A call for disability health curricula in medical schools

Ratakonda, Sanjana; Argersinger, Davis P.; Auchus, Gabriella C; McGowan, Caroline; Ship, Hannah; Wang, David R; McKee, Michael

doi:10.1016/j.molmed.2022.08.004

Cited by 14 publications

(19 citation statements)

References 9 publications

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“…Participants encouraged the inclusion of disability content across the curriculum and ensured that students had the opportunity to interact with a variety of patients with disabilities. 62 Communication in the ED, like other healthcare settings, must be The limitations and strengths of this study should be considered when evaluating results. First, there was a small sample size relative to most other qualitative work and, consistent with the qualitative tradition, we do not promote the claim of generalizability of these results.…”

Section: Recommendations For Ed Carementioning

confidence: 99%

Emergency department patient‐centred care perspectives from deaf and hard‐of‐hearing patients

James,

Sullivan,

McKee

et al. 2023

Health Expectations

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BackgroundDeaf and hard‐of‐hearing (DHH) patients are a priority population for emergency medicine health services research. DHH patients are at higher risk than non‐DHH patients of using the emergency department (ED), have longer lengths of stay in the ED and report poor patient–provider communication. This qualitative study aimed to describe ED care‐seeking and patient‐centred care perspectives among DHH patients.MethodsThis qualitative study is the second phase of a mixed‐methods study. The goal of this study was to further explain quantitative findings related to ED outcomes among DHH and non‐DHH patients. We conducted semistructured interviews with 4 DHH American Sign Language (ASL)‐users and 6 DHH English speakers from North Central Florida. Interviews were transcribed and analysed using a descriptive qualitative approach.ResultsTwo themes were developed: (1) DHH patients engage in a complex decision‐making process to determine ED utilization and (2) patient‐centred ED care differs between DHH ASL‐users and DHH English speakers. The first theme describes the social‐behavioural processes through which DHH patients assess their need to use the ED. The second theme focuses on the social environment within the ED: patients feeling stereotyped, involvement in the care process, pain communication, receipt of accommodations and discharge processes.ConclusionsThis study underscores the importance of better understanding, and intervening in, DHH patient ED care‐seeking and care delivery to improve patient outcomes. Like other studies, this study also finds that DHH patients are not a monolithic group and language status is an equity‐relevant indicator. We also discuss recommendations for emergency medicine.Patient or Public ContributionThis study convened a community advisory group made up of four DHH people to assist in developing research questions, data collection tools and validation of the analysis and interpretation of data. Community advisory group members who were interested in co‐authorship are listed in the byline, with others in the acknowledgements. In addition, several academic‐based co‐authors are also deaf or hard of hearing.

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Section: Recommendations For Ed Carementioning

confidence: 99%

Emergency department patient‐centred care perspectives from deaf and hard‐of‐hearing patients

James,

Sullivan,

McKee

et al. 2023

Health Expectations

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“…These medical breakthroughs have yielded significant improvements in health outcomes, such as more effective treatments and timely diagnoses. − Nevertheless, despite this incredible progress, significant disparities in access to state-of-the-art medical technology remain. These disparities lead to marked differences in health and life expectancy among high-, middle-, and low-income countries. , Notably, healthcare inequalities are not exclusive to low- and middle-income countries (LMIC), as within the United States there are unacceptable disparities in healthcare received by marginalized and vulnerable populations, including those based on race/ethnicity, gender and sexual orientation, and disabilities . The COVID-19 pandemic has further highlighted these inequalities as evidenced by the disproportionate mortality rate among Black and Latino populations in comparison to white populations .…”

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confidence: 99%

“…1,5 Notably, healthcare inequalities are not exclusive to low-and middle-income countries (LMIC), as within the United States there are unacceptable disparities in healthcare received by marginalized and vulnerable populations, including those based on race/ ethnicity, 6 gender and sexual orientation, 7 and disabilities. 8 The COVID-19 pandemic has further highlighted these inequalities as evidenced by the disproportionate mortality rate among Black and Latino populations in comparison to white populations. 9 As a consequence, there exists a critical need to develop effective measures that provide all populations access to state-of-the-art medical care.…”

mentioning

confidence: 99%

Recent Advances in Skin-Interfaced Wearable Sweat Sensors: Opportunities for Equitable Personalized Medicine and Global Health Diagnostics

Clark,

Ray

2023

ACS Sens.

