Necessity of sign language at medical support for people with a hearing disability: Providing safe and reassuring health care

Abstract

Around 300 000 people with a hearing disability (PHD), which includes congenital hearing disorder (CHD), post-lingual hearing loss, and hearing impaired people live in Japan. Those with a CHD have difficulty in acquiring language, and many elderly persons with CHD have signing skills and a small vocabulary. In 2000, a Japan Research Institute surveyed on barrier faced by the hearing impaired and revealed that hospitals are one of the most inconvenient facilities, next to public transportation (Mizuno 2003). In 2011, the Tokyo Sign Language Interpreter Dispatch Center received 6233 interpreter requests from PHD, and 4261 (68%) of these requests were healthcare related. However, there is only about 30 medical facilities in Japan that have a staff sign language interpreter and are sign-language compliant. Besides there are many cases in which patients are refused treatment on account of PHD. There are only a few hospitals that PHD can visit without anxiety. On the bright side, regular sign language courses for medical personnel are offered in Hiroshima Prefecture, which has Japan's first nursing home for the hearing impaired. Moreover, Hiroshima International University offers sign language courses in its Faculty of Healthcare and Faculty of Health and Welfare. As discussed in the articles noted, it is characteristic for PHD sufferers to be prone to disease worsening, sexually transmitted disease and prevalence of infections because of a lack of relevant information on healthcare (Bat-Chava et al. 2005; Scheier 2009). Communication is the major barrier to healthcare individuals with hearing loss, so healthcare professionals should educate themselves about ways to reduce barriers (McAleer 2006). In 2007, I encountered a diabetic patient with CHD who required injection of insulin that was essential for his treatment. Therefore he was repeatedly hospitalized because he was unconvinced of the necessity of treatment with self-injection. With the help of a sign-language book, I successfully convinced him. It was a case that made me realize the power of sign language, and led me to learn. Shiseikai Daini Hospital became a cooperative training hospital for postgraduate residents of Tokyo Women's Medical University in 2004. Being a professor dealing with postgraduate residents of Tokyo Women's Medical University, I added a course on medical sign language (MSL) to the curriculum for regional healthcare. Opinions of the residents taking the MSL course included, there are many barriers in a hospital for a hearing-impaired person, and the medical staff was required to acquire basic sign language. Ninety percent of the 45 residents who took the MSL course rated it very useful or useful. There are lecture series staffed with a sign language interpreter to allow PHD to participate in lectures designed for people with normal hearing, but PHD have difficulty in keeping pace with these lectures. Faced with this situation, CHD requested health education programs specific for the hearing impaired. Their requests led me to initiate such courses. The first course was held in April 2011 in Seijo Hall on the topic of the prevention and handling of lifestyle-related diseases, which was attended by 17 CHD and two sign language students. Continuing to hold courses once every 3 months, thereafter the number of participants gradually grew. A questionnaire given after the conclusion of the course revealed check-in, examinations, and tests to be difficulties encountered when going to the hospital. The respondents stated that hospitals should provide written conversation services and medical personnel should explain about diseases using diagrams and pictures. In conclusion, hospitals are institutions that PHD perceive to have the greatest information barrier and find most difficult to use. Japan has few medical institutions that offer care in sign language. Awareness among medical personnel that they must adjust their care for patients with impediments is the first step toward eliminating barriers. Much work is needed to ensure that medical personnel give more thought to PHD disability, eliminate barriers, and provide safe and reassuring services for PHD. I hope that healthcare professionals can educate themselves about the culture of PHD to provide safe and reassuring health care. I am indebted to Mrs Akiko Shirai for her sign language and staff of Setagaya-ku Sign Language Interpreters Dispatch Center for their help. None.