing Supplement was administered. The data were collected during in-home interviews of a sample of the U.S. civilian noninstitutionalized population. STUDY DESIGN: Cross-sectional analyses comparing health-related measures of adults deafened before (prelingually) and after (postlingually) the age of 3 and those of a representative sample of the general population, adjusting for sociodemographics and health status. Key measures were physician visits and preventive health care services utilization. PRINCIPAL FINDINGS: Compared with the general population, prelingually deafened adults had fewer physician visits and were less likely to have visited a physician in the preceding 2 years, whereas postlingually deafened adults had more physician visits and were more likely to have visited a physician in the preceding 2 years. Postlingually deafened women were less likely to have had a mammogram within the previous 2 years. CONCLUSIONS: In terms of health care utilization, the deaf population is heterogeneous. Prelingually deafened adults' use of health care is similar to that of other language minority groups. Postlingually deafened adults' use of health care services appears similar to people with chronic illness. Future studies must distinguish different groups of people with hearing loss in order to identify barriers and monitor improvements in health care services access.
Cross-cultural communication with patients who use American Sign Language.
BACKGROUND: Although American Sign Language (ASL) is the third most commonly used primary language in the United States, physicians are often not adequately prepared for the challenges of conducting an interview with a deafpatient who signs. METHODS: A search of MEDLINE and PsychINFO databases for research on physician-patient communication and deaf people who use ASL was performed. Expert opinion helped guide discussion and recommendations. RESULTS: Few articles examined physician-patient communication involving ASL. Deaf people and their physicians report difficulties with physician-patient communication. Deaf people also report fear that their health care is substandard because of these difficulties. CONCLUSIONS: Preparing residents and medical students for working with patients and families who communicate in ASL presents many opportunities for teaching about physician-patient communication. ASL is quite different from English, and users of ASL often have sociocultural norms that differ from those of the majority culture. In addition to learning how to communicate with patients and families across languages and cultures, students and residents can learn how to collaborate with interpreters and how low literacy impacts physician-patient communication. Opportunities to teach about family dynamics, disability issues, and nonverbal communication also present themselves when working with families with Deaf members. Physician-patient communication involving ASL is an area that is ready for further research.