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Grazioli VS, Graells M, Schmutz E, Cantero O, Sebaï T, Favre V, Richème-Roos J, Morisod K, Jeanneret M, Singy P, Bodenmann P. Developing a capacity-building intervention for healthcare workers to improve communication skills and awareness of hard of hearing and D/deaf patients: results from a participatory action research study. BMC Health Serv Res 2024; 24:301. [PMID: 38448935 PMCID: PMC10918938 DOI: 10.1186/s12913-024-10574-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 01/07/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Healthcare workers (HCWs) are commonly not prepared to properly communicate with D/deaf and hard of hearing (HoH) patients. The resulting communication challenges reinforce the existing barriers to accessing and benefiting from quality of care in these populations. In response, this study aimed to develop and evaluate a capacity-building intervention for HCWs to raise their awareness of D/deaf and HoH individuals' experiences in healthcare and improve their capacity to communicate with these populations. METHODS This study featured a participatory action research design using qualitative and quantitative methods. The intervention was developed and tested through 4 iterative phases. Reactions (i.e., satisfaction and perception of the intervention content, quality, appropriateness and usefulness) were assessed quantitatively and qualitatively after the intervention, whereas perceived knowledge and self-efficacy in communicating with D/deaf and HoH patients and organizational payoffs (use frequency of basic rules and tools improving communication) were quantitatively assessed before, after and 6-month post-intervention. RESULTS Main qualitative and quantitative findings showed that the final version of the intervention reached high levels of satisfaction among participants. Next, perceived knowledge and self-efficacy scores obtained after receiving the intervention and 6 months later were significantly higher than those yielded in the initial assessment, although both scores significantly decreased at 6 months (compared to the scores obtained just after the intervention). Finally, findings showed no significant changes in organizational payoffs after receiving the intervention. Echoing these results, main qualitative findings documented that after receiving the intervention, participants felt more confident yet not more equipped to communicate with D/deaf and HoH patients. CONCLUSIONS Findings suggest that the capacity-building intervention is a promising means to sustainably increase HCWs' perceived knowledge and self-efficacy on how communicating with D/deaf and HoH patients, although complementary approaches and follow-up intervention reminders may be necessary to enable practice changes in the working environment.
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Affiliation(s)
- Véronique S Grazioli
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Lausanne, Switzerland.
| | - Madison Graells
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Lausanne, Switzerland
| | - Elodie Schmutz
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Lausanne, Switzerland
| | - Odile Cantero
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Lausanne, Switzerland
| | - Tanya Sebaï
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Lausanne, Switzerland
| | - Vanessa Favre
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Lausanne, Switzerland
| | - Jessica Richème-Roos
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Lausanne, Switzerland
| | - Kevin Morisod
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Lausanne, Switzerland
| | - Michel Jeanneret
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Lausanne, Switzerland
| | - Pascal Singy
- Psychiatric Liaison Service, Lausanne University Hospital, Les Allières, Lausanne, 1011, Switzerland
| | - Patrick Bodenmann
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Lausanne, Switzerland
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Weerapol N, Leelakanok N. Communication between healthcare professionals and patients with hearing loss: A systematic review and meta-analysis. Am J Health Syst Pharm 2024:zxae045. [PMID: 38430534 DOI: 10.1093/ajhp/zxae045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Indexed: 03/04/2024] Open
Abstract
DISCLAIMER In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE We aimed to systematically review and meta-analyze published evidence on modes of communication between healthcare professionals and patients with hearing loss. METHODS MEDLINE/PubMed, Scopus, CINAHL, ScienceDirect, and Thai Journals Online Complete databases were searched. A meta-analysis was performed using a random-effects model. Data on the prevalence and types of communication between healthcare professionals and patients with any extent of hearing loss were extracted. RESULTS Twenty studies were included. Using a hearing aid (pooled prevalence, 57.4%; 95% CI, 11.4%-103.4%, N = 3, I2 = 99.33) and gestures (pooled prevalence = 54.8%, 95%CI: 17.4% to 92.1%, N = 7, I2 = 99.68) were the most commonly reported modes of communication. Few healthcare professionals could use sign language, and limited access to qualified interpreters was common. CONCLUSION Communication barriers exist. Qualified sign language interpreters and assistive technology should be used to improve communication.
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Affiliation(s)
- Neeranun Weerapol
- Department of Pharmacy, Sawaengha Hospital, Ang Thong Thailand, and Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, Chonburi, Thailand
| | - Nattawut Leelakanok
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, Chonburi, Thailand
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Natto ZS. Promoting Arabic Sign Language Skills Among Dental Students. J Multidiscip Healthc 2024; 17:171-176. [PMID: 38222476 PMCID: PMC10788059 DOI: 10.2147/jmdh.s420388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 10/31/2023] [Indexed: 01/16/2024] Open
Abstract
Purpose While the services available to deaf people in the Middle East have yet to be documented, they need improvement in several countries. The aim of this article was to reduce miscommunication between dentists and deaf patients through the introduction of an optional sign language course for pre-doctoral students and faculty of dentistry at King Abdulaziz University (KAUFD). Patients and Methods All fourth-year pre-doctoral students were invited to participate in an Arabic sign language course. A survey with 11 multiple choice and 38 true/false questions with an "I don't know" option was distributed, both before and two weeks after the course. This survey was extensively validated and pilot-tested before distribution. Results The response rate was 141 students (84.9%), 49 of which were males (34.8%) and 92 of which were females (65.2%). The pre-doctoral students had a higher overall knowledge score (mean 22.9±14.8) and sign language skills (11.1±1.7) after the course compared to before the course (9.8±7.1, and 3.7±3.3, respectively) (all P-value <0.001). All the pre-course individual questions had lower scores compared to the post-course questions (P-value <0.05). Conclusion Deaf people might face difficulties communicating at dental health care clinics, which may be improved by equipping dentistry providers with cultural competency training, like this course.