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Recent advances in skin-interfaced wearable sweat sensors enable the noninvasive, real-time monitoring of biochemical signals associated with health and wellness. These wearable platforms leverage microfluidic channels, biochemical sensors, and flexible electronics to enable the continuous analysis of sweat-based biomarkers such as electrolytes, metabolites, and hormones. As this field continues to mature, the potential of lowcost, continuous personalized health monitoring enabled by such wearable sensors holds significant promise for addressing some of the formidable obstacles to delivering comprehensive medical care in under-resourced settings. This Perspective highlights the transformative potential of wearable sweat sensing for providing equitable access to cutting-edge healthcare diagnostics, especially in remote or geographically isolated areas. It examines the current understanding of sweat composition as well as recent innovations in microfluidic device architectures and sensing strategies by showcasing emerging applications and opportunities for innovation. It concludes with a discussion on expanding the utility of wearable sweat sensors for clinically relevant health applications and opportunities for enabling equitable access to innovation to address existing health disparities.

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“…Clinicians and health care staff need to be trained on best practices with communication and how to effectively serve patients with communication disabilities. With nearly 1 in 5 adults with hearing loss, health training programs, including medical schools, need to integrate mandatory disability health curricula . Addressing the needs of patients with hearing loss is critical to both equitable and accessible health care.…”

mentioning

confidence: 99%

“…With nearly 1 in 5 adults with hearing loss, health training programs, including medical schools, need to integrate mandatory disability health curricula. 16 Addressing the needs of patients with hearing loss is critical to both equitable and accessible health care.…”

mentioning

confidence: 99%

Technological Tools to Improve Communication in Patients With Hearing Loss

James

McKee

2022

JAMA

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The risk of hearing loss increases as the population ages, with approximately 23 million adults aged 70 years or older (63%) in the US having diminished speech perception. 1 Although hearing loss is common in elderly people, management is largely ineffective due to several factors: poor screening, high cost of hearing aids, vanity, hearing loss stigma, and inadequate training of health care practitioners. As a result, hearing loss results in adverse consequences both in health care settings and in everyday life. 2 Studies have demonstrated that those with untreated hearing loss use hospitals and emergency departments more often than those without hearing loss and generate, on average, an additional $22 000 in health care expenses over 10 years. 3 Chang et al 4 analyzed Medicare recipients with hearing loss and selfreported communication difficulties and found that they were 32% more likely to be readmitted to the hospital within 30 days of discharge compared with those who did not report hearing loss or communication difficulties.Hearing loss is a major source of social isolation among older adults and causes health care communication breakdowns between clinicians and patients, 5 reducing patients' health care satisfaction and adherence. 6 Despite the considerable adverse effects of age-related hearing loss, hearing aid use remains low even though these aids provide communication benefits, reduce social isolation, and improve quality of life. Less than 20% of those aged 70 years or older with hearing loss reported hearing aid use. 7 Due to infrequent use of hearing aids, many older adults with hearing loss struggle with understanding clinicians. 6 A potential tool is the use of personal sound amplification products (PSAPs); these devices, not much larger than a smartphone, amplify sounds close to the user while reducing noises farther away. In previous small studies, PSAPs have shown benefits in improving the quality of hearing and communication. 8,9 In this issue of JAMA, Nieman et al 10 report a randomized trial of a community health worker-delivered PSAP intervention among 151 older adults with hearing loss. Participants in the intervention group received 1 of 2 PSAPs and were encouraged to use the device in their daily routines. The community health worker-led device instruction took place in 1 to 2 individual sessions in less than 2 hours of total time. The primary outcome was self-perceived communication at 3 months; secondary outcomes included physical health, depression, social isolation, loneliness, and self-efficacy in

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A call for disability health curricula in medical schools

Cited by 14 publications

References 9 publications

Emergency department patient‐centred care perspectives from deaf and hard‐of‐hearing patients

Emergency department patient‐centred care perspectives from deaf and hard‐of‐hearing patients

Recent Advances in Skin-Interfaced Wearable Sweat Sensors: Opportunities for Equitable Personalized Medicine and Global Health Diagnostics

Technological Tools to Improve Communication in Patients With Hearing Loss

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