Accessibility and communication in health: experiences of deaf people in Recife-PE, Brazil

Abstract

Despite the principle of universality in the Unified Health System (SUS), access to healthcare for the deaf population is limited due to a lack of professionals fluent in Brazilian Sign Language (LIBRAS). This qualitative study, conducted in the metropolitan region of Recife-PE, Brazil, included interviews carried out using a semi-structured questionnaire addressing participants' previous healthcare experiences. The sample consisted of eight deaf individuals, aged 18 to 70 years, who had been treated within the SUS public network and were proficient in LIBRAS. The data were analyzed using Bardin's content analysis, resulting in three thematic categories (professional care, the need for a third party, and facilitators), seven subcategories, and 16 sense nuclei. The results demonstrated that deaf individuals face numerous barriers to receiving humanized healthcare. In the professional care category, communicative barriers stood out, including the use of incomprehensible technical terms and a near-total lack of LIBRAS knowledge among professionals, alongside a lack of trust stemming from attitudes of apathy and fear of medication errors. The need for a third party (family member or interpreter) to mediate communication revealed issues of dependency, privacy violations, and financial and logistical availability constraints. Conversely, facilitators were identified in the use of technology (such as ICOM and mobile phones) and adaptations with visual resources, which significantly improved understanding and the care experience. In conclusion, the lack of LIBRAS proficiency among health professionals and the reliance on indirect communication compromise the equity and integrality of SUS, leading to inadequate care for this population. The findings imply the urgent need for training health professionals in LIBRAS, strengthening the presence of interpreters in health units, and implementing institutional policies that promote assistive technologies and visual adaptations.