Communication Challenges While Dealing with a Deaf and Non-Speaking Patient in the Emergency Departments in Yemen

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Alsubari, Wadhah A. Al-Fakih, Abdulrahman A. Al-Ghabri, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7048271/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Background: This research focuses on improving communication between emergency doctors and deaf and dumb patients in Yemen.Which the effective social communication with all patients in the emergency department is essential for case management. If there are any problems or obstacles in this communication, the patient's safety is at risk. This study aims to raise the culture of the Yemeni doctor and feed the community awareness especially for the deaf and dumb category and improve the level of medical quality and address the problems that occur during communication between them as it helps emergency doctors and deaf and dumb patients to understand each other. Methodology: A cross-sectional and descriptive study analysis was conducted on emergency physicians working in the general emergency department. Data were collected from physicians working in 8 different government centers in 8 governorates around Yemen (Sana'a, Hadramout, Aden, Al Hodeida, Thamar, Ibb, Taiz, Amran). Data analysis was conducted using the SPSS statistical program. Results: The majority of the participants in this study were emergency physicians (38%), while the percentage of resident physicians in the emergency department was 43% and volunteers in the emergency department was 19%. They reported that they met the most deaf and mute cases (90.59%), which makes the subject common and therefore we find that most doctors feel anxious when dealing with these cases because they are not prepared or do not have the capabilities that help them deal with them. A large number of them recommended holding awareness workshops and training courses (47%). Another study confirmed that (83.7%) would help them develop their dealings with these cases, in addition to adopting a book that helps them know the basics of dealing with this segment to provide them with appropriate healthcare. This was praised by 94%. Conclusion: This study has proven the importance of dealing with deaf and dumb cases, and the extent of the spread of these cases with the lack of knowledge and important skills to communicate with the deaf and dumb segment. We also recommend teaching doctors medical sign language, as well as holding awareness and training workshops and adopting a book that contains the basics of medical sign language, which will raise readiness to deal with cases. Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction Background Emergency doctors often struggle to communicate effectively with deaf patients in emergency departments. This lack of communication can lead to safety issues for the patient. Many doctors feel unprepared to deal with deaf patients, and most emergency physicians don't have the necessary training to provide appropriate care for this group. From the first day of medical school, many future doctors are told that most diagnoses are the result of a comprehensive medical history developed through conversation with the patient and primarily through language. The doctor works to establish a close relationship. Therefore, good communication between the doctor and the patient is essential for good health care. The United Nations Sustainable Development Goals emphasize the importance of good health and well-being for everyone, including marginalized groups and people with special needs. This includes ensuring that everyone has access to quality healthcare, regardless of their background or circumstances. Good effective communication is the most important key factor, which plays an important role in providing appropriate medical care according to the patient’s needs, ensuring full understanding and compliance with medical guidelines and tips. The World Health Organization (WHO) estimates that 1.5 billion people worldwide have hearing problems. They predict that this number could rise to 2.5 billion by 2050. Deaf patients are often overlooked in our society despite their need for deep attention to their communication needs. If they cannot communicate with healthcare professionals, they may not be able to access and receive appropriate care. However, medical providers who fail to address patients' language difficulties will highlight unequal access to medical care by deaf patients and the impact of barriers that may occur between physician and patient. Deaf and hard of hearing patients will face health inequalities when they enter the health care system. Patients who are deaf or hard of hearing suffer from increased length of stay in the emergency department due to factors of deafness or hearing loss. Therefore, deaf people find communication a major barrier that must be overcome every time they enter the health care system. Miscommunication or misunderstanding between patients and health care providers can lead to substandard care or long delays. The aim of this study is to study the methods of dealing with deaf and mute cases by emergency doctors and what they rely on in diagnosis and to make them aware of the importance of understanding deaf and mute cases through understanding medical sign language, as well as the most important difficulties they may face Objectives of the study General objective : Raising the culture of the Yemeni doctor and nourishing community awareness, especially for the deaf and dumb category, improving the level of medical quality and addressing the problems that occur during communication between them, as emergency doctors and deaf and dumb patients help in understanding. Special objectives : Enhancing cognitive awareness and exploring communication methods that suit patients while developing strategies to better understand and manage deaf patients. Helping doctors quickly determine the cause of the disease to prevent complications, reducing errors that can arise from communication difficulties. Educating the deaf and mute community about health issues, promoting health education, and improving medical quality by keeping up with medical developments and focusing on providing care to disadvantaged groups. Teaching doctors medical sign language to improve their skills and understanding. And build confidence that increases the ability of doctors to provide appropriate care for deaf patients. The justification Improving the level of health care through the scientific and cognitive awareness of emergency physicians and their ability to understand with the deaf and dumb category and avoid problems and difficulties that may occur. Choosing the governorates that contain a building or a governmental educational hospital, as it is more targeted for deaf and dumb cases. Selecting the governorates in which there is a medical college to activate and facilitate the medical survey. The deaf and dumb category was chosen because they are the most affected and marginalized groups in our society that need different health care and are above health care laws. The target group was emergency doctors, as they are the first to come into contact with patients from this category, as well as the first to help diagnose the condition. Research problem : Language is considered a method of communication to understand cases and take a medical history. The barrier of inability to communicate between this group of deaf and mute people must be avoided. Therefore, to ensure the practice of a good communication method, we tried to propose radical solutions in order to create a transit station between emergency doctors and deaf and mute patients. Literature review locally study -Yemen (Hadramout) The study aimed to improve healthcare for deaf and mute people in a Yemeni governorate. It found that nurses and doctors often lack training and experience in communicating with patients who have communication difficulties. A cross-sectional study was conducted in two government hospitals, involving 120 medical personnel. Most of the participants were recent graduates with little experience dealing with deaf and mute patients. A communication diagram was developed and found to be useful by many medical staff. The study highlights the need for more training and resources to support healthcare providers in effectively caring for patients with communication disabilities. Regional Study Saudi Arabia A study in Saudi Arabia examined the challenges faced by emergency physicians when treating deaf patients. The study found that many hospitals lack policies or procedures for dealing with deaf patients, and most physicians rely on family members or writing to communicate. The majority of physicians had not received training on how to communicate with deaf patients, and many were unaware of existing resources like the Saudi Society for Hearing Impairment Services or communication apps. The study concluded that there is a significant need for more training and resources to help physicians effectively communicate with deaf patients. It recommends that hospitals provide interpreters 24 hours a day and require physicians to receive training on communication with deaf patients. Global study USA : The study examined emergency department use among deaf and hard-of-hearing patients. It found that American Sign Language (ASL) users and English speakers with hearing impairments were more likely to use the emergency department than English speakers without hearing impairments. The study also found that patients who had used the emergency department in the past were more likely to return. Abdominal pain was the most common reason for emergency department visits. Overall, the study suggests that deaf and hard-of-hearing patients, especially those who use ASL, may have higher rates of emergency department use. Methodology Study design A cross sanctional and descriptive study. Study setting The current study was carried at 8 governmental hospitals in 8 of Yemen Governorates (Sana’a. Hadramout. Aden. Al Hodeida. Thamar. Ibb. Taiz. Amran). simple size The current study includes 8 governorates, focusing on emergency physicians in 8 government hospitals, so that the sample is collected from all emergency physicians residing in these hospitals. Sampling technique : The current study relied on non-probability and convenience sampling, which was conducted by medical students who interviewed emergency doctors in the governorate’s hospitals, filled out the electronic questionnaire, and explained the details of the study. Data analysis: Data analysis was performed using SPSS. Percentages were used to display categorical variables. Tables were used to test for association between categorical variables. To determine whether the doctor’s level of experience, the nature of his work, or the patient’s history would affect his ability to diagnose the condition or his readiness when receiving this type of case, as well as his readiness to learn sign language. Ethical consideration : The study