Comprehensibility of written and verbal nutrition recommendations for individuals with hearing impairment in Germany

Peer reviewed / Manuscript (original) submitted: 23 May 2024; revision accepted: 6 September 2024

Introduction

From a medical perspective, hearing impairment is a physical condition that encompasses various forms of hearing loss, ranging from partial hearing reduction to complete deafness [1]. Currently, 302.510 individuals in Germany are affected by hearing impairment (deaf: 50,160; hard of hearing: 252,350)[2]. Hearing impairments result in significant communication challenges, as the perception and understanding of information, such as a nutrition recommendation by the recipient, is crucial for effective communication [3], not merely the sender's intention to communicate [4]. For individuals with hearing impairments, the perception of messages itself poses a challenge. While spoken language communication remains possible through the auditory channel for individuals with hearing loss, depending on their degree of impairment, deafness necessitates visual forms of communication, such as German Sign Language (Deutsche Gebärdensprache, DGS), since speech sounds cannot be adequately perceived [5]. This reliance on DGS also affects the acquisition of written language, as DGS is not a signed version of German spoken or written language but a distinct language in its own right [6–8].

The preferred modes of communication among hearing-impaired individuals also vary depending on their socio-cultural identification with the sign language community. Deaf individuals predominantly use DGS, while those who are hard of hearing or have lost their hearing later in life often use sign-supported spoken German or rely solely on spoken German [5].1 Consequently, for these groups, perceiving written messages – and thus understanding them – often involves barriers similar to those encountered with spoken messages [8, 9]. ...

Abstract

Hearing disability encompasses all levels of hearing loss, from mild impairment to deafness. Verbal communication can pose challenges for those affected, particularly in cases of deafness. Written communication may also create barriers, as it often serves as a prerequisite for engaging with predominantly written health and nutrition education materials. This article explores the issues surrounding the comprehensibility of nutrition recommendations and consultation for individuals with hearing impairments in Germany and offers suggestions for improving their presentation and communication. A survey conducted with hard of hearing and deaf individuals (n = 218) revealed that the comprehensibility of these recommendations is closely linked to health literacy and proficiency in German spoken and written language. To enhance communication, respondents expressed a preference for visualisations to reduce barriers to accessing health and nutrition information.

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