Patient-centered care seeks to be responsive to patients’ values and needs and patient preferences guide decision-making.
The Institute of Medicine (IOM) endorsed six dimensions of patient-centered care, emphasizing that care must be:
- respectful to patients’ values, preferences, and expressed needs;
- coordinated and integrated;
- provide information, communication, and education;
- ensure physical comfort;
- provide emotional support – relieving fear and anxiety; and
- involve family and friends.[19]
Healthcare organizations that pursue the delivery of patient-centered care inevitably provide higher-quality treatment that meets both the medical and emotional needs of their patients, as well as their preferences, needs, values, and goals.[20]
In the context of Deaf and hard of hearing individuals, accomplishing each of these dimensions and delivering patient-centered care requires the provision of effective communication and healthcare professionals practicing cultural humility.
Effective Communication
Within the Deaf and hard of hearing community, communication needs and preferences exist on a wide spectrum. As such, to ensure effective communication, the provision of auxiliary aids and services should cater to each patient and the support they need.
Ultimately, effective communication positions Deaf and hard of hearing patients, companions, and patient representatives to better understand medical procedures, provide clearer answers to providers’ questions, and enable them to make fully informed decisions regarding their own care or the care of loved ones.
Furthermore, developing a collaborative and empathetic bond is a cornerstone of patient-centered care. By ensuring effective communication takes place, healthcare organizations better position their professionals to build a strong foundation of trust and mutual understanding with patients, companions, and patient representatives.
It is important to note that despite the ADA, Section 504, and Section 1557 defining effective communication, some healthcare organizations do not even adhere to these requirements. At the same time, only providing appropriate auxiliary aids and services does not equate to providing patient-centered care to Deaf and hard of hearing individuals.
We elaborate on this in the next subsection.
Cultural Humility
Delivering culturally appropriate and sensitive care to Deaf and hard of hearing individuals is another essential component to fostering a collaborative relationship between healthcare professionals and patients. This requires healthcare professionals to practice cultural humility, a dynamic where clinicians understand the complexities of identities and its impact in healthcare settings.
With respect to working with Deaf and hard of hearing individuals, healthcare providers will recognize that there are always opportunities to learn more about Deaf and hard of hearing patients’ sociocultural needs and preferences. This is because healthcare professionals are generally not Deaf or hard of hearing and do not have lived experiences as members of the community.
Practicing cultural humility will also help healthcare professionals be more sensitive and empathetic to the evolving and dynamic nature of Deaf and hard of hearing patients’ experiences in healthcare settings. This includes being aware of relevant health disparities and potential issues with health literacy this population encounters in healthcare settings and beyond, as well as being aware of how biases and power imbalances may negatively impact a Deaf or hard of hearing patient’s experience in healthcare settings.
All of this is important because anyone who experiences a health concern or enters a healthcare setting may be nervous or experience anxiety. With respect to Deaf and hard of hearing individuals, this stress can be compounded by having to navigate an inaccessible healthcare system and working with individuals who do not understand how to meet their respective needs.
Healthcare professionals can ultimately create positive patient experiences for Deaf and hard of hearing individuals when they lead with empathy and respect Deaf and hard of hearing patients’ diverse experiences, identities, and communication preferences and needs.
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[19] Institute of Medicine . Crossing The Quality Chasm: A New Health System for the 21st Century. Washington DC: National Academy Press; 2001.
[20] See What Is Patient-Centered Care? Available at https://catalyst.nejm.org/doi/full/10.1056/CAT.17.0559.