protocol was reviewed and approved by the community faculty council of the Department of Medicine, Faculty of Medicine, Sana'a University. Through verbal informed consent as well as written informed consent, with participant data, collection was completed. Data collection : To verify the accuracy of the questionnaire and its ability to reach all emergency doctors in the governorates in Yemen, medical students in advanced stages were initially recruited and introduced to the research project. They were then distributed to government hospitals with medical colleges, which include emergency doctors. They then conducted an interview and explained the questionnaire questions. This was done. Approval of the questionnaire for wide distribution. Through the use of e-mail, an electronic questionnaire was created and then the questionnaire was sent to all concerned medical students for delivery to emergency doctors and follow-up. Make sure to fill out the questionnaire, and the response rate was about 65%. Study questionnaire The questionnaire contains information about his level of experience and knowledge of medical sign language, as well as his experience in the field of emergency, how many cases of this category he has encountered, how he was able to diagnose the case, and what helped him in doing so. Also regarding the possibility of dealing with these cases. In addition, it included the most important difficulties facing emergency doctors and previous communication experiences, as well as the communication method that is used. The questionnaire asked about their advice on methods, courses learned and experience in dealing and communicating with deaf patients. It also included questions about the extent of doctors’ readiness to support the subject in various training and educational activities and courses to raise awareness of the importance of medical sign language. limitations of the study. 1- There is a great need to expand the research, but it is difficult because the rest of the governorates do not contain a government teaching hospital or a medical college. 2- Despite the cooperation of the Deaf Society in Yemen, it did not treat the matter as a serious issue that should be considered. 3- The absence of any previous Yemeni research on the issue of the difficulties by emergency department in communicating with the deaf and dumb patients. 4- The limited number of Yemeni research related to this category of deaf and dumb. 5- The difficulty of obtaining a permit from the Ministry of Health office to facilitate some procedures, including the preparation of the medical sign language book. 6- Difficulty dealing with deaf and dumb people. Results of Study General description of the study simple : Table 1 The number of participants who met deaf and dumb patient (N = 85) Question Category F % Have you ever met a deaf and dumb patients? Yes 77 90.59% No 8 9.41% Total 85 100% Its clear from Table 1 total of (85) participant, 77 (90.59%) who met a deaf and non-speaking patient, only 8 (9.41%) had been not met deaf and non-speaking patient (9.41%), it was done excluding them, so they become the number pf participant (77). Table 2 Sociodemographic data of the participant and their working place (N = 77) Variable Category n % Age in group (25–29) year 44 57% More than 29 33 43% Age Mean ± SD 30.13 ± 3.603 The sex Male 46 60% Female 31 40% Level experience in the emergency department Less than 4 Years 48 62% ( 4 – 7 ) Years 16 21% More than 7 Years 13 17% The Specialization Emergency doctor 29 38% Resident doctor 33 43% Volunteer 15 19% A total of 77 participants were included in the study, Table 2 shows the sociodemographic data and their Level experience in the emergency department, and The Specialization of the participants. 44 (57%), were (25–29) years old, 33 (43%) were more than 29 years old, the mean of age was 30.13 with stander deviations 3.603, 46(60%) were female and 32(40%) male, 48(62%) less than 4 years in Level experience in the emergency department level, 13(17%) from 4 to 7 years, and 16(21%) more than 7 years, 29(38%) were emergency doctor, 33(43%) were resident doctor, and 15(19%) as volunteer doctor. Figure 1 presents the Level experience in the emergency department of the participation, in total, (43%) participants were Resident doctor, 29 (38%) were Emergency doctor, and 15 (19%) were Volunteer. Figure 2 presents the specialization of the participation, in total, (62%) less than 4 years in Level experience in the emergency department level, (17%) from 4 to 7 years, and (21%) more than 7 years Figure 3 presents the hospital of the participation, in total, (45%) from Al- Thawra Hospital in Sanaa city, (18%) from the Al- Thawra Hospital in IBB city, (6%) from syeiun hadhramout city, (5%), from the Al-Wahda Hospital Thammar city, Al-Shaheed Al-Samad Hospital Amran city, (3%) Al-Gamhouria Hospital Aden city (1%) Alsahool Hospital Taiz city A-lthawrah Hospital Al-Hodayda city, 22may Hospital Amran city. Figure 5 presents the governorate of the participation, in total, (45%) from Sanaa city, (25%) from Hadhramaut city, (13%) from IBB city (5%), from Thamar city, Al-Shaheed Al-Samad Hospital Amran city, and (6%) from Amran city, (3%) from Aden city, (1%) from Taiz city, Al-Hodeida city. Table 3 Participant’s awareness, perception, and experience, toward deaf and dumb patients (N = 77) Question Category F % Was hearing and speech loss associated with? Congenital 62 81% Acquired 15 19% How many deaf patients have you encountered during your work? ( 1 – 5 ) cases 47 61% ( 6 – 10 ) cases 17 22% more than 10 cases 13 17% Have you ever learned sign language? No 55 71% Yes 22 29% How well do you know sign language? There is no knowledge 18 23% Weak 26 34% Good 23 30% Very good 10 13% Do deaf and dumb patients came to the hospital alone? Yes 22 29% No, with their family 54 70% Other 1 1% Were you able to diagnose the situation easily? No 14 18% Yes 17 22% To some extent I could 46 60% What helped you the most in diagnosing the situation? The patient's way of explaining 34 44% Medical examinations and results 22 29% Explanation of the facilities or family for his condition 10 13% Other 11 14% The difficulty of dealing with deaf and dumb patients of the category? The Children 48 62% The Adult 21 27% All of them 8 10% How to deal with the deaf patient when taking the medical history? Dependence on the person accompanying the patient 40 52% Attempt to address the patient himself 14 18% Reliance on pathological signs and diagnostic methods 23 30% Most of the patients who are deaf and dumb are arriving at the hospital? stable condition 53 68.8% Emergency and critical cases 24 31.2% Table 3 shows the Participants’ awareness, perception, and experience, toward deaf and dumb patients, 100% met a deaf and dumb patient, 81% perception the hearing and speech loss associated with Congenital, 19% Acquired, Onley 13% very good in sign language, 61% encountered with ( 1 – 5 ) deaf patients during their work, 70% deaf and dumb patients came to the hospital with their family, 1% came with friends, 9% came alone, 60% To some extent able to diagnose the situation easily, 22% they can diagnose easily, 18% they can’t diagnose easily. helped the most in diagnosing the situation 44%The patient's way of explaining, 29% Medical examinations and results, 13% explanation of the facilities or family for his condition, 14% answered all above. 62% difficulty of dealing with deaf and dumb Children patients, 27% The Adult, 10% All of them. Type of dealing with the deaf patient when taking the medical history, 52% Dependence on the person accompanying the patient, 18% Attempt to address the patient himself, 30% Reliance on pathological signs and diagnostic methods. 68.8% of the patients who are deaf and dumb are arriving at the hospital in stable condition 31.2% in an Emergency and critical cases. Table 4 Factors associated with participants’ able to diagnose the situation easily (N = 77) Variable Category able to diagnose the situation easily No Yes To some extent I could p- value Age in group (25–29) year 10 13.0% 9 11.7% 25 32.5% 0.488 More than 29 4 5.2% 8 10.4% 21 27.3% The sex Male 10 13.0% 7 9.1% 29 37.7% 0.179 Female 4 5.2% 10 13.0% 17 22.1% level experience in the emergency department 7 Years 4 5.2% 0 0.0% 9 11.7% The Specialization Emergency doctor 4 5.2% 8 10.4% 17 22.1% 0.765 Resident doctor 6 7.8% 7 9.1% 20 26.0% Volunteer 4 5.2% 2 2.6% 9 11.7% * Significant at level 0.05 Table 4 shows the factors associated with the participants’ able to diagnose the situation easily. Age, sex, level experience in the emergency apartment, and The Specialization were all not significantly associated with the able to diagnose the situation easily. Table 5 suggestions for solutions to this problem (way to deal with deaf and dumb patients (n = 77) Question Category F % What are your suggestions for solutions to this problem? Addition as a curriculum for medical colleges 11 14% Doing training courses 36 47% Making a medical reference that facilitates communication with a deaf person 9 12% Make a pocket booklet that accompanies the doctor 3 4% Providing an interpreter for each hospital 15 19% Other 3 4% Do you think that psychological support should be given to this category over other groups in society? No 2 3% Yes 75 97% Most of the patients who are deaf and dumb are arriving at the hospital? stable condition 53 68.8% Emergency and critical cases 24 31.2% Do you think the approach for the deaf patient book project can contribute to solving this problem? No 5 6% Yes 72 94% Table 5 showed the suggestions for solutions to this problem (way to deal with deaf and dumb patients, 47% suggested Doing training courses, 19% Providing an interpreter for each hospital, 14% Addition as a curriculum for medical colleges, 12% Making a medical reference that facilitates communication with a deaf person, 4% Make a pocket booklet that accompanies the doctor, 4% suggested all above. 97% think that psychological support should be given to this category over other groups in society, 68.8% the deaf and dumb were arriving to the hospital in a stable condition, and 31.2% arriving in a Emergency and critical cases. 