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Affiliation(s)
- Zuhair S Natto
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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James TG, Argenyi MS, Guardino DL, McKee MM, Wilson JAB, Sullivan MK, Griest Schwartzman E, Anderson ML. Communication Access In Mental Health And Substance Use Treatment Facilities For Deaf American Sign Language Users. Health Aff (Millwood) 2022; 41:1413-1422. [DOI: 10.1377/hlthaff.2022.00408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Tyler G. James
- Tyler G. James , University of Michigan, Ann Arbor, Michigan
| | - Michael S. Argenyi
- Michael S. Argenyi, Wake Forest University, Winston-Salem, North Carolina
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Wilkins AM, Morere DA, Pick LH, Day LA, Anderson ML. Characteristics of Psychologists Assessing Deaf and Hard of Hearing Clients. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2022; 27:115-124. [PMID: 34952541 DOI: 10.1093/deafed/enab039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/25/2021] [Accepted: 10/28/2021] [Indexed: 06/14/2023]
Abstract
Psychological assessment plays a large part in the practice of psychology. Over the years, steps have been taken towards ensuring ethical and culturally sensitive psychological assessment for underserved populations, but little is known about the current state of the field of assessment of deaf and hard-of-hearing (DHH) individuals. An exploratory survey of school and clinical psychologists who work with DHH clients (n = 30) was conducted to obtain a snapshot of the state of the field. The current article focuses on sociodemographic characteristics, clinical training, clinical experiences, and language abilities of clinical psychologists who work with DHH clients. Participants averaged 15 years of assessment experience and almost all participants had some type of specialized training in assessing DHH clients. More than half of participants reported their ability to use multiple languages and communication approaches as either excellent or good. Current findings were compared with a similar survey from nearly 50 years ago (Levine, E. S. (1974). Psychological tests and practices with the deaf: A survey of the state of the art. Volta Review, 76, 298-319), and significant differences were found in participants' self-reported experience with DHH clients, training, and methods of communication.
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Affiliation(s)
- Alexander M Wilkins
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Donna A Morere
- Department of Psychology, Gallaudet University, Washington, DC, USA
| | - Lawrence H Pick
- Department of Psychology, Gallaudet University, Washington, DC, USA
| | - Lori A Day
- Department of Psychology, Gallaudet University, Washington, DC, USA
| | - Melissa L Anderson
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
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Borghouts J, Neary M, Palomares K, De Leon C, Schueller SM, Schneider M, Stadnick N, Mukamel DB, Sorkin DH, Brown D, McCleerey-Hooper S, Moriarty G, Eikey EV. Understanding the Potential of Mental Health Apps to Address Mental Health Needs of the Deaf and Hard of Hearing Community: A Mixed Methods Study (Preprint). JMIR Hum Factors 2021; 9:e35641. [PMID: 35404259 PMCID: PMC9039808 DOI: 10.2196/35641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 02/14/2022] [Accepted: 02/21/2022] [Indexed: 02/06/2023] Open
Affiliation(s)
- Judith Borghouts
- Department of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Martha Neary
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Kristina Palomares
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Cinthia De Leon
- Department of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Stephen M Schueller
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
- Department of Informatics, University of California, Irvine, Irvine, CA, United States
| | - Margaret Schneider
- Department of Public Health, University of California, Irvine, Irvine, CA, United States
| | - Nicole Stadnick
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
- Dissemination and Implementation Science Center, Altman Clinical and Translational Research Institute, University of California, San Diego, La Jolla, CA, United States
- Child and Adolescent Services Research Center, San Diego, CA, United States
| | - Dana B Mukamel
- Department of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Dara H Sorkin
- Department of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Dakota Brown
- Riverside University Health System-Behavioral Health, Riverside, CA, United States
| | | | - Gloria Moriarty
- Center on Deafness Inland Empire, Riverside, CA, United States
| | - Elizabeth V Eikey
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
- The Design Lab, University of California, San Diego, La Jolla, CA, United States
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James TG, Varnes JR, Sullivan MK, Cheong J, Pearson TA, Yurasek AM, Miller MD, McKee MM. Conceptual Model of Emergency Department Utilization among Deaf and Hard-of-Hearing Patients: A Critical Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412901. [PMID: 34948509 PMCID: PMC8701061 DOI: 10.3390/ijerph182412901] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/26/2021] [Accepted: 11/28/2021] [Indexed: 11/16/2022]
Abstract
Deaf and hard-of-hearing (DHH) populations are understudied in health services research and underserved in healthcare systems. Existing data indicate that adult DHH patients are more likely to use the emergency department (ED) for less emergent conditions than non-DHH patients. However, the lack of research focused on this population’s ED utilization impedes the development of health promotion and quality improvement interventions to improve patient health and quality outcomes. The purpose of this study was to develop a conceptual model describing patient and non-patient (e.g., community, health system, provider) factors influencing ED utilization and ED care processes among DHH people. We conducted a critical review and used Andersen’s Behavioral Model of Health Services Use and the PRECEDE-PROCEED Model to classify factors based on their theoretical and/or empirically described role. The resulting Conceptual Model of Emergency Department Utilization Among Deaf and Hard-of-Hearing Patients provides predisposing, enabling, and reinforcing factors influencing DHH patient ED care seeking and ED care processes. The model highlights the abundance of DHH patient and non-DHH patient enabling factors. This model may be used in quality improvement interventions, health services research, or in organizational planning and policymaking to improve health outcomes for DHH patients.
