{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T01:53:14Z","timestamp":1790992394172,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine how D\/deaf people experience communication access during emergency department visits and identify changes they consider most important for accessible and safe emergency care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Interpretive qualitative survey study using reflexive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Written responses to open\u2010ended questions in an accessible bilingual Auslan\u2010English survey were analysed within a critical, system\u2010oriented framework. Interpretation was informed by Deaf Elder and D\/deaf advisory perspectives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Accounts described widespread communication barriers, including absent or delayed interpreters, limitations of video remote interpreting and expectations to lip\u2010read, write or rely on family members. These reflected hearing\u2010centred emergency care that shifted communicative responsibility onto patients. Fear, confusion and frustration were particularly evident during urgent or painful presentations. Positive experiences were associated with early interpreter engagement, visual communication strategies and staff familiarity with sign language. Participants identified system\u2010level changes, including on\u2010call interpreter pathways, Deaf awareness training and improved visual and non\u2010auditory communication systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Communication access was uncertain and inconsistently supported for D\/deaf patients. Improving care requires organisational approaches that embed interpreter access, visual communication systems and Deaf\u2010informed training within routine practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for the Profession and\/or Patient Care<\/jats:title>\n                    <jats:p>Communication access should be embedded within routine emergency care through reliable interpreter pathways, visual communication systems and Deaf\u2010informed staff education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>This study identifies communication barriers that can affect safety, understanding and participation for D\/deaf patients in emergency care and highlights the need for organisational approaches to communication access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>Reporting was guided by the Consensus\u2010Based Checklist for Reporting of Survey Studies (CROSS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>D\/deaf people contributed to study design, recruitment, analysis and interpretation. Survey items were refined with Deaf Elders and a D\/deaf advisory team. A Deaf Elder co\u2010author contributed to recruitment and manuscript development, while advisory input informed theme refinement and challenged hearing\u2010centred interpretations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocn.70578","type":"journal-article","created":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T01:11:21Z","timestamp":1790989881000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Communication Access and Emergency Care for D\/deaf People: A Reflexive Thematic Analysis of Patient Experiences"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3611-1189","authenticated-orcid":false,"given":"Sarah","family":"Hazelwood","sequence":"first","affiliation":[{"name":"School of Nursing, University of the Sunshine Coast  Sippy Downs Queensland Australia"},{"name":"The Prince Charles Hospital  Chermside Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9140-6775","authenticated-orcid":false,"given":"Jennifer","family":"Dermer","sequence":"additional","affiliation":[{"name":"School of Nursing, University of the Sunshine Coast  Sippy Downs Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Wood","sequence":"additional","affiliation":[{"name":"Deaf Elder, Cultural Advisor  Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1699-6143","authenticated-orcid":false,"given":"Stephen","family":"Neville","sequence":"additional","affiliation":[{"name":"School of Nursing, University of the Sunshine Coast  Sippy Downs Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,2]]},"reference":[{"key":"e_1_2_13_2_1","volume-title":"Remoteness Areas","author":"Australian Bureau of Statistics [ABS]","year":"2023"},{"key":"e_1_2_13_3_1","volume-title":"Australian Charter of Healthcare Rights","author":"Australian Commission on Safety and Quality in Health Care","year":"2020"},{"key":"e_1_2_13_4_1","volume-title":"National Safety and Quality Health Service Standards (Version 2)","author":"Australian Commission on Safety and Quality in Health Care","year":"2021"},{"key":"e_1_2_13_5_1","volume-title":"Action 6.10 Partnering With Consumers Standard \u2010 Communication That Supports Effective Partnerships","author":"Australian Commission on Safety and Quality in Health Care","year":"2025"},{"key":"e_1_2_13_6_1","unstructured":"Australian Government.1992.\u201cDisability Discrimination Act 1992 [Updated 2024].\u201dAccessed December 31 2025.https:\/\/www.legislation.gov.au\/C2004A04426\/latest\/text."},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/14780887.2020.1769238"},{"issue":"1","key":"e_1_2_13_9_1","first-page":"14","article-title":"Communication Barriers: The Experience of Deaf People in the Emergency Department","volume":"30","author":"Gonz\u00e1lez A.","year":"2021","journal-title":"Index de Enfermer\u00eda"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jen.2025.10.018"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10900\u2010018\u20100511\u20103"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/10497323211046238"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.14573"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/deafed\/env042"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0025817217743416"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1037\/rep0000252"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.4102\/ajod.v10i0.800"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dhjo.2015.05.004"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467\u20109566.12199"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0003535"},{"key":"e_1_2_13_21_1","doi-asserted-by":"crossref","first-page":"145","DOI":"10.4324\/9780429430817-11","volume-title":"Routledge Handbook of Disability Studies","author":"Scully J.","year":"2019"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010021\u201006737\u20101"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/hsc.12504"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.15037"},{"issue":"4","key":"e_1_2_13_25_1","doi-asserted-by":"crossref","first-page":"638","DOI":"10.5750\/ejpch.v6i4.1566","article-title":"Barriers to the Use of Health Services Among Deaf and Hard of Hearing Adults in Greece: A Cross\u2010Sectional Study","volume":"6","author":"Tsimpida D.","year":"2018","journal-title":"European Journal for Person Centered Healthcare"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2015.03.012"}],"container-title":["Journal of Clinical Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocn.70578","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jocn.70578","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocn.70578","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T01:11:23Z","timestamp":1790989883000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocn.70578"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,2]]},"references-count":25,"alternative-id":["10.1111\/jocn.70578"],"URL":"https:\/\/doi.org\/10.1111\/jocn.70578","archive":["Portico"],"relation":{},"ISSN":["0962-1067","1365-2702"],"issn-type":[{"value":"0962-1067","type":"print"},{"value":"1365-2702","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,2]]},"assertion":[{"value":"2026-08-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jocn.70578"}}