Communication in Healthcare Settings

Author(s):  
Elizabeth Schniedewind

Deaf persons who use American Sign Language (ASL) as their primary form of communication are members of a cultural and linguistic minority that experiences significant health disparities yet are not recognized as a health disparity population by the National Institutes of Health. Studies have reported ineffective communication in healthcare interactions and reduced access to care experienced by Deaf patients. Requests for sign language interpreters in healthcare encounters are frequently denied, despite federal mandates to provide effective communication. Comprised of three articles, this dissertation investigates the diminished access to communication in healthcare settings experienced by Deaf patients and qualitative research methods when working with Deaf communities. Chapter One provides an overview of the dissertation purpose along with authorship and statement contributions for each article. Chapter Two features an autoethnographic study which recommends specific research methods and paradigms researchers who can hear should consider when conducting research with Deaf people. Reflections on the process of qualitative data analysis in this context is provided. Chapter Three reports the results in article form from a mixed-method, bilingual, and online survey which received 170 responses from Deaf respondents in 42 states. The survey provides a deeper understanding of the communication barriers experienced by Deaf patients than has been available or documented previously. Chapter Four documents the diminished access to care experienced by Deaf patients as documented in a "secret shopper" study. Appointment success rates of Deaf simulated patients compared to success rates of simulated patients who can hear, and reasons associated with denials are reported from a field-experiment audit study of a stratified random sample of primary care and general dentistry clinics throughout Idaho. Chapter Five provides a summary of the dissertation findings, action and policy recommendations, planned and completed dissemination of the research results, and areas of future research.

2011 ◽  
Vol 31 ◽  
pp. 137-158 ◽  
Author(s):  
David Quinto-Pozos

American Sign Language (ASL) has become a very popular language in high schools, colleges, and universities throughout the U.S., due, in part, to the growing number of schools that allow students to take the language in order to fulfill a foreign or general language requirement. Within the past couple decades, the number of students enrolled in ASL classes has increased dramatically, and there are likely more instructors of ASL at the present time than ever before. ASL and spoken language instruction are similar in some aspects; however, there are also differences between the two (e.g., modality differences involving visual rather than auditory perception and processing, no commonly used writing system in ASL, and the socio-cultural history of deaf-hearing relations). In spite of these differences, minimal research has been done on ASL learning and classroom pedagogy—especially in recent years. This article reports on studies that have been performed recently and it also suggests various themes for future research. In particular, three main areas of research are proposed: the possible role of the socio-political history of the Deaf community in which ASL teaching is situated, linguistic differences between signed and spoken languages, and the use of video and computer-based technologies.


2020 ◽  
Vol 48 (6) ◽  
pp. 883-915 ◽  
Author(s):  
Ezra R. Morris ◽  
Louis Lindley ◽  
M. Paz Galupo

Negative experiences in healthcare settings have been linked to decreased treatment satisfaction and reduction of future help-seeking behaviors among transgender individuals. The present study used gender-identity based microaggressions as a model for understanding the client–therapist relationship. Using a qualitative approach, we investigated instances of microaggressions from mental health providers as experienced by 91 adults who identified as transgender or gender diverse. Participants completed an online survey and described instances of microaggressions directed towards them from mental health providers. Thematic analysis resulted in four therapy-salient themes: Lack of Respect for Client Identity, Lack of Competency, Saliency of Identity, and Gatekeeping. Our discussion of the results focuses on the examination of microaggressions as ethical guideline violations. We discuss methods to improve the practical application of ethical standards to counseling with transgender clients. Implications for practice, training, and future research are also discussed.