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Affiliation(s)
- Tyler G. James
- Department of Family Medicine, School of Medicine, University of Michigan, 1018 Fuller St., Ann Arbor, MI 48104, USA;
- Department of Health Education and Behavior, University of Florida, Florida Gym Room 5, P.O. Box 118210, Gainesville, FL 32611, USA; (J.C.); (A.M.Y.)
- Correspondence:
| | - Julia R. Varnes
- Department of Health Services Research, Management, and Policy, University of Florida, P.O. Box 100185, Gainesville, FL 32610, USA;
| | | | - JeeWon Cheong
- Department of Health Education and Behavior, University of Florida, Florida Gym Room 5, P.O. Box 118210, Gainesville, FL 32611, USA; (J.C.); (A.M.Y.)
| | - Thomas A. Pearson
- Department of Epidemiology, University of Florida, P.O. Box 100231, Gainesville, FL 32610, USA;
| | - Ali M. Yurasek
- Department of Health Education and Behavior, University of Florida, Florida Gym Room 5, P.O. Box 118210, Gainesville, FL 32611, USA; (J.C.); (A.M.Y.)
| | - M. David Miller
- School of Human Development and Organizational Studies in Education, University of Florida, P.O. Box 117047, Gainesville, FL 32611, USA;
| | - Michael M. McKee
- Department of Family Medicine, School of Medicine, University of Michigan, 1018 Fuller St., Ann Arbor, MI 48104, USA;
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Association of self-reported hearing loss severity and healthcare utilization outcomes among Medicare beneficiaries. Am J Otolaryngol 2021; 42:102943. [PMID: 33550025 DOI: 10.1016/j.amjoto.2021.102943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 01/25/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE Understanding health utilization trends in the elderly population is pivotal for Medicare and policymakers. This study evaluates the association between hearing status and health utilization outcomes in a representative sample of elderly Medicare beneficiaries. MATERIALS AND METHODS We employed the 2017 Medicare Current Beneficiary Survey (MCBS), which includes self-reported hearing loss data and weighted health utilization information. Analyses were limited to Medicare beneficiaries aged 65 and older without hearing aids. Multivariable logistic regression was performed to assess association between self-reported hearing loss and health utilization outcomes. RESULTS Of 7160 respondents, 55.1%, 39.9% and 4.9% reported no trouble hearing, little trouble hearing, and a lot of trouble hearing, respectively. On multivariable logistic regression, both a little and a lot of trouble hearing were associated with trouble accessing care (little trouble hearing: odds ratio [OR] = 1.79, 95% confidence interval [CI]: 1.33-2.40, p < 0.001; lot of trouble hearing: OR = 2.89, 95% CI: 1.81-4.60, p < 0.001) and emergency room (ER) visits (little trouble hearing: OR = 1.24, 95% CI: 1.08-1.42, p = 0.002; lot of trouble hearing: OR = 1.44, 95% CI: 1.10-1.89, p = 0.01). A lot of trouble hearing was associated with avoiding doctor visits (OR = 1.63 95% CI: 1.21-2.21, p = 0.002). Self-reported hearing status was not associated with inpatient or skilled nursing facility (SNF) admission on adjusted analyses. CONCLUSIONS Increasing reported hearing loss severity is associated with decreased access to and avoidance of routine medical visits, and increased utilization of ER visits. These findings have important implications for Medicare, clinicians and policymakers. Further studies should evaluate if hearing aids can mitigate these outcomes.
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James TG, McKee MM, Sullivan MK, Ashton G, Hardy SJ, Santiago Y, Phillips DG, Cheong J. Community-Engaged Needs Assessment of Deaf American Sign Language Users in Florida, 2018. Public Health Rep 2021; 137:730-738. [PMID: 34161191 DOI: 10.1177/00333549211026782] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES Deaf American Sign Language (ASL) users comprise a linguistic and cultural minority group that is understudied and underserved in health education and health care research. We examined differences in health risk behaviors, concerns, and access to health care among Deaf ASL users and hearing English speakers living in Florida. METHODS We applied community-engaged research methods to develop and administer the first linguistically accessible and contextually tailored community health needs assessment to Deaf ASL users living in Florida. Deaf ASL users (n = 92) were recruited during a 3-month period in summer 2018 and compared with a subset of data on hearing English speakers from the 2018 Florida Behavioral Risk Factor Surveillance System (n = 12 589). We explored prevalence and adjusted odds of health behavior, including substance use and health care use. RESULTS Mental health was the top health concern among Deaf participants; 15.5% of participants screened as likely having a depressive disorder. Deaf people were 1.8 times more likely than hearing people to engage in binge drinking during the past month. In addition, 37.2% of participants reported being denied an interpreter in a medical facility in the past 12 months. CONCLUSION This study highlights the need to work with Deaf ASL users to develop context-specific health education and health promotion activities tailored to their linguistic and cultural needs and ensure that they receive accessible health care and health education.