94% think that the approach for the deaf patient book project can contribute to solving this problem. Result report : a total of (85) participant, 77 (90.59%) who met a deaf and dumb patient, only 8 (9.41%) had been not met deaf and dumb patient (9.41%), it was done excluding them, so they become the number pf participants (77). (57%), were (25–29) years old, (43%) were more than 29 years old, the mean of age was 30.13 with stander deviations 3.603, (60%) were female and (40%) male, (62%) less than 4 years in Level experience in the emergency department level, (17%) from 4 to 7 years, and (21%) more than 7 years, (38%) were emergency doctor, (43%) were resident doctor, and (19%) as volunteer doctor. (62%) less than 4 years in Level experience in the emergency department level, (17%) from 4 to 7 years, and (21%) more than 7 years (45%) from Al- Thawra Hospital in Sanaa city, (18%) from the Al- Thawra Hospital in IBB city, (6%) from Syeiun Hadhramaut city, (5%), from the Al-Wahda Hospital Thamar city, Al-Shaheed Al-Samad Hospital Amran city, (3%) Al-Gamhouria Hospital Aden city (1%) Alsahool Hospital Taiz city Al-Thawrah Hospital Al-Hodeida city, 22may Hospital Amran city (45%) from Sanaa city, (25%) from Hadhramaut city, (13%) from IBB city (5%), from Thammar city, Al-Shaheed Al-Samad Hospital Amran city, and (6%) from Amran city, (3%) from Aden city (1%) from Taiz city, Al-Hodeida city 81% perception the hearing and speech loss associated with Congenital, 19% Acquired, Onley 13% very good in sign language, 61% encountered with ( 1 – 5 ) deaf patients during their work, 70% deaf and dumb patients came to the hospital with their family, 1% came with friends, 9% came alone, 60% To some extent able to diagnose the situation easily, 22% they can diagnose easily, 18% they can’t diagnose easily. helped the most in diagnosing the situation 44%The patient's way of explaining, 29% Medical examinations and results, 13% explanation of the facilities or family for his condition, 14% answered all above. 62% difficulty of dealing with deaf and dumb Children patients, 27% The Adult, 10% All of them. Type of dealing with the deaf patient when taking the medical history, 52% Dependence on the person accompanying the patient, 18% Attempt to address the patient himself, 30% Reliance on pathological signs and diagnostic methods. 68.8% of the patients who are deaf and dumb are arriving at the hospital in stable condition 31.2% in an Emergency and critical cases. the factors associated with the participants’ able to diagnose the situation easily. Age, sex, level experience in the emergency apartment, and The Specialization were all not significantly associated with the able to diagnose the situation easily the suggestions for solutions to this problem (way to deal with deaf and dumb patients, 47% suggested Doing training courses, 19% Providing an interpreter for each hospital, 14% Addition as a curriculum for medical colleges, 12% Making a medical reference that facilitates communication with a deaf person, 4% Make a pocket booklet that accompanies the doctor, 4% suggested all above. 97% think that psychological support should be given to this category over other groups in society, 68.8% the deaf and dumb were arriving to the hospital in a stable condition, and 31.2% arriving in a Emergency and critical cases. 94% think that the approach for the deaf patient book project can contribute to solving this problem. Discussion The majority of the participants in this study were emergency physicians, with a percentage of about 38%, while resident physicians in the emergency department were 43% and volunteers in the emergency department were 19%. They acknowledged that they had met deaf and mute cases at a rate of (59.90%), which makes the topic common and relevant. According to estimates by the World Health Organization, which confirmed that in 2021, 1.5 billion people around the world suffered from hearing loss and 430 million people needed rehabilitation services to treat this category, and that by 2050 their prevalence rate may rise to 2.5 billion people, or at least 700 million who need rehabilitation. Therefore, more light was shed on this segment of the deaf and mute, as the percentage of resident physicians in the emergency department and those who did not meet this segment was 9.41%. The demographic information related to age, gender and level of experience in this study was not influential or helpful in dealing with emergency physicians with the deaf and mute, although 62% of those had less than 4 years of experience, while their level of experience was ( 4 – 7 ) years. Emergency Department by 21% and more than 7 years by 17%. According to the results, the study also proved that the majority of deaf and dumb people who were interviewed by emergency doctors were diagnosed more according to the patient's way of explaining his condition himself by 44%, as well as medical examinations by 29%, and then the help of the family in that by 13%, as the participants lacked a clear policy in the way of dealing with this segment, as proven by a study conducted in Saudi Arabia and a study in Hadhramaut, which proved that 74.1% of those who do not have a policy in the procedures for dealing with this segment, and praised the need to pay attention to this segment, an American study proved that this segment of people with special needs is more exposed to use in the emergency department. The majority of cases admitted to the emergency department were children (62%), while adults (27%). An American study showed that hearing loss was detected in 45 children and that cases increase in prevalence with age. The consequences of hearing loss have been documented and have a devastating impact on the individual's quality of life and social communication skills. It is often ignored as a global health priority. Most of the cases admitted were relatively stable (68.8%), while 31.2% were in critical condition. Most of the cases suffered from congenital hearing problems (81%), while acquired hearing problems (19%). Physicians play a major role in the health outcomes of their patients, as demonstrated by a study in China. Therefore, effective communication by the emergency department is essential for managing cases. If there are any problems in communication, it may expose the patient to danger. Therefore, we find that most doctors are worried when dealing with these cases because they are not ready or lack the capabilities that help them deal with them. Many of them advised holding awareness workshops and also holding training courses at a rate of 47%. Another study confirmed at a rate of 83.7% that it would help them develop their dealings with these cases, as well as adopting a book that would help them know the basics of dealing with this segment to provide them with appropriate health care. This was praised by 94%. Conclusions This study proved that a high percentage of emergency physicians do not have the knowledge and skills necessary to communicate with deaf patients and that they are the category that receives the most such cases, as they met deaf and dumb cases at about 90.59%. The study confirmed the importance of conducting awareness workshops and training courses (47%) to help them improve communication with deaf patients, as well as educating emergency physicians by adopting a book containing the basics of medical sign language, which was praised by about 94%. As well as the presence of an interpreter in each hospital, which was praised by about 19%. Recommendation : 1- Paying attention to the deaf and dumb segment and reducing the risks they are exposed to while receiving health care. 2- Notifying emergency doctors and the health sector of the importance of knowing medical sign language. 3- Avoiding the difficulties faced by emergency doctors while dealing with deaf and dumb cases by holding awareness workshops in medical sign language. 4- Recommending the concerned authorities to teach emergency doctors and trainees in the emergency department medical sign language due to its importance by attaching a book that explains the basics of dealing with this segment. 5- Attaching medical sign language trainers to each hospital in order to reduce the complications that may occur to deaf and dumb cases when their diagnosis is delayed. 6- Giving this segment of deaf and dumb their right to health care. 7- Raising the awareness of the health community in learning knowledge that helps them develop health care. Declarations Collaborators: Majed M. Alfakeh ,Shaima S. Al-Yousefi ,Shora S.Abdulkream ,Amgad H.Meqdam ,Hamdan H.Al-Dumaini,Ebrahim A.Al-Sharabi, Osama S.ELqudimi ,Maria S. ELqudimi, Khlood S.Bin Sanad,Abdualjabbar M.Al-Qutami, Adeebah A.Bashamkhah,Samera M.Alsharafi, Marwa O. Bin Saad, Khadijah S. Belfaqih,Mahfoodh M. Al-huthaifi ,Bashar M.Alfanos, Mansour A. Bahaj, Galal A.Saeed, Mohammed A.Alsrory, Yazeed M.Alzazai, Mohammed H. Shaabeen, Talal F. Al-magrami, Ziad A. Alkamel, Bashar H. Al-Aromi,Shaima A .Dahan ,Enayat M.Rashid, Eman M. Sultan, Abdullah M. Alsameeai, Sarah A. Alhamdani, Osama A. Alnaggar, Naaim H. Ahmed, Radhwan M.Aldomaini, Mohammed F. Al Kelly, Mohannad Y.Hamzah ,Hafsa Y. Alsaeedi, Ali M. Alansi, Suleiman M. Alsalahi, Mofeed A. Maqrami ,Mazen N. Alwesabi, Anwar A Sayor, Ismail M. Antar, Abeer Y. Alghubary. Funding: This research did not receive any specific funding from public, commercial, or non-profit organizations. It was conducted as an independent academic study by the research team. EthicalConsiderations: This study was approved by the Ethics Committee at Sana'a University Faculty of Medicine. All participants gave verbal consent before taking part, and their privacy was protected by keeping all data anonymous. No personal information was collected, and participation was completely voluntary. The research followed ethical guidelines to ensure fairness and respect for all involved. Author Contribution *A.A. and W.A. conceived the study and designed the methodology. A.A. collected and analyzed the data. M.A. and S.A. contributed to literature review and manuscript drafting. W.A. prepared the figures and tables. All authors (A.A., W.A., A.A., M.A., S.A.) reviewed, edited, and approved the final manuscript. References Communication Challenges While Dealing With Deaf Patient in the Emergency Department andSuggested Solutions. Yahia Y. Akeely , Abdulhamid Q. Alenezi.2022.4.11. Improving communication with deaf and dumb at health care facility to improve health care in Coastal Region of Hadhramout Governorate – Yemen. Yahya Khamis Ahmed Almualm , Abdullah Mubark Kaity and Mona Omer Alkathiri. Health Care Delivery and Deaf People: Practice, Problems,and Recommendations for Change.Lisa M. Harmer.1999. “They’re Not Willing To Accommodate.Deaf patients”: Communication.Experiences of Deaf American Sign.Language Users in the Emergency Department.Tyler G. James1, Kyle A. Coady1, Jeanne-Marie R.2022 Deaf Patients, Doctors, and the Law: Compelling a Conversation About Communication.Michael A. Schwartz .2008. Healthcare access for deaf patients - The legal and ethical perspectives.Audrey Laur. Med Leg J. 2018 Mar. Strategies to Improve Emergency Department Care of the Deaf and Hard of Hearing Patient‏ G Lyons, PA Normandin - Journal of emergency nursing, 2023. Deafness and hearing loss - World Health Organization (WHO). https://www.who.int Audiologists’ Perception of Hearing and Balance Health-care Resources and Services in Saudi Arabia‏Reem Elbeltagy, Dima Almutairi, Abeer Alotaibi, Sarah Almutairi, Rahaf Alburaidi, Sara Alosaimi, Joud Alshehri.