M/C Journal ◽  
2019 ◽  
Vol 22 (5) ◽  
Author(s):  
Crisia Constantine

Of Ancient Greek origins, the concept of prosthetics unfolds across centuries, denoting an 'addition', 'application', or 'attachment'. For most part, it is used in its medicalised sense, as an ‘instrument’ especially designed to restore the functionality of missing or disabled body parts. This issue of M/C Journal seeks to explore the meaning of ‘prosthetics’ beyond its iatric employment. It aims to emphasize prosthetics’ functions and resulting outcomes as 'application' or ‘attachment’ to a structure, either natural – innate, or artificial – cultural, that needs further development or transformation. The ten contributions significantly align with the editorial scope, unpacking the concept of ‘prosthetics’ and offering a vast array of alternative uses of the term. In the feature article of the issue, Pamela See (Xue Mei-Ling) examines branding as prosthesis of identity. See frames the practice of branding from the Halaf Period (6100-5100 BCE) to the present as a method of imbuing the identity of a person, family, clan, organisation or kingdom. Brands, then, propose a system that assists consumers to convey and recognizes identities at prima facie. Ultimately, individuals evoke the subsequent brands as prosthetics in the process of value attribution, writes See, but, also, to signal to one another.A different take on the role of prosthetics in identity formation is advanced by Alexander Hudson Beare. Drawing upon the HBO original series The Sopranos, Beare argues how the characters of Tony and his friends, severed from their Italian origins, employ prosthetic memories to create hybrid ethnic identities. Filmmaking industry proves to be an inspiring field for the investigation on alternative uses of the concept of prosthetics. Sharon Jane Mee focuses on Errol Morris’s documentary Mr. Death: The Rise and Fall of Fred A. Leuchter, Jr. to demonstrate how various apparatuses – such as the cinematic one – operates prosthetically. Eventually, Mee expands her argument, contending that cinema itself is a prosthesis of film spectatorship. At her turn, Maria Alberto examines how Steven Spielberg’s 2001 film A.I. Artificial Intelligence complicates the ‘prosthetic impulse’ by depicting prosthetics as technologies that enhance, augment, or replace parts of social bodies such as the nuclear family.This use of prosthetics is also explored by Fiona Andreallo and Chris Chesher in their commentary upon the sex robots market. Rather than simply rejecting the possibility that sexbots can be sexual partners or companions, the authors argue that they can be considered as a medium for companionship. Therefore, in field literature terms, the sex robots represent extensions, or prostheses, that support sexuality and parasocial companionship. A new contribution to the debate is made by Pamela J Kincheloe who considers how the American Sign Language (ASL), is used in media as a narrative prosthetic. Excerpted from a longer chapter for a book in progress, her article takes a very quick look at how American Sign Language is becoming more and more visible in mainstream visual culture, how it is being commodified and serves a prosthetic device that reinforces normalcy in various cultural narratives. The essay poses questions about the possible consequence, positive and negative, of this use of a living language.The impact of media technology on the various developments of the concept of prosthetics, is discussed by Lekhaa A Nair and Lauren Cruikshank. Through her article, Nair positions self-tracking technology (STT) as an interactive media technology, a tool for surveillance and regulation, and, specifically, an ‘extension of man’. She argues that STT is able to extend man’s natural capabilities as a result of datafication and regulation, and shows how this process can compromise personal autonomy. In this context, Cruikshank’s article reaches a significant conclusion. Only by acknowledging and exploring how our embodied relationships with media technologies are complex, contested, and often uncomfortable, emphasizes Cruikshank, we can construct alternative, more equitable models for media prosthesis.An introspective look on prosthetics is taken by Elaine M Laforteza’s examination on how prosthetic devices are used to treat chronic and auto-immune conditions. Reflecting upon her experiences with surviving Type 1 diabetes for 28 years, Laforteza raises a number of challenging questions: What happens when insulin pump technologies fail? What then happens to the human body that is attached to the pump? How can we speak, write and think about re-organised bodies in which, for example, an internal organ’s pancreatic beta cells (those that secrete insulin), are external to the body and battery operated? The possibilities of the body are further explored, in an artistic context this time, by Ali Na. Analysing the contemporary art installations The Slug Princess of the Degenerate Art Ensemble (DAE) and the performance installation Cultural Animal of Xu Bing, Na examines the prosthetic prospects and capacities of the body around issues of race, animality, and aesthetics. Although far from exhausting the multiplicity of alternative meanings and interpretations of the term, this issue of M/C Journal opens up new perspectives for the re-defining and re-inventing of the concept of prosthetics, and, we hope, encourages future research avenues. We are highly grateful to our contributors and reviewers for accepting this challenge.  


2016 ◽  
Vol 11 (2) ◽  
pp. 177-201
Author(s):  
Laura Maddux ◽  
Brenda Nicodemus

Anecdotally, interpreters report experiencing self-talk before, during, and after assignments; however, this inner dialogue has neither been confirmed nor described in the literature. Prior studies suggest that guided self-talk can boost performance in learning and human performance activities. It follows that self-talk may also affect interpreting performance, either positively or negatively. In this study, reports of self-talk of American Sign Language-English interpreters were examined for the following characteristics: frequency, valence, overtness, self-determination, motivation, and function. Participants (N = 445) responded to online survey questions about the experience of self-talk in their interpreting work. For frequency, more than half of the respondents reported experiencing self-talk between 1–5 times during their work. Regarding valence, 62% of respondents reported a mix of positive and negative self-talk about their performance. For overtness, 62% reported talking (or signing) aloud in isolated settings about their work experiences. Regarding self-determination, nearly half of the respondents (48%) reported self-talk as a mix of conscious and unconscious thoughts. Eighty-nine percent of the respondents reported using self-talk for motivation, but 65% reported their self-talk was actually de-motivational at times. The most frequently reported function of self-talk was to improve interpreting. The findings offer a rich description of self-talk by American Sign Language-English interpreters. We suggest that more information about self-talk during interpretation may lead to greater self-awareness of the role of this phenomenon in working practitioners, as well as offer insights for the instruction of student interpreters.