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Affiliation(s)
- Tyler G James
- 3463 Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA
| | - Michael M McKee
- 21614 Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Meagan K Sullivan
- 12234 Florida Disability and Health Program, Department of Health Services Research, Management, and Policy, University of Florida, Gainesville, FL, USA
| | - Glenna Ashton
- Deaf Community Advisory Workgroup, Gainesville, FL, USA
| | - Stephen J Hardy
- Deaf Community Advisory Workgroup, Gainesville, FL, USA.,Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, FL, USA
| | - Yary Santiago
- Deaf Community Advisory Workgroup, Gainesville, FL, USA.,Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, FL, USA
| | | | - JeeWon Cheong
- 3463 Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA
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Greene SJ, Scott JA. Promoting cultural awareness, professionalism, and communication skills in medicine through anatomy: The Deaf culture session. Clin Anat 2021; 34:899-909. [PMID: 33984159 DOI: 10.1002/ca.23752] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 04/28/2021] [Accepted: 05/03/2021] [Indexed: 11/07/2022]
Abstract
The anatomy curriculum is a place where professionalism can be learned and practiced, including training in cultural competence and communication skills for working with diverse populations. One population that has received little attention in terms of medical education are d/Deaf and hard of hearing (d/DHH) patients, although there is much evidence to support health care disparities in this population. Several major contributing factors include differing views of deafness between medical professionals and those who are culturally Deaf, a lack of understanding of Deaf culture and American Sign Language (ASL) by medical professionals, a lack of educational resources in ASL, and poor experiences in health care. To address this need, a Deaf Culture Applied Anatomy session was incorporated into the first-year curriculum at Morehouse School of Medicine while medical students were studying anatomy of the ear and hearing. Panelists, who were culturally Deaf, hard of hearing, and hearing children of deaf adults, shared their experiences in healthcare, including challenges they faced with communication and care. Surveys were provided to students before and after the panel session. Surveys indicated a lack of knowledge prior to this session, while also demonstrating that this 90-min session improved students' understanding of effective communication with future patients and issues related to deafness. Qualitative feedback also suggested that the students found the session to be personally and professionally beneficial. Implementing the Deaf Culture session was an effective means for introducing students to Deaf culture and working with d/DHH patients.
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Affiliation(s)
- Sarah J Greene
- Department of Pathology and Anatomy, Morehouse School of Medicine, Atlanta, Georgia, USA
| | - Jessica A Scott
- College of Education and Human Development, Georgia State University, Atlanta, Georgia, USA
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Bodenmann P, Singy P, Kasztura M, Graells M, Cantero O, Morisod K, Malebranche M, Smith P, Beyeler S, Sebaï T, Grazioli VS. Developing and Evaluating a Capacity-Building Intervention for Healthcare Providers to Improve Communication Skills and Awareness of Hard of Hearing and D/deaf Populations: Protocol for a Participative Action Research-Based Study. Front Public Health 2021; 9:615474. [PMID: 33996710 PMCID: PMC8113414 DOI: 10.3389/fpubh.2021.615474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 03/23/2021] [Indexed: 11/15/2022] Open
Abstract
Background: D/deaf and hard of hearing populations are at higher risk for experiencing physical and mental health problems compared to hearing populations. In addition, they commonly encounter barriers to accessing and benefiting from health services, which largely stem from challenges they face in communicating with healthcare providers. Healthcare providers commonly lack tailored communication skills in caring for D/deaf and hard of hearing populations, which lead to difficulties and dissatisfaction for both staff and D/deaf and hard of hearing communities. This research project aims to develop and evaluate a capacity-building intervention for healthcare providers with the goal of increasing their awareness of D/deaf and hard of hearing individuals' experiences with the healthcare system, their distinct needs, and improving their capacity to communicate effectively with this patient population. Methods: This research project features a participative action research design using qualitative and quantitative methods. Consistent with participative action research, the study will actively involve the target populations, key stakeholders and representative associations. The intervention will be developed and tested through iterative phases. The Integrated Model of Training Evaluation and Effectiveness will guide prospective evaluation of the intervention. The latter will involve qualitative and quantitative assessments in participants before and after the intervention and at 6-months follow-up. Discussion: Results will contribute to research aimed at decreasing barriers to accessing and benefiting from healthcare services for D/deaf and hard of hearing individuals. Findings will be presented to representative associations and political authorities, as well as disseminated at research conferences and in peer-reviewed journals.