‏ Indian Journal of Otology 30 (1), 43-51, 2024‏ Emergency department utilization among deaf and hard-of-hearing patients: A retrospective chart review Tyler G James et al. Disabil Health J. 2022 Jul. Deaf patients' preferred communication in clinical settings: implications for healthcare providers‏ S Hall, M Ballard - Journal of Deaf Studies and Deaf Education, 2024‏ capacity-building intervention for healthcare workers to improve communication skills and awareness of hard of hearing and D/deaf patients: results from a …‏ VS Grazioli, M Graells, Schmutz, O Cantero… - BMC Health Services …, 2024‏ - Springer Transforming Language Access for Deaf Patients in Healthcare‏ R Mathew, WA Dannels - The Journal on Technology …, 2024‏ - scholarworks.calstate.edu Volume 105, Issue 9, September 2022, Pages 2841-2849 Review article Communication methods between physicians and Deaf patients: A scoping review Author links open overlay panelAndrea Xue Jin Yet, Vinuri Hapuhinne, Weilyn Eu, Elizabeth Yie-Chuen Chong, Uma Devi Palanisamy Additional Declarations No competing interests reported. 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Alsubari","email":"","orcid":"","institution":"Sana'a University","correspondingAuthor":false,"prefix":"","firstName":"Asma'a","middleName":"M.","lastName":"Alsubari","suffix":""},{"id":521708819,"identity":"e2971162-8868-4294-8a2b-f6c12679dbd0","order_by":1,"name":"Wadhah A. 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Al-Ghabri","email":"","orcid":"","institution":"Arab Board Of Health Specializations","correspondingAuthor":false,"prefix":"","firstName":"Abdulrahman","middleName":"A.","lastName":"Al-Ghabri","suffix":""},{"id":521708821,"identity":"ba7e9a7b-52c0-4807-ac15-46e3055abdd2","order_by":3,"name":"Mohammed H. Aljalei","email":"","orcid":"","institution":"National center of mental health","correspondingAuthor":false,"prefix":"","firstName":"Mohammed","middleName":"H.","lastName":"Aljalei","suffix":""},{"id":521708822,"identity":"d7215f9f-6153-4931-aabe-8412d82ead8d","order_by":4,"name":"Shaima A. 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1","display":"","copyAsset":false,"role":"figure","size":17992,"visible":true,"origin":"","legend":"\u003cp\u003epercentage of participants who met deaf and Non-Speaking patients\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7048271/v1/8285864161350f68a59ae8cb.png"},{"id":92475596,"identity":"c43cdafd-9c4f-47e5-b2d2-bf2ff2db54df","added_by":"auto","created_at":"2025-09-30 07:17:18","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":17216,"visible":true,"origin":"","legend":"\u003cp\u003edisplays the specialization of the participation\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7048271/v1/ddf4025d8712314c0e2b5011.png"},{"id":92478554,"identity":"732a2019-e833-4750-8d4d-0fd4227ed7a0","added_by":"auto","created_at":"2025-09-30 07:33:18","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":26546,"visible":true,"origin":"","legend":"\u003cp\u003edisplays the level of experience in the emergency department of the participation\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-7048271/v1/7f1584558f49c04dac6aa579.png"},{"id":92477794,"identity":"5d2bf35f-2225-436b-bbfb-d6b130976759","added_by":"auto","created_at":"2025-09-30 07:25:18","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":24026,"visible":true,"origin":"","legend":"\u003cp\u003edisplays the hospital of the participation\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-7048271/v1/36a28edf98fb03343b5bcf19.png"},{"id":92475591,"identity":"d7174dd7-8ed1-42e7-86c7-0ab250bd5613","added_by":"auto","created_at":"2025-09-30 07:17:18","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":40019,"visible":true,"origin":"","legend":"\u003cp\u003edisplays the governorate of the participation\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-7048271/v1/c6f1a14e3f5d624d42c0b4bc.png"},{"id":92480456,"identity":"874b4b96-9161-405f-a29a-fc3c70711340","added_by":"auto","created_at":"2025-09-30 07:41:18","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":979847,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7048271/v1/30511185-f1ec-4bcd-a617-468d6a0d8f75.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Communication Challenges While Dealing with a Deaf and Non-Speaking Patient in the Emergency Departments in Yemen","fulltext":[{"header":"Introduction","content":"\n\u003ch3\u003eBackground\u003c/h3\u003e\n\u003cp\u003eEmergency doctors often struggle to communicate effectively with deaf patients in emergency departments. This lack of communication can lead to safety issues for the patient. Many doctors feel unprepared to deal with deaf patients, and most emergency physicians don't have the necessary training to provide appropriate care for this group.\u003c/p\u003e\u003cp\u003eFrom the first day of medical school, many future doctors are told that most diagnoses are the result of a comprehensive medical history developed through conversation with the patient and primarily through language. The doctor works to establish a close relationship. Therefore, good communication between the doctor and the patient is essential for good health care.\u003c/p\u003e\u003cp\u003eThe United Nations Sustainable Development Goals emphasize the importance of good health and well-being for everyone, including marginalized groups and people with special needs. This includes ensuring that everyone has access to quality healthcare, regardless of their background or circumstances.\u003c/p\u003e\u003cp\u003e Good effective communication is the most important key factor, which plays an important role in providing appropriate medical care according to the patient’s needs, ensuring full understanding and compliance with medical guidelines and tips.\u003c/p\u003e\u003cp\u003eThe World Health Organization (WHO) estimates that 1.5\u0026nbsp;billion people worldwide have hearing problems. They predict that this number could rise to 2.5\u0026nbsp;billion by 2050.\u003c/p\u003e\u003cp\u003eDeaf patients are often overlooked in our society despite their need for deep attention to their communication needs. If they cannot communicate with healthcare professionals, they may not be able to access and receive appropriate care. However, medical providers who fail to address patients' language difficulties will highlight unequal access to medical care by deaf patients and the impact of barriers that may occur between physician and patient.\u003c/p\u003e\u003cp\u003eDeaf and hard of hearing patients will face health inequalities when they enter the health care system. Patients who are deaf or hard of hearing suffer from increased length of stay in the emergency department due to factors of deafness or hearing loss. Therefore, deaf people find communication a major barrier that must be overcome every time they enter the health care system. Miscommunication or misunderstanding between patients and health care providers can lead to substandard care or long delays.\u003c/p\u003e\u003cp\u003eThe aim of this study is to study the methods of dealing with deaf and mute cases by emergency doctors and what they rely on in diagnosis and to make them aware of the importance of understanding deaf and mute cases through understanding medical sign language, as well as the most important difficulties they may face\u003c/p\u003e\n\u003ch3\u003eObjectives of the study\u003c/h3\u003e\n\u003cp\u003e\u003cb\u003eGeneral objective\u003c/b\u003e:\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eRaising the culture of the Yemeni doctor and nourishing community awareness, especially for the deaf and dumb category, improving the level of medical quality and addressing the problems that occur during communication between them, as emergency doctors and deaf and dumb patients help in understanding.\u003c/p\u003e\u003cp\u003e\u003cb\u003eSpecial objectives\u003c/b\u003e:\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003eEnhancing cognitive awareness and exploring communication methods that suit patients while developing strategies to better understand and manage deaf patients.\u003c/span\u003e\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003eHelping doctors quickly determine the cause of the disease to prevent complications, reducing errors that can arise from communication difficulties.\u003c/span\u003e\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003eEducating the deaf and mute community about health issues, promoting health education, and improving medical quality by keeping up with medical developments and focusing on providing care to disadvantaged groups.\u003c/span\u003e\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003eTeaching doctors medical sign language to improve their skills and understanding. And build confidence that increases the ability of doctors to provide appropriate care for deaf patients.\u003c/span\u003e\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eThe justification\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003eImproving the level of health care through the scientific and cognitive awareness of emergency physicians and their ability to understand with the deaf and dumb category and avoid problems and difficulties that may occur.\u003c/span\u003e\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003eChoosing the governorates that contain a building or a governmental educational hospital, as it is more targeted for deaf and dumb cases.\u003c/span\u003e\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003eSelecting the governorates in which there is a medical college to activate and facilitate the medical survey.\u003c/span\u003e\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003eThe deaf and dumb category was chosen because they are the most affected and marginalized groups in our society that need different health care and are above health care laws.\u003c/span\u003e\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003eThe target group was emergency doctors, as they are the first to come into contact with patients from this category, as well as the first to help diagnose the condition.\u003c/span\u003e\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eResearch problem\u003c/b\u003e:\u003c/p\u003e\u003cp\u003eLanguage is considered a method of communication to understand cases and take a medical history. The barrier of inability to communicate between this group of deaf and mute people must be avoided. Therefore, to ensure the practice of a good communication method, we tried to propose radical solutions in order to create a transit station between emergency doctors and deaf and mute patients.\u003c/p\u003e\n\u003ch3\u003eLiterature review\u003c/h3\u003e\n\u003cp\u003e\u003cb\u003elocally study\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e-Yemen (Hadramout)\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe study aimed to improve healthcare for deaf and mute people in a Yemeni governorate. It found that nurses and doctors often lack training and experience in communicating with patients who have communication difficulties. A cross-sectional study was conducted in two government hospitals, involving 120 medical personnel. Most of the participants were recent graduates with little experience dealing with deaf and mute patients. A communication diagram was developed and found to be useful by many medical staff. The study highlights the need for more training and resources to support healthcare providers in effectively caring for patients with communication disabilities.