2020 ◽  
Vol 10 ◽  
Author(s):  
Josée-Anna Tanner ◽  
Nina Doré

This article draws on translanguaging theory and research to consider a common pedagogical practice in American Sign Language (ASL) as a second language (L2) classroom, the No Voice policy (i.e., spoken language use is forbidden). The No Voice policy serves important cultural and practical purposes, but by nature limits learners’ access to their entire linguistic repertoire, which raises questions about the overall impact of the policy on learners’ language development. Current literature about pedagogical translanguaging has not yet addressed practices that integrate (and, by extension, limit) selective modalities; we evaluate this gap and propose several directions for future research on the topic.Moreover, previous discussions of translanguaging practices involving recognized minority (e.g., Basque, Welsh, Irish) spoken languages are not wholly comparable to sign languages, which are not yet official or fully recognized languages in most countries and are therefore additionally vulnerable.We take into account the impact of ASL L2 learners on the language community, as many learners go on to become interpreters and allies to the deaf community. Keywords: American Sign Language as a second language, hearing adult learners, selective modality, pedagogical translanguaging, minority language


2016 ◽  
Author(s):  
Adrian Barnett

Winning funding for health and medical research usually involves a lengthy application process. With success rates under 20% most of this time has no immediate value. An alternative funding system that could save time is using democracy to award the most deserving researchers based on votes from the research community. We aimed to test how such a system could work and examine some potential biases. We used an online survey with a convenience sample of Australian researchers. Researchers were asked to name the 10 scientists currently working in Australia that they thought most deserved funding for future research. For comparison we used recent winners from large national fellowship schemes that used traditional peer review. We received 1119 eligible votes from 169 voters. Voting took a median of 5 minutes (inter-quartile range 3 to 10 minutes). Extrapolating to a national voting scheme we estimate 599 working days of voting time (95% CI 490 to 728), compared with 827 working days for the current peer review system. The gender ratio in the votes was 45:55 (female:male) compared with 34:66 in recent fellowship winners, although this could be partly explained by Simpson’s paradox as the votes were not stratified by research field. Voters were biased towards their own institution, with an additional 1.6 votes per ballot (inter-quartile range 0.8 to 2.2) above the expected number. Voting would take less time than traditional peer review and would spread the workload over many more reviewers. The study provides some support for using democracy based on time saved and gender balance, but also showed evidence of friendly voting.


Crisis ◽  
2017 ◽  
Vol 38 (3) ◽  
pp. 202-206 ◽  
Author(s):  
Karl Andriessen ◽  
Dolores Angela Castelli Dransart ◽  
Julie Cerel ◽  
Myfanwy Maple

Abstract. Background: Suicide can have a lasting impact on the social life as well as the physical and mental health of the bereaved. Targeted research is needed to better understand the nature of suicide bereavement and the effectiveness of support. Aims: To take stock of ongoing studies, and to inquire about future research priorities regarding suicide bereavement and postvention. Method: In March 2015, an online survey was widely disseminated in the suicidology community. Results: The questionnaire was accessed 77 times, and 22 records were included in the analysis. The respondents provided valuable information regarding current research projects and recommendations for the future. Limitations: Bearing in mind the modest number of replies, all from respondents in Westernized countries, it is not known how representative the findings are. Conclusion: The survey generated three strategies for future postvention research: increase intercultural collaboration, increase theory-driven research, and build bonds between research and practice. Future surveys should include experiences with obtaining research grants and ethical approval for postvention studies.


2011 ◽  
Author(s):  
M. Leonard ◽  
N. Ferjan Ramirez ◽  
C. Torres ◽  
M. Hatrak ◽  
R. Mayberry ◽  
...  

2018 ◽  
Author(s):  
Leslie Pertz ◽  
Missy Plegue ◽  
Kathleen Diehl ◽  
Philip Zazove ◽  
Michael McKee

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