Appendix 4 - Tables 4 and 5

U.K.

To explore the accessibility of health information provided by NHS to people with disabilities.

Quantitative. Review key information booklets and leaflets.

130 people with a physical and sensory disability.

People with disabilities do not receive health information in appropriate formats.

U.S.A.

To explore the experiences of mothers with a visual impairment during the transition to parenthood.

Qualitative descriptive, exploratory. Structured telephone interviews.

42 visually impaired mothers.

The degree of visual impairment does not impact on, nor is it predictive of mothers' parenting experiences. Mothers experienced a variety of attitudes/reactions pertaining to their parenting ability. Tried to conform to sighted ways of parenting; this was a source of frustration and anxiety.

Ireland

See Table 5

See Table 5

See Table 5

See Table 5.

U.K.

To examine the provision of services for deaf and hard of hearing people.

Qualitative descriptive, exploratory.5 focus groups.

15 people - 9 deaf and 6 hard of hearing.

Deaf and hard of hearing people are excluded from society. The organisation and provision of services undermine their parental role. Despite policies with the core principle of social inclusion people are still excluded.

U.S.A.

To examine the health care perceptions and experiences of people who are deaf or hard of hearing and provide suggestions to improve care.

Qualitative. Semi structuredinterviews.

26 people - 14 deaf and between 23-51 yrs and 12 hard of hearing between 30-74 yrs.

Physicians and deaf or hard of hearing individuals have conflicting views about being deaf or hard of hearing. There are different perceptions of facilitating effective communication and many physicians do not communicate effectively with this population. Adverse outcomes may result from ineffective communication. Interacting with office personnel is difficult and communication about physical examinations and procedures inadequate.

U.K.

To investigate the maternity care provided to one deaf woman

Case study.

One deaf woman.

Communication, informational and attitudinal challenges were encountered by deaf women when accessing reproductive health care.

Ireland

See Table 5

See Table 5

See Table 5

See Table 5

Ireland

See Table 5

See Table 5

See Table 5

See Table 5

U.K.

To identify the experiences of visually impaired people when using the NHS.To identify areas of improvement and to address the needs of blind people.

Quantitative. Telephone survey.

832 blind and partially sighted people - 400 owners of guide dogs and 432 not owners of guide dogs

Findings from the survey indicate that visually impaired people experience numerous challenges when accessing services in the NHS especially GP, outpatient and inpatient services. These challenges include - limited physical access to services, limited provision of information in appropriate format, limited staff awareness, limited assistance offered by staff and little assistance provided to guide dog users.

U.S.A.

To investigate the factors that impact on deaf women's satisfaction with pre-natal care and compare care of deaf and hearing women.

Quantitative. Questionnaire.

55 women - 23 deaf and 32 hearing women.

Deaf women are less satisfied than hearing women with the care received during the prenatal period. Hearing women had more prenatal visits, received more information and had better communication experiences with their physician than deaf women. Deaf women's rate of satisfaction was influenced by whether or not women's expectations of provision of sign language interpreters were met.

Ireland

See Table 5

Qualitative. Interviews.

9 minority people with disabilities.

See Table 5

U.K.

To determine if anecdotal evidence suggesting widespread insufficient quality treatment for deaf people was true.

Quantitative. Survey.

866 deaf and hard of hearing people.

While attending their GP or hospital, deaf or hard of hearing people experience difficulty with communication; some people avoid attending G.P. because of this. Making appointments was difficult, so some were missed, and one third was unclear about instruction regarding medication use.

U.S.A.

To explore women's perceptions of health care issues - including barriers to care and sources of information

Qualitative. Focus groups.Online survey.

61 - 59 women with a physical or sensory impairment. 2 physicians with an interest in the health care of women with disabilities.

The 7 themes (below) indicate the challenges experienced by the study population: Communication barriers, lack of knowledge and awareness among healthcare providers, access issues, working the system, systems issues, outreach to healthcare providers, reaching hard to reach women with disabilities.

Ireland

To examine the experiences of deaf Irish mothers as they negotiated access to maternity care services over a 15 year period.

Qualitative. Interviews.

11 deaf women.

Communication and attitudinal barriers were the major challenges experienced by deaf women. Access to information was impaired at both a personal and institutional level. Mothers adapted various methods of communication but health professionals relied on pen and paper and provision of sign language interpreters was limited. Deafness was women's defining characteristic. Health professional's lack of deaf awareness compounded the challenges.

U.K.

See Table 5

See Table 5

See Table 5

See Table 5

U.K.

See Table 5

See Table 5

See Table 5

See Table 5

U.K.

To examine deaf women's access to health care services in Cheshire U.K.

Quantitative and qualitative. Group discussions and questionnaires.

259 deaf women. 27 participated in qualitative strand. 138 out of 232 were completed and returned.

Deaf women encountered inequalities when accessing health care. Communication was the main problem. Health professionals lacked deaf awareness. Appointments and waiting rooms posed great difficulty; women often missed appointments because they were not aware it was their turn. Stigma existed; they were considered cognitively impaired. Terminology was inappropriate. Women felt embarrassed and frustrated

Ireland

See Table 5

See Table 5

See Table 5

See Table 5

U.K.

See Table 7

Quantitative. Review information booklets and leaflets.

130 people with a physical and sensory disability.

The report proposes recommendations that should be adapted to provide health information in appropriate formats to facilitate informed consent and decision making.

U.S.A.

See Table 5

See Table 5

See Table 5

The majority of physicians did use auxiliary aids e.g. printed material.

U.S.A.

To test the effect-iveness of the Deaf Heart Health Intervention (DHHI)

Quantitative - quasi experimental pre-post test study over 8 weeks.

84 deaf adults in Phoenix and Arizona.

Developing interventions specifically for deaf adults would facilitate an increase in self-confidence for adopting positive health behaviours.

U.K.

See Table 7

See Table 7

See Table 7

Measures to overcome communication, informational and attitudinal challenges were identified.

U.S.A.

See Table 7

See Table 7

See Table 7

Deaf women's rate of satisfaction was influenced by whether or not women's expectations in the provision of sign language interpreters were met.

U.S.A.

See Table 7

See Table 7

See Table 7

The authors suggest that women with disabilities should be recognised as a critical source of education.

Ireland

See Table 5

See Table 5

See Table 5

See Table 5