\u003c/p\u003e\u003cp\u003e\u003cb\u003eRegional Study\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eSaudi Arabia\u003c/b\u003e\u003c/p\u003e\u003cp\u003eA study in Saudi Arabia examined the challenges faced by emergency physicians when treating deaf patients. The study found that many hospitals lack policies or procedures for dealing with deaf patients, and most physicians rely on family members or writing to communicate. The majority of physicians had not received training on how to communicate with deaf patients, and many were unaware of existing resources like the Saudi Society for Hearing Impairment Services or communication apps. The study concluded that there is a significant need for more training and resources to help physicians effectively communicate with deaf patients. It recommends that hospitals provide interpreters 24 hours a day and require physicians to receive training on communication with deaf patients.\u003c/p\u003e\u003cp\u003e\u003cb\u003eGlobal study\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eUSA\u003c/b\u003e:\u003c/p\u003e\u003cp\u003eThe study examined emergency department use among deaf and hard-of-hearing patients. It found that American Sign Language (ASL) users and English speakers with hearing impairments were more likely to use the emergency department than English speakers without hearing impairments. The study also found that patients who had used the emergency department in the past were more likely to return. Abdominal pain was the most common reason for emergency department visits. Overall, the study suggests that deaf and hard-of-hearing patients, especially those who use ASL, may have higher rates of emergency department use.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cp\u003e\u003cstrong\u003eStudy design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA cross sanctional and descriptive study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy setting\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe current study was carried at 8 governmental hospitals in 8 of Yemen Governorates (Sana\u0026rsquo;a. Hadramout. Aden. Al Hodeida. Thamar. Ibb. Taiz. Amran).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003esimple size\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe current study includes 8 governorates, focusing on emergency physicians in 8 government hospitals, so that the sample is collected from all emergency physicians residing in these hospitals.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSampling technique\u003c/strong\u003e:\u003c/p\u003e\n\u003cp\u003eThe current study relied on non-probability and convenience sampling, which was conducted by medical students who interviewed emergency doctors in the governorate\u0026rsquo;s hospitals, filled out the electronic questionnaire, and explained the details of the study.\u003c/p\u003e\n\u003ch2\u003eData analysis:\u003c/h2\u003e\n\u003cp\u003eData analysis was performed using SPSS. Percentages were used to display categorical variables. Tables were used to test for association between categorical variables. To determine whether the doctor\u0026rsquo;s level of experience, the nature of his work, or the patient\u0026rsquo;s history would affect his ability to diagnose the condition or his readiness when receiving this type of case, as well as his readiness to learn sign language.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical consideration\u003c/strong\u003e:\u003c/p\u003e\n\u003cp\u003eThe study protocol was reviewed and approved by the community faculty council of the Department of Medicine, Faculty of Medicine, Sana'a University. Through verbal informed consent as well as written informed consent, with participant data, collection was completed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collection\u003c/strong\u003e:\u003c/p\u003e\n\u003cp\u003eTo verify the accuracy of the questionnaire and its ability to reach all emergency doctors in the governorates in Yemen, medical students in advanced stages were initially recruited and introduced to the research project. They were then distributed to government hospitals with medical colleges, which include emergency doctors. They then conducted an interview and explained the questionnaire questions. This was done. Approval of the questionnaire for wide distribution. Through the use of e-mail, an electronic questionnaire was created and then the questionnaire was sent to all concerned medical students for delivery to emergency doctors and follow-up. Make sure to fill out the questionnaire, and the response rate was about 65%.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy questionnaire\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe questionnaire contains information about his level of experience and knowledge of medical sign language, as well as his experience in the field of emergency, how many cases of this category he has encountered, how he was able to diagnose the case, and what helped him in doing so. Also regarding the possibility of dealing with these cases. In addition, it included the most important difficulties facing emergency doctors and previous communication experiences, as well as the communication method that is used. The questionnaire asked about their advice on methods, courses learned and experience in dealing and communicating with deaf patients. It also included questions about the extent of doctors\u0026rsquo; readiness to support the subject in various training and educational activities and courses to raise awareness of the importance of medical sign language.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003elimitations of the study.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e1- There is a great need to expand the research, but it is difficult because the rest of the governorates do not contain a government teaching hospital or a medical college.\u003c/p\u003e\n\u003cp\u003e2- Despite the cooperation of the Deaf Society in Yemen, it did not treat the matter as a serious issue that should be considered.\u003c/p\u003e\n\u003cp\u003e3- The absence of any previous Yemeni research on the issue of the difficulties by emergency department in communicating with the deaf and dumb patients.\u003c/p\u003e\n\u003cp\u003e4- The limited number of Yemeni research related to this category of deaf and dumb.\u003c/p\u003e\n\u003cp\u003e5- The difficulty of obtaining a permit from the Ministry of Health office to facilitate some procedures, including the preparation of the medical sign language book.\u003c/p\u003e\n\u003cp\u003e6- Difficulty dealing with deaf and dumb people.\u003c/p\u003e"},{"header":"Results of Study","content":"\u003cp\u003e\u003cb\u003eGeneral description of the study simple\u003c/b\u003e:\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eThe number of participants who met deaf and dumb patient (N = 85)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eQuestion\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eF\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHave you ever met a deaf and dumb patients?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e90.59%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9.41%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eIts clear from Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e total of (85) participant, 77 (90.59%) who met a deaf and non-speaking patient, only 8 (9.41%) had been not met deaf and non-speaking patient (9.41%), it was done excluding them, so they become the number pf participant (77).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSociodemographic data of the participant and their working place (N = 77)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eAge in group\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e(25–29) year\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e44\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e57%\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eMore than 29\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e33\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e43%\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eAge Mean ± SD 30.13 ± 3.603\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eThe sex\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eMale\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e46\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e60%\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eFemale\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e31\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e40%\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eLevel experience in the emergency department\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eLess than 4 Years\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e48\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e62%\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e(\u003cspan additionalcitationids=\"CR5 CR6\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e–\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e) \u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eYears\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e16\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e21%\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eMore than 7 Years\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e13\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e17%\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eThe Specialization\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eEmergency doctor\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e29\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e38%\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eResident doctor\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e33\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e43%\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eVolunteer\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e15\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003e19%\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eA total of 77 participants were included in the study, Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the sociodemographic data and their Level experience in the emergency department, and The Specialization of the participants.\u003c/p\u003e\u003cp\u003e44 (57%), were (25–29) years old, 33 (43%) were more than 29 years old, the mean of age was 30.13 with stander deviations 3.603, 46(60%) were female and 32(40%) male, 48(62%) less than 4 years in Level experience in the emergency department level, 13(17%) from 4 to 7 years, and 16(21%) more than 7 years, 29(38%) were emergency doctor, 33(43%) were resident doctor, and 15(19%) as volunteer doctor.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents the Level experience in the emergency department of the participation, in total, (43%) participants were Resident doctor, 29 (38%) were Emergency doctor, and 15 (19%) were Volunteer.