Vocational sign language on medicine

Deaf individuals, who are among the disadvantaged groups, experience many problems in their social lives. One of the most important problems is the communication difficulties that they experience when they need to receive health care services. Moreover, this situation gains more importance especially in emergency cases. It is a requirement of the social state understanding to ensure the full utilisation of health services by the deaf individuals as they deserve the same services as well as any member of the society. In the report titled “Hearing Loss: The Statistics” published by the European Federation of the Hearing Impaired (EFHOH) in 2015, it is seen that 50 million people, which is equivalent to 10% of the European Union population, are deaf or hearing impaired. The Turkish National Federation of the Deaf states that the number of the hearing impaired people that live in Turkey is 3.5 million.
The native language of the deaf individuals is the sign language. Contrary to the popular belief, the sign language of each country is different from others. Sign languages have their unique structures and grammatical rules. The structures and grammar rules are different from that of the structure of the spoken language used in the same country. In short, sign language is not dependent on the spoken language. The reason why deaf people have difficulty in learning spoken languages in our country or in different countries is that the sign languages are structurally different from the spoken languages (Dikyuva & Zeshan 2008).

Health services in our country and in the world are primarily designed and prepared for people who do not have any disabilities. Then, some measures are taken and people with disabilities are included in these programs. In healthcare services for the deaf, this approach is reducted to only sign language translation. Moreover, high majority of the sign language translators are not experts in the medical sciences and/or they do not have the required sufficient terminological knowledge or background about the field. This approach is insufficient and unacceptable for the deaf community. In the Ministry of Family, Labour and Social Services, the number of tenured sign language interpreters for the whole of Turkey is only 56 for the year 2022.
Failure to establish effective communication between healthcare professionals and sick individuals has important repercussions on health outcomes. The situation can become even more complicated when it is to be established with deaf individuals. Problems arise such as the inability of deaf individuals to explain their situation to health care professionals or the inability of the professionals to provide information to the deaf individuals about their health conditions. Some individuals with disabilities have difficulty in understanding the information given by health care professionals or cannot effectively express their thoughts, expectations or needs regarding their healthcare needs. Deaf individuals using sign language cannot meet their health needs due to the fact that health care workers do not know the sign language or lack the educational material (Pollard et al., 2009). Considering the continuity of the principle of health care, the limited time allocated to individuals causes an inability to establish an effective and sufficient communication with disabled individuals (Mastebroek et al., 2014).

Communication barriers reported by healthcare professionals include the difficulties experienced in processes such as calming patients, explaining hospital procedures, assessing pain levels, and discharge (Tyler et al., 2010). Negative attitudes of healthcare professionals resulting from their communication sometimes affect the disabled person's inability to receive treatment or to stop treatment. Greenwood et al. (2014) reported in their study that caregivers had to undertake this responsibility because some disabled individuals could not obtain consent for treatment and health screenings, and they also had difficulty in making decisions.

Approaches to increase access to health services for people with disabilities regarding communication problems with healthcare professionals, a training program for all professionals must be planned in order to increase the understanding of health care professionals and the quality of care for people with disabilities. In the education of nursing and medical students, special training should be given to ensure that they are competent enough in order to understand the disabled individual, determine their needs and provide the care that they need. For example; in order to communicate with deaf people, sign language courses should be added to the curriculum of health students and even certified (Ö. Karatana, K. Gür, 2019).

The reason for preparing this project is our belief that we can produce applicable and practical solutions to the problems mentioned above. Our target groups are all employees of the health sector, as well as the deaf, whose numerical values are above. In our country, the number of employees working only under the Ministry of Health is 1,142,469 in 2020. (Health Statistics Yearbook, 2020).

The results to be produced within the scope of our project are as follows:
1. A MOOC platform that is free of charge will be prepared to be used by health care professionals (Mass open online course (MOOC) is a free online course that supports learning in different fields and it is open to anyone with a computer and internet connection).
2. A sign language teaching program focused on Medicine and Health Services will be established at A1 and A2 levels.
3. A B1 level Medical and Health Services-oriented sign language teaching program will be established.
4. Educational materials will be prepared for the curriculum to be created at A1, A2 and B1 levels.
5. A Glossary of Medical Terms in Sign Language will be created, it will include the signs that are frequently used in Medicine and Health Services.
6. Application of Patient Anamnesis Form in accordance with Manchester Protocol, video- recorded in sign language - 1 (For deaf parents who come to the examination with theirnewborn deaf child).
7. Application of Patient Anamnesis Form in accordance with Manchester Protocol, video- recorded in sign language - 2 (For deaf parents who come to the examination with their pre-school deaf child).