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Affiliation(s)
- Patrick Bodenmann
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Pascal Singy
- Psychiatric Liaison Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Miriam Kasztura
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Madison Graells
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Odile Cantero
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Kevin Morisod
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Mary Malebranche
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland.,Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Pascal Smith
- Schweizerischer Gehörlosenbund-Fédération Suisse des Sourds (SGB-FSS), Lausanne, Switzerland
| | - Stéphane Beyeler
- Schweizerischer Gehörlosenbund-Fédération Suisse des Sourds (SGB-FSS), Lausanne, Switzerland
| | - Tanya Sebaï
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Véronique S Grazioli
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
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Tateno S, Liu H, Ou J. Development of Sign Language Motion Recognition System for Hearing-Impaired People Using Electromyography Signal. SENSORS (BASEL, SWITZERLAND) 2020; 20:E5807. [PMID: 33066452 PMCID: PMC7602266 DOI: 10.3390/s20205807] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/10/2020] [Accepted: 10/12/2020] [Indexed: 06/11/2023]
Abstract
Sign languages are developed around the world for hearing-impaired people to communicate with others who understand them. Different grammar and alphabets limit the usage of sign languages between different sign language users. Furthermore, training is required for hearing-intact people to communicate with them. Therefore, in this paper, a real-time motion recognition system based on an electromyography signal is proposed for recognizing actual American Sign Language (ASL) hand motions for helping hearing-impaired people communicate with others and training normal people to understand the sign languages. A bilinear model is applied to deal with the on electromyography (EMG) data for decreasing the individual difference among different people. A long short-term memory neural network is used in this paper as the classifier. Twenty sign language motions in the ASL library are selected for recognition in order to increase the practicability of the system. The results indicate that this system can recognize these twenty motions with high accuracy among twenty participants. Therefore, this system has the potential to be widely applied to help hearing-impaired people for daily communication and normal people to understand the sign languages.
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Affiliation(s)
- Shigeyuki Tateno
- Graduate School of Information, Production and Systems, Waseda University, Kitakyushu 808-0135, Japan; (H.L.); (J.O.)
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Fox ML, James TG, Barnett SL. Suicidal Behaviors and Help-Seeking Attitudes Among Deaf and Hard-of-Hearing College Students. Suicide Life Threat Behav 2020; 50:387-396. [PMID: 31721275 PMCID: PMC9351548 DOI: 10.1111/sltb.12595] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 08/27/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this study was to examine the prevalence of suicidal ideation, suicide attempts, and help-seeking attitudes among D/HH and hearing college students. METHOD A total of 500,860 students completed the ACHA-NCHA-IIb (Fall 2011-Spring 2015). Survey administration and sampling methods differed across institutions. We randomly selected hearing students to have a 1:1 ratio of D/HH and hearing students (analytic N = 12,056). The mean age was 20.3 years, and the sample was predominantly white (68%) and female (65%). Multinomial and binary logistic regressions determined the relation between hearing status, suicide ideation and attempt, and help-seeking. RESULTS D/HH college students were more likely than hearing college students to have seriously considered suicide or attempted suicide in their lifetime. [Correction added on November 26, 2019, after first online publication: The phrase "but not in the past year" was deleted in the previous sentence.] In adjusted analyses, D/HH college students were more likely than hearing college students to have attempted suicide in the past year (OR 2.42, 95% CI 1.85, 3.17). There were no differences between D/HH and hearing groups in help-seeking attitudes. CONCLUSIONS Findings from this national data set indicate that D/HH college students are more likely to consider or attempt suicide. These results underscore the need for focused suicide risk prevention interventions with this population.
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Affiliation(s)
| | - Tyler G. James
- State University System of Florida, Tallahassee, FL, USA
| | - Steven L. Barnett
- National Center for Deaf Health Research, University of Rochester Medical Center National, Rochester, NY, USA
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Schmidt S, Metzner F. [Interpreter-Aided Psychotherapy for Deaf and Hearing-Impaired Patients - a Systematic Review of Research and Recommendations for Psychotherapists with Normal Hearing and Sign Language Interpreters]. DAS GESUNDHEITSWESEN 2019; 82:180-187. [PMID: 31810109 DOI: 10.1055/a-1033-7449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In Germany, deaf patients undergoing psychotherapy have the right to have the costs of a sign language interpreter covered by the insurance since 2001. The effectiveness of interpreter-aided psychotherapy worldwide is disputed. A systematic literature review was conducted on sign language interpreter-aided psychotherapy. Six scientific databases were searched. Two independent raters conducted a 2-step rating process. Out of 1,184 identified publications, 10 studies in German and English language were included. These 10 studies examined between 1 and 85 deaf patients (7-60 years) in different psychotherapeutic settings (8 ambulatory, 4 family therapy). Nine studies reported therapy success. Relevant knowledge (e. g. about culture of deaf people), attitudes (e. g. openness), abilities (e. g. sign language) and general conditions (e. g. declaration for professional secrecy, light conditions) were recommended for psychotherapists with normal hearing and sign language interpreters. Empirical data on psychotherapy with sign language interpreters is low and methodologically limited. The present study can be considered as a starting point for further research.
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Affiliation(s)
- Steffi Schmidt
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - Franka Metzner
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
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Blakely ML, Salvo MC. Improving communication between healthcare professionals and deaf and hard of hearing patients. Res Social Adm Pharm 2019; 15:1193-1194. [PMID: 30975522 DOI: 10.1016/j.sapharm.2019.03.076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 03/27/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Michelle L Blakely
- Department of Pharmaceutical Sciences, University of Wyoming School of Pharmacy, Laramie, USA.