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e presents the specialization of the participation, in total, (62%) less than 4 years in Level experience in the emergency department level, (17%) from 4 to 7 years, and (21%) more than 7 years\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eFigure \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e presents the hospital of the participation, in total, (45%) from Al- Thawra Hospital in Sanaa city, (18%) from the Al- Thawra Hospital in IBB city, (6%) from syeiun hadhramout city, (5%), from the Al-Wahda Hospital Thammar city, Al-Shaheed Al-Samad Hospital Amran city, (3%) Al-Gamhouria Hospital Aden city (1%) Alsahool Hospital Taiz city A-lthawrah Hospital Al-Hodayda city, 22may Hospital Amran city.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eFigure \u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e presents the governorate of the participation, in total, (45%) from Sanaa city, (25%) from Hadhramaut city, (13%) from IBB city (5%), from Thamar city, Al-Shaheed Al-Samad Hospital Amran city, and (6%) from Amran city, (3%) from Aden city, (1%) from Taiz city, Al-Hodeida city.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eParticipant’s awareness, perception, and experience, toward deaf and dumb patients (N = 77)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eQuestion\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eF\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eWas hearing and speech loss associated with?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCongenital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e81%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAcquired\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eHow many deaf patients have you encountered during your work?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e(\u003cspan additionalcitationids=\"CR2 CR3 CR4\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e–\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) cases\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e61%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e(\u003cspan additionalcitationids=\"CR7 CR8 CR9\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e–\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e) cases\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e22%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003emore than 10 cases\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHave you ever learned sign language?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e71%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e29%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eHow well do you know sign language?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eThere is no knowledge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e23%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWeak\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e34%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGood\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eVery good\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eDo deaf and dumb patients came to the hospital alone?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e29%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo, with their family\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e70%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOther\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eWere you able to diagnose the situation easily?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e22%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTo some extent I could\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e60%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eWhat helped you the most in diagnosing the situation?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eThe patient's way of explaining\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e44%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMedical examinations and results\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e29%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eExplanation of the facilities or family for his condition\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOther\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eThe difficulty of dealing with deaf and dumb patients of the category?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eThe Children\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e62%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eThe Adult\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e27%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAll of them\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eHow to deal with the deaf patient when taking the medical history?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDependence on the person accompanying the patient\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e52%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAttempt to address the patient himself\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eReliance on pathological signs and diagnostic methods\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eMost of the patients who are deaf and dumb are arriving at the hospital?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003estable condition\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e68.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEmergency and critical cases\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e31.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e shows the Participants’ awareness, perception, and experience, toward deaf and dumb patients, 100% met a deaf and dumb patient,\u003c/p\u003e\u003cp\u003e81% perception the hearing and speech loss associated with Congenital, 19% Acquired, Onley 13% very good in sign language, 61% encountered with (\u003cspan additionalcitationids=\"CR2 CR3 CR4\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e–\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) deaf patients during their work, 70% deaf and dumb patients came to the hospital with their family, 1% came with friends, 9% came alone, 60% To some extent able to diagnose the situation easily, 22% they can diagnose easily, 18% they can’t diagnose easily.\u003c/p\u003e\u003cp\u003ehelped the most in diagnosing the situation 44%The patient's way of explaining, 29% Medical examinations and results, 13% explanation of the facilities or family for his condition, 14% answered all above.\u003c/p\u003e\u003cp\u003e62% difficulty of dealing with deaf and dumb Children patients, 27% The Adult, 10% All of them.\u003c/p\u003e\u003cp\u003eType of dealing with the deaf patient when taking the medical history, 52% Dependence on the person accompanying the patient, 18% Attempt to address the patient himself, 30% Reliance on pathological signs and diagnostic methods.\u003c/p\u003e\u003cp\u003e68.8% of the patients who are deaf and dumb are arriving at the hospital in stable condition 31.2% in an Emergency and critical cases.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eFactors associated with participants’ able to diagnose the situation easily (N = 77)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003c/colgroup\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e\u003cp\u003eable to diagnose the situation easily\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eTo some extent I could\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep- value\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAge in group\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e(25–29) year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10 13.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9 11.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e25 32.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.488\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMore than 29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 5.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8 10.4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e21 27.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eThe sex\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10 13.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7 9.1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e29 37.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.179\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 5.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10 13.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e17 22.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003elevel experience in the emergency department\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt; 4 Years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7 9.1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13 16.9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e28 36.4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.178\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e(\u003cspan additionalcitationids=\"CR5 CR6\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e–\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e) Years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3 3.9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4 5.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e9 11.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt; 7 Years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 5.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0 0.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e9 11.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eThe Specialization\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEmergency doctor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 5.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8 10.4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e17 22.1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.765\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eResident doctor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6 7.8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7 9.1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e20 26.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eVolunteer\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 5.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2 2.6%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e9 11.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"6\"\u003e* Significant at level 0.05\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e shows the factors associated with the participants’ able to diagnose the situation easily. Age, sex, level experience in the emergency apartment, and The Specialization were all not significantly associated with the able to diagnose the situation easily.