Journal article
Communication Access and Emergency Care for D/deaf People: A Reflexive Thematic Analysis of Patient Experiences
Journal of Clinical Nursing, Vol.Advanced access
02-Oct-2026
PMID: 42827035
Appears in UniSC Supported Open Access Outputs
Abstract
Aim
To examine how D/deaf people experience communication access during emergency department visits and identify changes they consider most important for accessible and safe emergency care.
Design
Interpretive qualitative survey study using reflexive thematic analysis.
Methods
Written responses to open-ended questions in an accessible bilingual Auslan-English survey were analysed within a critical, system-oriented framework. Interpretation was informed by Deaf Elder and D/deaf advisory perspectives.
Results
Accounts described widespread communication barriers, including absent or delayed interpreters, limitations of video remote interpreting and expectations to lip-read, write or rely on family members. These reflected hearing-centred emergency care that shifted communicative responsibility onto patients. Fear, confusion and frustration were particularly evident during urgent or painful presentations. Positive experiences were associated with early interpreter engagement, visual communication strategies and staff familiarity with sign language. Participants identified system-level changes, including on-call interpreter pathways, Deaf awareness training and improved visual and non-auditory communication systems.
Conclusion
Communication access was uncertain and inconsistently supported for D/deaf patients. Improving care requires organisational approaches that embed interpreter access, visual communication systems and Deaf-informed training within routine practice.
Implications for the Profession and/or Patient Care
Communication access should be embedded within routine emergency care through reliable interpreter pathways, visual communication systems and Deaf-informed staff education.
Impact
This study identifies communication barriers that can affect safety, understanding and participation for D/deaf patients in emergency care and highlights the need for organisational approaches to communication access.
Reporting Method
Reporting was guided by the Consensus-Based Checklist for Reporting of Survey Studies (CROSS).
Patient or Public Contribution
D/deaf people contributed to study design, recruitment, analysis and interpretation. Survey items were refined with Deaf Elders and a D/deaf advisory team. A Deaf Elder co-author contributed to recruitment and manuscript development, while advisory input informed theme refinement and challenged hearing-centred interpretations.
Details
- Title
- Communication Access and Emergency Care for D/deaf People: A Reflexive Thematic Analysis of Patient Experiences
- Authors
- Jennifer Dermer (Corresponding Author) - University of the Sunshine CoastSarah Hazelwood - University of the Sunshine CoastNeil WoodStephen Neville - University of the Sunshine Coast
- Publication details
- Journal of Clinical Nursing, Vol.Advanced access
- Publisher
- Wiley-Blackwell Publishing Ltd.
- DOI
- 10.1111/jocn.70578
- ISSN
- 1365-2702
- PMID
- 42827035
- Copyright note
- © 2026 The Author(s). Journal of Clinical Nursing published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
- Data Availability
- The qualitative dataset generated and analysed during the current study is not publicly available due to the potential identifiability of participants in a small community and restrictions within the ethics approvals. De-identified extracts supporting the findings are included in the article. Further information may be available from the corresponding author on reasonable request, subject to ethics approval and data governance requirements.
- Organisation Unit
- School of Health - Nursing
- Language
- English
- Record Identifier
- 991264396302621
- Output Type
- Journal article
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