title: Deaf women: experiences and perceptions of healthcare system access.
abstract: BACKGROUND
  The authors investigated the knowledge, attitudes, and healthcare experiences of Deaf women.
  
  
  METHODS
  Interviews with 45 deaf women who participated in focus groups in American Sign Language were translated, transcribed, and analyzed. Deaf women's understanding of women's health issues, knowledge of health vocabulary in both English and American Sign Language, common health concerns among Deaf women, and issues of access to information, including pathways and barriers, were examined. As a qualitative study, the results of this investigation are limited and should be viewed as exploratory.
  
  
  RESULTS
  A lack of health knowledge was evident, including little understanding of the meaning or value of cancer screening, mammography, or Pap smears; purposes of prescribed medications, such as hormone replacement therapy (HRT); or necessity for other medical or surgical interventions. Negative experiences and avoidance or nonuse of health services were reported, largely due to the lack of a common language with healthcare providers. Insensitive behaviors were also described. Positive experiences and increased access to health information were reported with practitioners who used qualified interpreters. Providers who demonstrated minimal signing skills, a willingness to use paper and pen, and sensitivity to improving communication were appreciated.
  
  
  CONCLUSIONS
  Deaf women have unique cultural and linguistic issues that affect healthcare experiences. Improved access to health information may be achieved with specialized resource materials, improved prevention and targeted intervention strategies, and self-advocacy skills development. Healthcare providers must be trained to become more effective communicators with Deaf patients and to use qualified interpreters to assure access to healthcare for Deaf women.
authors.affiliation: Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA. drannie@mail.med.upenn.edu
authors.forename: Annie G
authors.initials: AG
authors.lastname: Steinberg
authors.forename: Erin A
authors.initials: EA
authors.lastname: Wiggins
authors.forename: Carlin Henry
authors.initials: CH
authors.lastname: Barmada
authors.forename: Vicki Joy
authors.initials: VJ
authors.lastname: Sullivan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002983:Clinical Competence; D003144:Communication Barriers; D003638:Deafness / Q000523:psychology*; D060345:Education of Persons with Hearing Disabilities; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D008875:Middle Aged; D020380:Needs Assessment; D009511:New England; D010353:Patient Education as Topic / Q000592:standards; D019986:Persons with Hearing Disabilities / Q000523:psychology*; D036301:Qualitative Research; D012813:Sign Language; D011795:Surveys and Questionnaires; D014930:Women / Q000193:education / Q000523:psychology*; D016387:Women's Health