成年聽覺障礙者的就醫經驗之研究

游政諺(Cheng-Yen Yu)

指導教授 ： 陳孝平

國立中正大學/社會科學院/社會福利學系/碩士(2014年)

摘要

本研究旨在於探討成年聽覺障礙者就醫經驗的不同樣貌，瞭解不同聽障者在就醫過程當中遇到的困境與因應策略。而研究者本身是聽障者，從聾人文化和障礙觀點社會模式的角度詮釋不同聽障者的就醫經驗。
本研究採用質性研究方法，以「深度訪談法」和「參與觀察法」蒐集不同資料，並以「內容分析法」作為主要的資料分析方式。本研究邀請到十二位成年聽障者(20-55歲)參與研究，這十二位聽障者來自於大臺北地區、台中市、彰化縣和嘉義市，障礙程度以極重度(91dB以上)居多。
研究發現，有的聽障者由於缺乏手語翻譯員而無法向醫護人員表達其病痛狀況，只能以紙筆與醫護人員溝通，但是筆談難以深入討論病情。有的聽障者遇到醫護人員配戴口罩時而無法以讀唇方式接收任何訊息，需要醫護人員多次覆述才能理解到對方的意思，而且聽障者沒有在適當協助下容易發生醫護人員提問時卻答非所問的情形。甚至聽障者因為聽力受限的關係，接收反應能力較慢，不容易照循醫護人員的口語指令操作。
目前仍有許多醫療機構缺乏聽障專用的無障礙設施，例如：號碼顯示器或指示燈號、電腦看板或字幕、跑馬燈、書面文宣說明等，讓聽障者無法即時取得各種訊息，而影響其後續就醫流程。而目前絕大部分醫療機構的掛號專線僅提供電話預約和網路掛號兩種管道，沒有考量到聽障者的需求，只能透過他人協助以電話方式預約或直接到院現場排隊掛號。此外，目前台灣手語翻譯服務制度仍然沒有很完善，像是手語翻譯申請須事先預約、申請時間太久、各縣市手譯資源不均等問題，難以百分之百服務到有溝通需求的聽障者。而且聽障者由於緊急就醫而需要手譯員的協助，卻無法即時得到資源，讓手語模式的聽障者在求醫路走得十分辛苦。
由於台灣受到中文主流語言的影響，使聽障者的溝通模式多元，以口語、筆談、手語最為常見，加上台灣因為缺乏聾文化的討論，導致多數醫護人員不知道如何與聽障者溝通，也對聽障者的中文能力有誤解，難以提升醫病之間的有效溝通。此外，有些醫護人員對聽障者的態度不佳，缺乏同理心、耐心和愛心，也不願意配合聽障者的溝通需求，因而讓聽障者產生不被尊重或是被歧視的感受。
最後，根據以上研究結果而提出一些台灣聽障醫療福利政策建議，讓衛福部、相關醫療機構依據聽障者的就醫需求而改善當前狀況，以提升聽障者的就醫服務品質。

關鍵字

就醫經驗 ； 聽覺障礙者 ； 聾人文化

並列摘要

This study aims to explore the hindrance in the medical system through the medical-seeking experience of twelve adult deaf people (20-55 years old),drawing on the social model of disability and in the context of the Deaf culture. And this researcher is a deaf person himself.
This study used "in-depth interviews" and "participant observation" to collect the data, and "content analysis" as the primary data analyzing methods. These subjects of deaf people are from the greater Taipei area, Taichung City, Changhua County and Chiayi City in Taiwan.
Due to lack of sign language interpreters, some deaf people cannot express their pain conditions to the doctor, and they have to use note-writing to communicate with the medical personnel, but it is difficult to discuss in depth through note-writing. For some deaf people, it was hard to receive any information through lip-reading, especially when the care-giver has his surgical mask on. They have to ask the medical staff to repeat several times in order to understand the meaning of each other. And when further questions asked, the deaf people may give an irrelevant answer if without assistance. With poor or even non-existent hearing capacity, it is hard for the deaf people to grasp the medical staff’s commands in spoken language.
There are still many medical institutions lacking in deaf accessible environment, such as numerating lights, computer board, scrolling text, written papers, etc. Thus, the deaf people cannot receive information immediately, which pose a hindrance in their medical treatment processes. At present, a vast majority of medical institutions have provided telephone and Internet appointment service, but not yet considered the needs of the deaf people, and therefore the deaf people can only depend on other people’s help to make an appointment by telephone, or go straight to the hospital’s line-up. In addition, The Taiwanese Sign Language translation service system is still not well developed; the deaf people have to apply for sign language interpreters before they see a doctor, and it take a long time for the application.
Deaf culture has not yet taken root in Taiwan, and the majority of medical staff is not trained for effective communication; It is difficult to conduct a workable communication between the care-giver and the deaf patients. In addition, some of the medical staff posed a negative attitude of the deaf people, lacked in empathy and patience, and unwilling to fulfill some communication needs of the deaf people, and therefore leave the deaf people in a feeling of being discriminated.
Finally, based onthe above findings, this study proposed a number of suggestions for Taiwan's medical welfare policy in order to promote medical care services of the deaf people.

並列關鍵字

Medical Care Experience ； Hard of hearing ； Deaf ； Deaf Culture

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