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Exploration of Deaf people’s health information sources and techniques for information delivery in Cape Town: A qualitative study for the design and development of a mobile health application
Date Submitted: Sep 15, 2016
Open Peer Review Period: Sep 18, 2016 - Oct 2, 2016
Background: Many cultural and linguistic Deaf people in South Africa face disparity when accessing health information because of social and language barriers. The number of certified South African Sig...
Background: Many cultural and linguistic Deaf people in South Africa face disparity when accessing health information because of social and language barriers. The number of certified South African Sign Language interpreters is also insufficient to meet the demand of the Deaf population in the country. Our research team, in collaboration with Deaf communities in Cape Town, devised a mobile health application called SignSupport to bridge the communication gaps in healthcare contexts. We consequently plan to extend our work with a Health Knowledge Transfer System to provide Deaf people with accessible, understandable, and accurate health information. We conducted an explorative study to prepare the groundwork for the design and development of the system. Objective: We aim to: investigate the current modes of health information distributed to Deaf people in Cape Town; identify the health information sources Deaf people prefer and their reasons; and define effective techniques for delivering understandable information to generate the groundwork for the mobile health application development with and for Deaf people. Methods: A qualitative methodology using semi-structured interviews with sensitizing tools was used in a community-based co-design setting. Twenty-three Deaf people and 10 health professionals participated in this study. Inductive and deductive coding was used for the analysis. Results: Deaf people currently have access to 4 modes of health information distribution through: Deaf and other relevant organizations, hearing health professionals, personal interactions, and the mass media. Their preferred and accessible sources are those delivering information in signed language and with communication techniques that match Deaf people’s communication needs. Accessible and accurate health information can be delivered to Deaf people by 3 effective techniques: using signed language including its dialects, through health drama, and accompanying the information with pictures and concise text. Conclusions: We can apply the knowledge gained from this exploration to build the groundwork of the mobile health information system. We see an opportunity to design a Health Knowledge Transfer System to assist the information delivery during the patient-health professional interactions in primary health care settings. Deaf people want to understand the information relevant to their diagnosed disease and its self-management. The 3 identified preferred techniques will be applied to deliver health information through a mobile application.
Impact of Structured Rounding Tools on Time Allocation during Multidisciplinary Rounds: An Observational Study
Date Submitted: Sep 13, 2016
Open Peer Review Period: Sep 14, 2016 - Sep 28, 2016
Background: Recent research has shown evidence of disproportionate time allocation for patient communication during rounds. Several studies have shown that patients discussed later during rounds recei...
Background: Recent research has shown evidence of disproportionate time allocation for patient communication during rounds. Several studies have shown that patients discussed later during rounds receive lesser time. Objective: In this paper, we investigate whether such effects persist with the use of structured rounding tools. Methods: Using audio recordings of rounds (n=82 patients), we compared time allocation and communication breakdowns between a problem-based (SOAP) and a system-based (HAND-IT) rounding tool. Results: We found no significant linear dependence of the order of patient presentation on the time spent or on communication breakdowns for both structured tools. However, for the problem-based tool, there was a significant linear relationship between the time spent on discussing a patient and the number of breakdowns––with an average of additional 1.04 breakdowns with every 120s in additional discussion. Conclusions: The use of structured rounding tools potentially mitigated the disproportionate time allocation, and communication breakdowns during rounds; with the more structured HAND-IT, almost completely eliminating such effects. These results have potential implications for planning, prioritization, and training for time management during multidisciplinary rounds.