| | - Marissa C Salvo
- Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, USA
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Benkert R, Cuevas A, Thompson HS, Dove-Meadows E, Knuckles D. Ubiquitous Yet Unclear: A Systematic Review of Medical Mistrust. Behav Med 2019; 45:86-101. [PMID: 31343961 PMCID: PMC6855383 DOI: 10.1080/08964289.2019.1588220] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Peer-reviewed articles (n = 124) examining associations between medical mistrust (MM) and health outcomes from four databases, between January 1998 and May 2018, were reviewed; 36 qualitative and 88 quantitative studies met the inclusion criteria. The Williams and Mohammed framework guided our narrative synthesis of the studies; it argues that basic causes (e.g., biased institutions) affect the social status of marginalized groups which in turn effects multiple proximal pathways leading to responses and poor health. Most studies were cross-sectional with US-based samples. The MM in qualitative studies were categorized as interpersonal (n = 30), systemic (n = 22), and/or vicarious (n = 18); 25% did not explicitly note the basic causes of MM and race/ethnicity was often confounded with socioeconomic status (SES). All but three studies discussed an association between MM and a behavior response; no study focused on an actual health outcome. Most quantitative studies used multivariate regression analyses; only 15 of the 88 utilized advanced modeling techniques (e.g., mediation). Most (75%) studies did not describe basic causes for MM and 43% utilized low income samples. MM was conceptualized as a predictor/proximal pathway (in 73 studies) associated with a variety of responses, most commonly behavioral (e.g., diminished adherence); 14 studies found an association between MM and a specific health measure. This review underscores the need for future qualitative studies to place MM central to their research questions as in-depth descriptions of MM were limited. Future quantitative studies should replicate findings using more advanced analytical strategies that examine the relationship between MM and health outcomes.
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Affiliation(s)
| | | | - Hayley S. Thompson
- Community Outreach & Engagement, Faculty Director, Office of Cancer Health Equity & Community Engagement Karmanos Cancer Institute,Department of Oncology, Wayne State University School of Medicine
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Miller CA, Biskupiak A, Kushalnagar P. Deaf LGBTQ Patients' Disclosure of Sexual Orientation and Gender Identity to Health Care Providers. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2018; 62:194-203. [PMID: 31334302 DOI: 10.1037/sgd0000319] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Even with accessible communication, deaf patients who self-identify as LGBTQ might or might not feel comfortable disclosing their sexual orientation/gender identity to a health care provider based on social stigma concerns and previous negative experiences with healthcare providers. The current study examined whether deaf LGBTQ individuals' patient centered communication and level of comfort in sharing health information in the presence of an interpreter contributed to coming out to providers. METHODS Using an online health survey in American Sign Language (ASL) and English, data was gathered from 313 (32% persons of color) self-identified LGBTQ deaf adults across diverse cities in the U.S.A. Binary logistic regression was used to examine the relationships between sexual orientation, gender identity, patient centered communication, and sharing health information with healthcare providers in front of an interpreter, and disclosing orientation/identity to healthcare providers. RESULTS After controlling for sociodemographic and patient-related variables, cisgender women were significantly less likely to disclose their LGBTQ identities to healthcare providers compared with cisgender men. Being accepted as LGBTQ by loved ones and high perceived patient centered communication significantly increased the likelihood of coming out to providers. The presence of an ASL interpreter did not prevent or promote the deaf LGBTQ patients' decision to share health information with their healthcare provider. CONCLUSION Implications for future research and recommendations for providers seeking to develop greater intersectional cultural competencies are discussed, with emphasis on the need for providers to be familiar with health access challenges and inequities facing deaf bisexual and queer women.
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Affiliation(s)
| | | | - Poorna Kushalnagar
- Department of Psychology
- Deaf Health Communication and Quality of Life Center
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18
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Orrie S, Motsohi T. Challenges experienced by healthcare workers in managing patients with hearing impairment at a primary health care setting: a descriptive case study. S Afr Fam Pract (2004) 2018. [DOI: 10.1080/20786190.2018.1507566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- S Orrie
- Division of Family Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - T Motsohi
- Division of Family Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Ackroyd V, Wright B. Working with British Sign Language (BSL) interpreters: lessons from child and adolescent mental health services in the U.K. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/17538068.2018.1492218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Anderson ML, Chang BH, Kini N. Alcohol and drug use among deaf and hard-of-hearing individuals: A secondary analysis of NHANES 2013-2014. Subst Abus 2018; 39:390-397. [PMID: 29452067 DOI: 10.1080/08897077.2018.1442383] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Within the field of behavioral health research, one of the most understudied populations is the US deaf and hard-of-hearing (D/HH) population-a diverse group of individuals with hearing loss that have varied language and communication preferences, community affiliations, and sociocultural norms. Recent research identified concerning behavioral health disparities experienced by the D/HH population; yet, little research has been conducted to extend these findings to the topic of substance use disorder. METHODS To begin to fill this gap, the authors conducted a secondary analysis of data from the 2013-2014 administration of the National Health and Nutrition Examination Survey, comparing alcohol and drug use between participants based on their reported hearing status, i.e., D/HH or hearing. RESULTS Findings suggest that the overall lifetime prevalence of alcohol and drug use does not differ based on hearing status, and that D/HH and hearing adolescents begin using cannabis on a similar timeline. However, findings also revealed that D/HH respondents were more likely to have been regular cannabis users and heavy alcohol users than hearing respondents. In other words, when D/HH individuals use substances, they tend to be heavy users. CONCLUSIONS These findings stress the importance of directing resources to the prevention and treatment of heavy alcohol use in the D/HH population, given that binge drinking is associated with a number of health problems and social consequences. Additionally, the continuation of this empirical work is rather urgent given recent legislative changes regarding cannabis use. D/HH individuals possess a number of risk factors for substance use disorder and, as such, may be more greatly impacted by these legislative changes than individuals from the general US population. It is imperative that this impact be captured by future research efforts in order to inform the development of prevention and intervention efforts for the traditionally underserved D/HH population.