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003esuggestions for solutions to this problem (way to deal with deaf and dumb patients (n = 77)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eQuestion\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eF\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e\u003cp\u003eWhat are your suggestions for solutions to this problem?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAddition as a curriculum for medical colleges\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDoing training courses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e47%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMaking a medical reference that facilitates communication with a deaf person\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMake a pocket booklet that accompanies the doctor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eProviding an interpreter for each hospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOther\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eDo you think that psychological support should be given to this category over other groups in society?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e97%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eMost of the patients who are deaf and dumb are arriving at the hospital?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003estable condition\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e68.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEmergency and critical cases\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e31.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eDo you think the approach for the deaf patient book project can contribute to solving this problem?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e94%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e showed the suggestions for solutions to this problem (way to deal with deaf and dumb patients, 47% suggested Doing training courses, 19% Providing an interpreter for each hospital, 14% Addition as a curriculum for medical colleges, 12% Making a medical reference that facilitates communication with a deaf person, 4% Make a pocket booklet that accompanies the doctor, 4% suggested all above.\u003c/p\u003e\u003cp\u003e97% think that psychological support should be given to this category over other groups in society, 68.8% the deaf and dumb were arriving to the hospital in a stable condition, and 31.2% arriving in a Emergency and critical cases.\u003c/p\u003e\u003cp\u003e94% think that the approach for the deaf patient book project can contribute to solving this problem.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResult report\u003c/b\u003e:\u003c/p\u003e\u003cp\u003ea total of (85) participant, 77 (90.59%) who met a deaf and dumb patient, only 8 (9.41%) had been not met deaf and dumb patient (9.41%), it was done excluding them, so they become the number pf participants (77).\u003c/p\u003e\u003cp\u003e(57%), were (25–29) years old, (43%) were more than 29 years old, the mean of age was 30.13 with stander deviations 3.603, (60%) were female and (40%) male, (62%) less than 4 years in Level experience in the emergency department level, (17%) from 4 to 7 years, and (21%) more than 7 years, (38%) were emergency doctor, (43%) were resident doctor, and (19%) as volunteer doctor.\u003c/p\u003e\u003cp\u003e(62%) less than 4 years in Level experience in the emergency department level, (17%) from 4 to 7 years, and (21%) more than 7 years\u003c/p\u003e\u003cp\u003e(45%) from Al- Thawra Hospital in Sanaa city, (18%) from the Al- Thawra Hospital in IBB city, (6%) from Syeiun Hadhramaut city, (5%), from the Al-Wahda Hospital Thamar city, Al-Shaheed Al-Samad Hospital Amran city, (3%) Al-Gamhouria Hospital Aden city (1%) Alsahool Hospital Taiz city Al-Thawrah Hospital Al-Hodeida city, 22may Hospital Amran city\u003c/p\u003e\u003cp\u003e(45%) from Sanaa city, (25%) from Hadhramaut city, (13%) from IBB city (5%), from Thammar city, Al-Shaheed Al-Samad Hospital Amran city, and (6%) from Amran city, (3%) from Aden city\u003c/p\u003e\u003cp\u003e(1%) from Taiz city, Al-Hodeida city\u003c/p\u003e\u003cp\u003e81% perception the hearing and speech loss associated with Congenital, 19% Acquired, Onley 13% very good in sign language, 61% encountered with (\u003cspan additionalcitationids=\"CR2 CR3 CR4\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e–\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) deaf patients during their work, 70% deaf and dumb patients came to the hospital with their family, 1% came with friends, 9% came alone, 60% To some extent able to diagnose the situation easily, 22% they can diagnose easily, 18% they can’t diagnose easily.\u003c/p\u003e\u003cp\u003ehelped the most in diagnosing the situation 44%The patient's way of explaining, 29% Medical examinations and results, 13% explanation of the facilities or family for his condition, 14% answered all above.\u003c/p\u003e\u003cp\u003e62% difficulty of dealing with deaf and dumb Children patients, 27% The Adult, 10% All of them.\u003c/p\u003e\u003cp\u003eType of dealing with the deaf patient when taking the medical history, 52% Dependence on the person accompanying the patient, 18% Attempt to address the patient himself, 30% Reliance on pathological signs and diagnostic methods.\u003c/p\u003e\u003cp\u003e68.8% of the patients who are deaf and dumb are arriving at the hospital in stable condition 31.2% in an Emergency and critical cases.\u003c/p\u003e\u003cp\u003ethe factors associated with the participants’ able to diagnose the situation easily. Age, sex, level experience in the emergency apartment, and The Specialization were all not significantly associated with the able to diagnose the situation easily\u003c/p\u003e\u003cp\u003ethe suggestions for solutions to this problem (way to deal with deaf and dumb patients, 47% suggested Doing training courses, 19% Providing an interpreter for each hospital, 14% Addition as a curriculum for medical colleges, 12% Making a medical reference that facilitates communication with a deaf person, 4% Make a pocket booklet that accompanies the doctor, 4% suggested all above.\u003c/p\u003e\u003cp\u003e97% think that psychological support should be given to this category over other groups in society, 68.8% the deaf and dumb were arriving to the hospital in a stable condition, and 31.2% arriving in a Emergency and critical cases.\u003c/p\u003e\u003cp\u003e94% think that the approach for the deaf patient book project can contribute to solving this problem.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe majority of the participants in this study were emergency physicians, with a percentage of about 38%, while resident physicians in the emergency department were 43% and volunteers in the emergency department were 19%. They acknowledged that they had met deaf and mute cases at a rate of (59.90%), which makes the topic common and relevant. According to estimates by the World Health Organization, which confirmed that in 2021, 1.5\u0026nbsp;billion people around the world suffered from hearing loss and 430\u0026nbsp;million people needed rehabilitation services to treat this category, and that by 2050 their prevalence rate may rise to 2.5\u0026nbsp;billion people, or at least 700\u0026nbsp;million who need rehabilitation. Therefore, more light was shed on this segment of the deaf and mute, as the percentage of resident physicians in the emergency department and those who did not meet this segment was 9.41%. The demographic information related to age, gender and level of experience in this study was not influential or helpful in dealing with emergency physicians with the deaf and mute, although 62% of those had less than 4 years of experience, while their level of experience was (\u003cspan additionalcitationids=\"CR5 CR6\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e) years. Emergency Department by 21% and more than 7 years by 17%.\u003c/p\u003e\u003cp\u003eAccording to the results, the study also proved that the majority of deaf and dumb people who were interviewed by emergency doctors were diagnosed more according to the patient's way of explaining his condition himself by 44%, as well as medical examinations by 29%, and then the help of the family in that by 13%, as the participants lacked a clear policy in the way of dealing with this segment, as proven by a study conducted in Saudi Arabia and a study in Hadhramaut, which proved that 74.1% of those who do not have a policy in the procedures for dealing with this segment, and praised the need to pay attention to this segment, an American study proved that this segment of people with special needs is more exposed to use in the emergency department. The majority of cases admitted to the emergency department were children (62%), while adults (27%). An American study showed that hearing loss was detected in 45 children and that cases increase in prevalence with age. The consequences of hearing loss have been documented and have a devastating impact on the individual's quality of life and social communication skills. It is often ignored as a global health priority. Most of the cases admitted were relatively stable (68.8%), while 31.2% were in critical condition. Most of the cases suffered from congenital hearing problems (81%), while acquired hearing problems (19%). Physicians play a major role in the health outcomes of their patients, as demonstrated by a study in China. Therefore, effective communication by the emergency department is essential for managing cases. If there are any problems in communication, it may expose the patient to danger. Therefore, we find that most doctors are worried when dealing with these cases because they are not ready or lack the capabilities that help them deal with them. Many of them advised holding awareness workshops and also holding training courses at a rate of 47%. Another study confirmed at a rate of 83.7% that it would help them develop their dealings with these cases, as well as adopting a book that would help them know the basics of dealing with this segment to provide them with appropriate health care. This was praised by 94%.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis study proved that a high percentage of emergency physicians do not have the knowledge and skills necessary to communicate with deaf patients and that they are the category that receives the most such cases, as they met deaf and dumb cases at about 90.59%. The study confirmed the importance of conducting awareness workshops and training courses (47%) to help them improve communication with deaf patients, as well as educating emergency physicians by adopting a book containing the basics of medical sign language, which was praised by about 94%.\u003c/p\u003e\u003cp\u003eAs well as the presence of an interpreter in each hospital, which was praised by about 19%.\u003c/p\u003e\u003cp\u003e\u003cb\u003eRecommendation\u003c/b\u003e:\u003c/p\u003e\u003cp\u003e1- Paying attention to the deaf and dumb segment and reducing the risks they are exposed to while receiving health care.\u003c/p\u003e\u003cp\u003e2- Notifying emergency doctors and the health sector of the importance of knowing medical sign language.