背景:医疗工作者(HCWs)通常不准备与D/聋人和听力障碍(HoH)患者进行适当的沟通。由此产生的沟通挑战加剧了这些人群获得和受益于护理质量的现有障碍。作为回应,本研究旨在开发和评估HCW的能力建设干预措施,以提高他们对D/聋人和HoH个人在医疗保健方面的经验的认识,并提高他们与这些人群的沟通能力。
方法:本研究采用定性和定量方法进行参与式行动研究设计。干预是通过4个迭代阶段开发和测试的。反应(即,对干预内容的满意度和感知,质量,适当性和有用性)在干预后进行定量和定性评估,而与D/聋人和HoH患者沟通的感知知识和自我效能感以及组织回报(使用基本规则和工具改善沟通的频率)之前进行了定量评估,干预后和干预后6个月。
结果:主要的定性和定量研究结果表明,干预措施的最终版本在参与者中达到了很高的满意度。接下来,接受干预后和6个月后获得的感知知识和自我效能感得分明显高于初始评估中的得分,尽管两个评分在6个月时都显着下降(与干预后刚获得的评分相比)。最后,研究结果表明,在接受干预后,组织收益没有显著变化.呼应这些结果,主要的定性发现表明,在接受干预后,参与者感到更有信心,但没有更有能力与D/聋人和HoH患者进行交流。
结论:研究结果表明,能力建设干预措施是一种有希望的手段,可以持续地增加医护人员在如何与D/聋人和HoH患者沟通方面的感知知识和自我效能感,虽然补充方法和后续干预提醒可能是必要的,以实现工作环境的实践变化。
BACKGROUND: Healthcare workers (HCWs) are commonly not prepared to properly communicate with D/deaf and hard of hearing (HoH) patients. The resulting communication challenges reinforce the existing barriers to accessing and benefiting from quality of care in these populations. In response, this
study aimed to develop and evaluate a capacity-building intervention for HCWs to raise their awareness of D/deaf and HoH individuals\' experiences in healthcare and improve their capacity to communicate with these populations.
METHODS: This
study featured a participatory action research design using qualitative and quantitative methods. The intervention was developed and tested through 4 iterative phases. Reactions (i.e., satisfaction and perception of the intervention content, quality, appropriateness and usefulness) were assessed quantitatively and qualitatively after the intervention, whereas perceived knowledge and self-efficacy in communicating with D/deaf and HoH patients and organizational payoffs (use frequency of basic rules and tools improving communication) were quantitatively assessed before, after and 6-month post-intervention.
RESULTS: Main qualitative and quantitative findings showed that the final version of the intervention reached high levels of satisfaction among participants. Next, perceived knowledge and self-efficacy scores obtained after receiving the intervention and 6 months later were significantly higher than those yielded in the initial assessment, although both scores significantly decreased at 6 months (compared to the scores obtained just after the intervention). Finally, findings showed no significant changes in organizational payoffs after receiving the intervention. Echoing these results, main qualitative findings documented that after receiving the intervention, participants felt more confident yet not more equipped to communicate with D/deaf and HoH patients.
CONCLUSIONS: Findings suggest that the capacity-building intervention is a promising means to sustainably increase HCWs\' perceived knowledge and self-efficacy on how communicating with D/deaf and HoH patients, although complementary approaches and follow-up intervention reminders may be necessary to enable practice changes in the working environment.