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Affiliation(s)
- Melissa L Anderson
- a Department of Psychiatry , University of Massachusetts Medical School , Worcester , Massachusetts , USA
| | - Bei-Hung Chang
- a Department of Psychiatry , University of Massachusetts Medical School , Worcester , Massachusetts , USA
| | - Nisha Kini
- a Department of Psychiatry , University of Massachusetts Medical School , Worcester , Massachusetts , USA
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Anderson ML, Wolf Craig KS, Ziedonis DM. Barriers and Facilitators to Deaf Trauma Survivors' Help-Seeking Behavior: Lessons for Behavioral Clinical Trials Research. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2017; 22:118-130. [PMID: 27881479 PMCID: PMC6083920 DOI: 10.1093/deafed/enw066] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/30/2016] [Accepted: 09/27/2016] [Indexed: 06/06/2023]
Abstract
Deaf individuals experience significant obstacles to participating in behavioral health research when careful consideration is not given to accessibility during the design of study methodology. To inform such considerations, we conducted an exploratory secondary analysis of a mixed-methods study that originally explored 16 Deaf trauma survivors' help-seeking experiences. Our objective was to identify key findings and qualitative themes from consumers' own words that could be applied to the design of behavioral clinical trials methodology. In many ways, the themes that emerged were not wholly dissimilar from the general preferences of members of other sociolinguistic minority groups-a need for communication access, empathy, respect, strict confidentiality procedures, trust, and transparency of the research process. Yet, how these themes are applied to the inclusion of Deaf research participants is distinct from any other sociolinguistic minority population, given Deaf people's unique sensory and linguistic characteristics. We summarize our findings in a preliminary "Checklist for Designing Deaf Behavioral Clinical Trials" to operationalize the steps researchers can take to apply Deaf-friendly approaches in their empirical work.
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Affiliation(s)
| | - Kelly S. Wolf Craig
- University of Massachusetts Medical School
- Connecticut Department of Developmental Services
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Anderson ML, Wolf Craig KS, Ziedonis DM. Deaf people's help-seeking following trauma: Experiences with and recommendations for the Massachusetts behavioral health care system. PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY 2016; 9:239-248. [PMID: 27797568 DOI: 10.1037/tra0000219] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Deaf trauma survivors are one of the more underserved populations in behavioral health care and experience significant obstacles to seeking help. Repeated encounters with these barriers fuel negative perceptions and avoidance of behavioral health treatment. The current study sought to explore Deaf trauma survivors' help-seeking experiences and elicit their recommendations for improving Deaf behavioral health services in Massachusetts. METHOD We conducted semistructured American Sign Language interviews with 16 trauma-exposed Deaf individuals that included questions from the Life Events Checklist and the PTSD Symptom Scale Interview and questions about Deaf individuals' help-seeking behaviors. Qualitative responses regarding help-seeking experiences were analyzed using a grounded theory approach. RESULTS In the aftermath of trauma, our participants emphasized a desire to work with a signing provider who is highly knowledgeable about Deaf culture, history, and experience and to interact with clinic staff who possess basic sign language skills and training in Deaf awareness. Most stressed the need for providers to better outreach into the Deaf community-to provide education about trauma, to describe available treatment resources, and to prove one's qualifications. Participants also provided suggestions for how behavioral health clinics can better protect Deaf survivors' confidentiality in a small-community context. CONCLUSIONS Deaf-friendly trauma treatment should incorporate the components of trauma-informed care but also carefully consider key criteria expressed by our participants: direct signed communication, understanding of Deaf history and experience, stringent practices to protect confidentiality, provider visibility in the community, and reliance on peer support and Deaf role models in treatment interventions. (PsycINFO Database Record
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23
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Moving forward with dignity: Exploring health awareness in an isolated Deaf community of Australia. Disabil Health J 2016; 9:281-8. [DOI: 10.1016/j.dhjo.2015.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 10/30/2015] [Accepted: 11/02/2015] [Indexed: 11/18/2022]
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Kuenburg A, Fellinger P, Fellinger J. Health Care Access Among Deaf People. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2016; 21:1-10. [PMID: 26405210 DOI: 10.1093/deafed/env042] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Accepted: 08/19/2015] [Indexed: 05/24/2023]
Abstract
Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in global health knowledge for deaf people including those with even higher risk of marginalization. Examples of approaches to improve access to health care, such as providing powerful and visually accessible communication through the use of sign language, the implementation of important communication technologies, and cultural awareness trainings for health professionals are discussed. Programs that raise health knowledge in Deaf communities and models of primary health care centers for deaf people are also presented. Published documents can empower deaf people to realize their right to enjoy the highest attainable standard of health.