\u003c/p\u003e\u003cp\u003e3- Avoiding the difficulties faced by emergency doctors while dealing with deaf and dumb cases by holding awareness workshops in medical sign language.\u003c/p\u003e\u003cp\u003e4- Recommending the concerned authorities to teach emergency doctors and trainees in the emergency department medical sign language due to its importance by attaching a book that explains the basics of dealing with this segment.\u003c/p\u003e\u003cp\u003e5- Attaching medical sign language trainers to each hospital in order to reduce the complications that may occur to deaf and dumb cases when their diagnosis is delayed.\u003c/p\u003e\u003cp\u003e6- Giving this segment of deaf and dumb their right to health care.\u003c/p\u003e\u003cp\u003e7- Raising the awareness of the health community in learning knowledge that helps them develop health care.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003ch2\u003eCollaborators:\u003c/h2\u003e\u003cp\u003eMajed M. Alfakeh ,Shaima S. Al-Yousefi ,Shora S.Abdulkream ,Amgad H.Meqdam ,Hamdan H.Al-Dumaini,Ebrahim A.Al-Sharabi, Osama S.ELqudimi ,Maria S. ELqudimi, Khlood S.Bin Sanad,Abdualjabbar M.Al-Qutami, Adeebah A.Bashamkhah,Samera M.Alsharafi, Marwa O. Bin Saad, Khadijah S. Belfaqih,Mahfoodh M. Al-huthaifi ,Bashar M.Alfanos, Mansour A. Bahaj, Galal A.Saeed, Mohammed A.Alsrory, Yazeed M.Alzazai, Mohammed H. Shaabeen, Talal F. Al-magrami, Ziad A. Alkamel, Bashar H. Al-Aromi,Shaima A .Dahan ,Enayat M.Rashid, Eman M. Sultan, Abdullah M. Alsameeai, Sarah A. Alhamdani, Osama A. Alnaggar, Naaim H. Ahmed, Radhwan M.Aldomaini, Mohammed F. Al Kelly, Mohannad Y.Hamzah ,Hafsa Y. Alsaeedi, Ali M. Alansi, Suleiman M. Alsalahi, Mofeed A. Maqrami ,Mazen N. Alwesabi, Anwar A Sayor, Ismail M. Antar, Abeer Y. Alghubary.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding:\u003c/h2\u003e\u003cp\u003eThis research did not receive any specific funding from public, commercial, or non-profit organizations. It was conducted as an independent academic study by the research team.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eEthicalConsiderations:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;This study was approved by the Ethics Committee at Sana'a University Faculty of Medicine. All participants gave verbal consent before taking part, and their privacy was protected by keeping all data anonymous. No personal information was collected, and participation was completely voluntary. The research followed ethical guidelines to ensure fairness and respect for all involved.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003e*A.A. and W.A. conceived the study and designed the methodology. A.A. collected and analyzed the data. M.A. and S.A. contributed to literature review and manuscript drafting. W.A. prepared the figures and tables. All authors (A.A., W.A., A.A., M.A., S.A.) reviewed, edited, and approved the final manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eCommunication Challenges While Dealing With Deaf Patient in the Emergency Department andSuggested Solutions. Yahia Y. Akeely , Abdulhamid Q. Alenezi.2022.4.11.\u003c/li\u003e\n\u003cli\u003eImproving communication with deaf and dumb at health care facility to improve health care in Coastal Region of Hadhramout Governorate \u0026ndash; Yemen. Yahya Khamis Ahmed Almualm , Abdullah Mubark Kaity and Mona Omer Alkathiri.\u003c/li\u003e\n\u003cli\u003eHealth Care Delivery and Deaf People: Practice, Problems,and Recommendations for Change.Lisa M. Harmer.1999.\u003c/li\u003e\n\u003cli\u003e\u0026ldquo;They\u0026rsquo;re Not Willing To Accommodate.Deaf patients\u0026rdquo;: Communication.Experiences of Deaf American Sign.Language Users in the Emergency Department.Tyler G. James1, Kyle A. Coady1, Jeanne-Marie R.2022\u003c/li\u003e\n\u003cli\u003eDeaf Patients, Doctors, and the Law: Compelling a Conversation About Communication.Michael A. Schwartz .2008.\u003c/li\u003e\n\u003cli\u003eHealthcare access for deaf patients - The legal and ethical perspectives.Audrey Laur. Med Leg J. 2018 Mar.\u003c/li\u003e\n\u003cli\u003eStrategies to Improve Emergency Department Care of the Deaf and Hard of Hearing Patient\u0026rlm; G Lyons, PA Normandin - Journal of emergency nursing, 2023.\u003c/li\u003e\n\u003cli\u003eDeafness and hearing loss - World Health Organization (WHO). https://www.who.int\u003c/li\u003e\n\u003cli\u003eAudiologists\u0026rsquo; Perception of Hearing and Balance Health-care Resources and Services in Saudi Arabia\u0026rlm;Reem Elbeltagy, Dima Almutairi, Abeer Alotaibi, Sarah Almutairi, Rahaf Alburaidi, Sara Alosaimi, Joud Alshehri.\u0026rlm; Indian Journal of Otology 30 (1), 43-51, 2024\u0026rlm;\u003c/li\u003e\n\u003cli\u003eEmergency department utilization among deaf and hard-of-hearing patients: A retrospective chart review Tyler G James et al. Disabil Health J. 2022 Jul.\u003c/li\u003e\n\u003cli\u003eDeaf patients' preferred communication in clinical settings: implications for healthcare providers\u0026rlm; S Hall, M Ballard - Journal of Deaf Studies and Deaf Education, 2024\u0026rlm;\u003c/li\u003e\n\u003cli\u003ecapacity-building intervention for healthcare workers to improve communication skills and awareness of hard of hearing and D/deaf patients: results from a \u0026hellip;\u0026rlm; VS Grazioli, M Graells,\u0026nbsp; \u0026nbsp;Schmutz, O Cantero\u0026hellip; - BMC Health Services \u0026hellip;, 2024\u0026rlm; - Springer\u003c/li\u003e\n\u003cli\u003eTransforming Language Access for Deaf Patients in Healthcare\u0026rlm; R Mathew, WA Dannels - The Journal on Technology \u0026hellip;, 2024\u0026rlm; - scholarworks.calstate.edu\u003c/li\u003e\n\u003cli\u003eVolume 105, Issue 9, September 2022, Pages 2841-2849 Review article Communication methods between physicians and Deaf patients: A scoping review Author links open overlay panelAndrea Xue Jin Yet, Vinuri Hapuhinne, Weilyn Eu, Elizabeth Yie-Chuen Chong, Uma Devi Palanisamy\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-emergency-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"emmd","sideBox":"Learn more about [BMC Emergency Medicine](http://bmcemergmed.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/emmd","title":"BMC Emergency Medicine","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-7048271/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7048271/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground:\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis research focuses on improving communication between emergency doctors and deaf and dumb patients in Yemen.Which the effective social communication with all patients in the emergency department is essential for case management. If there are any problems or obstacles in this communication, the patient's safety is at risk. This study aims to raise the culture of the Yemeni doctor and feed the community awareness especially for the deaf and dumb category and improve the level of medical quality and address the problems that occur during communication between them as it helps emergency doctors and deaf and dumb patients to understand each other.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethodology:\u003c/b\u003e\u003c/p\u003e\u003cp\u003eA cross-sectional and descriptive study analysis was conducted on emergency physicians working in the general emergency department. Data were collected from physicians working in 8 different government centers in 8 governorates around Yemen (Sana'a, Hadramout, Aden, Al Hodeida, Thamar, Ibb, Taiz, Amran). Data analysis was conducted using the SPSS statistical program.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults:\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe majority of the participants in this study were emergency physicians (38%), while the percentage of resident physicians in the emergency department was 43% and volunteers in the emergency department was 19%. They reported that they met the most deaf and mute cases (90.59%), which makes the subject common and therefore we find that most doctors feel anxious when dealing with these cases because they are not prepared or do not have the capabilities that help them deal with them. A large number of them recommended holding awareness workshops and training courses (47%). Another study confirmed that (83.7%) would help them develop their dealings with these cases, in addition to adopting a book that helps them know the basics of dealing with this segment to provide them with appropriate healthcare. This was praised by 94%.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion:\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis study has proven the importance of dealing with deaf and dumb cases, and the extent of the spread of these cases with the lack of knowledge and important skills to communicate with the deaf and dumb segment. We also recommend teaching doctors medical sign language, as well as holding awareness and training workshops and adopting a book that contains the basics of medical sign language, which will raise readiness to deal with cases.\u003c/p\u003e","manuscriptTitle":"Communication Challenges While Dealing with a Deaf and Non-Speaking Patient in the Emergency Departments in Yemen","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-30 07:17:13","doi":"10.21203/rs.3.rs-7048271/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-22T13:46:22+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"199590311355061235485273188960972911021","date":"2026-05-22T13:16:02+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-11T10:55:38+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"146528896824373595818035335895951580868","date":"2025-09-20T09:43:29+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-18T08:48:08+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-08-22T07:36:35+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-07-08T07:13:35+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-08T07:12:29+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Emergency Medicine","date":"2025-07-04T15:48:28+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-emergency-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"emmd","sideBox":"Learn more about [BMC Emergency Medicine](http://bmcemergmed.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/emmd","title":"BMC Emergency Medicine","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"1af49a2b-6f26-48bc-bd47-de2656621fb7","owner":[],"postedDate":"September 30th, 2025","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-22T13:46:22+00:00","index":89,"fulltext":""},{"type":"reviewerAgreed","content":"199590311355061235485273188960972911021","date":"2026-05-22T13:16:02+00:00","index":88,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-09-30T07:17:13+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-30 07:17:13","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7048271","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7048271","identity":"rs-7048271","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}