Looking for the Signs: OTs’ Experiences With Deaf Culture

Deaf culture unites members of the Deaf community with features such as shared language, history, art, customs, and beliefs. Considering the client’s cultural context in occupational therapy practice is important to address quality and satisfaction with client-centered outcomes and can lead to improved communication, feelings of trust, and familial involvement (Murden et al., 2008). While research suggests that the Deaf cultural and linguistic identities are often undervalued in healthcare settings (Lezzoni, O’Day, Killeen, & Harker, 2004), there is currently a lack of research exploring interactions between occupational therapy practitioners and culturally Deaf individuals. The purpose of this study was to explore the experiences of occupational therapists who have provided direct services to members of the Deaf community. What were the experiences of occupational therapy practitioners providing clinical services and communicating with Deaf clients? How did these occupational therapists recognize or consider Deaf culture in their clinical practice?

This study design was hermeneutical phenomenology (Creswell & Poth, 2018), as the meaning of each practitioner’s experience was interpreted to explore the impact on occupational therapy services for this population. Inclusion criteria were that the practitioner had provided direct services to a Deaf client within the past year, and that the client primarily communicated via American Sign Language (ASL). Four participants were recruited using a snowball sampling approach via e-mail invitation to personal and professional contacts. Each practitioner participated in a qualitative interview on two separate occasions, and interpretive phenomenological methods set forth by King, Horrocks, & Brooks (2019) were used to analyze the transcribed interview data for themes. To establish trustworthiness of the data and ensure quality, member-checking took place during the second interview and peer-debriefing among the research team was regularly practiced.

Four primary themes emerged from the data. The first reflected on the therapists’ experiences with cross-cultural communication, including using an ASL interpreter and alternate methods such as technology use, writing, and speechreading. A second theme explored cultural etiquette, including preferred terminology and the value of maintaining eye contact and space during interactions with Deaf clients. A third theme was cultural perceptions and practice considerations for the participants. Encompassed in this theme were the impacts of particular deficits on this population and provider attributes that are advantageous. The fourth theme to emerge was striving for cultural knowledge, as all participants demonstrated a motivation to seek information with the intention of improving cultural sensitivity and overall quality of care.

More frequent encounters with the Deaf population led to a greater awareness of the cultural and communicative influences for this population. Failing to understand the significance of functional deficits in the context of culture may sacrifice the client-centeredness of occupational therapy. The experiences included in this study offer the potential to increase access to culturally relevant services for members of the Deaf community. This may improve the effectiveness of occupational therapy services, including strengthened rapport, improved communication, and better therapy outcomes. By understanding the impact of cultural considerations on practice for the Deaf community, practitioners might be sensitized to the needs of other cultural groups. The methods for seeking cultural knowledge identified in this study can be beneficial for a practitioner providing services to clients with various cultural identities.

References

Creswell, J. W. & Poth, C. N. (2018). Qualitative inquiry and research design: Choosing among five approaches (4th ed.). Thousand Oaks, CA: SAGE.

King, N., Horrocks, C., & Brooks, J. (2019). Interviews in qualitative research (2nd ed.). Thousand Oaks, CA: SAGE.

Lezzoni, L. I., O’Day, B. L., Killeen, M., & Harker, H. (2004). Communicating about health care: Observations from persons who are Deaf or hard of hearing. Annals of Internal Medicine, 140(5), 356–362+I68. https://doi.org/10.7326/0003-4819-140-5-200403020-0001

Murden, R., Norman, A., Ross, J., Sturdivant, E., Kedia, M., & Shah, S. (2008). Occupational therapy students’ perceptions of their cultural awareness and competency. Occupational Therapy International, 15(3), 191–203. https://doi.org/10.1002/oti.253