Abstract
Introduction
Deaf and hard-of-hearing individuals encounter persistent barriers in emergency departments, where care often relies on rapid, spoken exchanges, auditory dominance, and limited willingness to adapt communication approaches. Without access to signed or visual communication, patient safety is compromised, informed consent becomes uncertain, and equitable care cannot be guaranteed.
Methods
This integrative review critically synthesizes empirical literature on the communication experiences of Deaf and hard-of-hearing patients in emergency settings. A systematic search of peer-reviewed and gray literature was conducted (1970 to March 10, 2025). Identifying 1929 records (967 after duplication), 7 studies met the inclusion criteria. Studies were appraised using the Joanna Briggs Institute and Mixed Methods Appraisal Tool checklists. Thematic synthesis followed the principles of critical interpretive synthesis and the weight of evidence framework.
Results
Five key themes emerged: (1) communication barriers, (2) delays and disparities in care, (3) patient care experiences, (4) systemic exclusion, and (5) strategies for accessible care. Across the literature, interpreter provision was inconsistent, Deaf cultural awareness was limited, and few systems embedded protocols to support language access.
Discussion
Equitable emergency care for Deaf and hard-of-hearing patients requires systemic reform. Key priorities include Deaf awareness training, timely interpreter provision, and the codesign of communication-access protocols led by Deaf communities. These measures are essential for delivering lawful, safe, and patient-centered emergency care.