Women with Disabilities: Barriers and Facilitators to Accessing ...

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WOMEN WITH DISABILITIES: BARRIERS AND FACILITATORS TO ACCESSING SERVICES DURING PREGNANCY,CHILDBIRTH AND EARLY MOTHERHOODSchool of Nursing and Midwifery, Trinity College Dublinsigning. An awareness of cultural differences in communication styles is lacking,which also leads to misinterpretations.4.9. Facilitators to overcome accessibility challenges forwomen with sensory lossIf entry to the health care facility is via an intercom system, it would be moreeffective to use one with a light that indicates when the door is open, or topurchase a video-entry system (RCN, 2007). The use of auxiliary aids such astelephone amplifiers, pictorial signage, audible, visual and tactile systems inwaiting rooms (Clark, 2002; Kaplan, 2006) will ensure that persons with asensory impairment can access the services when required and move aroundwith some sense of independence. In particular, installing a flashinglight/number system in all waiting areas will help women with hearingimpairment identify when it is their turn to be seen by the health professional.Seats should also be strategically placed to face the receptionist so that theycan signal to the woman when her name is announced. Hearing aid usersshould be encouraged to approach health professionals with any concerns orqueries (Ubido et al, 2002).4.10. Facilitators to overcome accommodation challenges forwomen with sensory loss (including those women from ethnicminority groups)4.10.1. General facilitating factorsIt has been suggested that developing facilities and interventions specifically fordeaf adults would help to facilitate accessibility and women’s self confidence(Jones et al, 2007). Women with sensory loss should have access to allinformation (Thomas, 1998) in an appropriate language and format that is easilyunderstandable. Early in the development of the relationship between healthprofessionals and the woman, her preferred method of communication shouldbe ascertained and clearly documented. Consultation times should be extendedin order to facilitate effective communication and the exchange of information.85
WOMEN WITH DISABILITIES: BARRIERS AND FACILITATORS TO ACCESSING SERVICES DURING PREGNANCY,CHILDBIRTH AND EARLY MOTHERHOODSchool of Nursing and Midwifery, Trinity College DublinCulturally sensitive antenatal education classes specifically for women withdisabilities should be provided (Conine et al, 1986; Carty et al, 1993).4.10.2. Facilitating communication with women with visualimpairmentAll information provided should be given in large print, audio or Braille format asappropriate (Clark, 2002; Nzegwu, 2004).4.10.3. Facilitating communication with women with hearingimpairmentTo facilitate lip-reading, health professionals should face women directly, speakslowly and clearly and avoid any exaggerated facial gestures. The exchangeshould occur in adequate light without glare. Background noise should bereduced and professionals should avoid wearing masks (RCN, 2007).It is reported in the literature that if a woman needs and wishes to have a signlanguage interpreter, then one should be arranged to be present for eachplanned interaction, and ‘on call’ to attend when necessary (Clark, 2002; Ubidoet al, 2002; Steinberg, 2006; Trotter, 2006). Using technology such astelephone or remote/video conferencing (Jones and Gill, 1998; Underwood,2004) may also be considered. Clark (2002) argues that health professionalsshould receive training in sign language to level 3 standard, which may alleviateproblems encountered when a shortage of professionally trained interpreters isencountered. Incorporating and increasing the use of technology, for example,visual alert, displays, minicom and loop systems are other ways to facilitatecommunication (Ubido et al, 2002; Underwood, 2004; Valios, 2004; D’Eath et al,2005).Health professionals should form links with deaf mothers and facilitate theestablishment of a peer support network which would be a vital source ofsupport for women who are deaf (Steinberg, 2006). All information providedshould be given in pictorial, written or video form with sub-titles (Nzegwu, 2004).86
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