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25
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Wright GW, Reese RJ. Strengthening Cultural Sensitivity in Mental Health Counseling for Deaf Clients. JOURNAL OF MULTICULTURAL COUNSELING AND DEVELOPMENT 2015. [DOI: 10.1002/jmcd.12021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Robert J. Reese
- Department of Educational, School, and Counseling Psychology; University of Kentucky
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26
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Hanks BB, Hill NR. Relational Dynamics Within the Context of Deafness: A Case Study of the Supervision Triad. JOURNAL OF COUNSELING AND DEVELOPMENT 2015. [DOI: 10.1002/jcad.12028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Brooks Bastian Hanks
- Bright Tomorrows Child Advocacy Center; Pocatello Idaho
- Now at School of Counseling; Walden University
| | - Nicole R. Hill
- Department of Counseling; Idaho State University
- Now at Department of Counseling; Syracuse University
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27
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Perspectives of people who are deaf and hard of hearing on mental health, recovery, and peer support. Community Ment Health J 2013; 49:649-57. [PMID: 23149648 DOI: 10.1007/s10597-012-9569-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 11/02/2012] [Indexed: 10/27/2022]
Abstract
This qualitative study sought to better understand the experiences of deaf and hard of hearing individuals with accessing recovery-oriented mental health services and peer support via a focus group and interviews. Cultural brokers were used to facilitate culturally-sensitive communication with study participants. Findings indicate that access to adequate mental health services, not just recovery-oriented and peer support services, is not widely available for this population, largely due to communication barriers. Feelings of isolation and stigma are high among this population. Public mental health systems need to adapt and expand services for various cultural groups to insure recovery.
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Diaz DR, Landsberger SA, Povlinski J, Sheward J, Sculley C. Psychiatric disorder prevalence among deaf and hard-of-hearing outpatients. Compr Psychiatry 2013; 54:991-5. [PMID: 23688857 DOI: 10.1016/j.comppsych.2013.04.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 03/26/2013] [Accepted: 04/01/2013] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To contribute to the dearth of literature on the prevalence rates of psychiatric disorders in deaf adults, this study examined the diagnostic and clinical characteristics of deaf psychiatric outpatients in comparison to hearing psychiatric outpatients. METHODS Archival clinical data for deaf adults (N=241), treated at a specialized, linguistically and culturally affirmative outpatient community mental health program from 2002 to 2010, was compared to data from a random sample of hearing adult outpatients (N=345) who were treated at the same community mental health center. RESULTS In various diagnostic categories, significant differences were seen between the deaf and hearing groups: bipolar disorders (3.7% versus 14.2%), impulse control disorders (15.8% versus 5.2%), anxiety disorders (18.7% versus 30.1%), attention deficit hyperactivity disorder (11.2% versus 4.9%), pervasive developmental disorders (3.3% versus 0.3%), substance use disorders (27.8% versus 48.4%), and intellectual disabilities (10.4% versus 2.9%). CONCLUSIONS The deaf outpatient group evidenced a different diagnostic profile than the hearing sample. It is suggested that the use of culturally competent and fluent ASL-signing clinicians provides more diagnostic clarity and is encouraged as a best practice for the care of deaf individuals.
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Affiliation(s)
- David R Diaz
- Indiana University School of Medicine, Department of Psychiatry, Indianapolis, Indiana.
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Assessment and treatment of deaf adults with psychiatric disorders: a review of the literature for practitioners. J Psychiatr Pract 2013; 19:87-97. [PMID: 23507810 DOI: 10.1097/01.pra.0000428555.48588.f9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Many deaf individuals comprise a unique cultural and linguistic minority group. This article reviews the current research literature related to the evaluation, diagnosis, and treatment of culturally deaf individuals suffering from mental disorders. Appropriate psychiatric assessment and treatment requires that clinicians be sensitive to issues of language and differences in social norms and cultural values. Emerging trends in research indicate greater diagnostic specificity and a broader range of diagnoses being assigned in services that are specialized for the treatment of deaf people with mental health issues. Culturally sensitive evaluation and treatment involves a thorough assessment of language modality and language fluency, deafness/audiological history, and cultural identification. Failure to consider these factors during the mental status exam can lead to misdiagnosis. Important issues that confound differential diagnosis and psychiatric treatment of the deaf population are highlighted and discussed. Recommendations for the provision of culturally and linguistically appropriate care are provided.
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Peters SW. Cultural Awareness: Enhancing Counselor Understanding, Sensitivity, and Effectiveness With Clients Who Are Deaf. JOURNAL OF MULTICULTURAL COUNSELING AND DEVELOPMENT 2011. [DOI: 10.1002/j.2161-1912.2007.tb00059.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Fusick L. Serving Clients With Hearing Loss: Best Practices in Mental Health Counseling. JOURNAL OF COUNSELING AND DEVELOPMENT 2011. [DOI: 10.1002/j.1556-6678.2008.tb00631.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Karras E, Rintamaki LS. An examination of online health information seeking by deaf people. HEALTH COMMUNICATION 2011; 27:194-204. [PMID: 21854224 DOI: 10.1080/10410236.2011.575539] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Research indicates that information seekers often turn to the Internet for health information; however, little is known about how Deaf people perceive, access, and utilize the Internet as a health information source. In this study, eight focus groups with Deaf participants (n = 39) were conducted to explore how Deaf people make use of (or avoid) the Internet as a health information source. Focus-group transcripts were analyzed using latent content and constant comparative techniques. Findings are presented using the model of online health information seeking and illustrate the reasons reported for both avoiding and utilizing the Internet as a health information source. In addition, findings illustrate the processes Deaf people navigate when accessing online health information, as well as the strategies they employ when doing so. This research underscores the need for continued investigation of access to and use of e-health resources by Deaf people.
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Affiliation(s)
- Elizabeth Karras
- Department of Communication, Illinois Informatics Institute, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
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Hoang L, LaHousse SF, Nakaji MC, Sadler GR. Assessing deaf cultural competency of physicians and medical students. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2011; 26:175-82. [PMID: 20652475 PMCID: PMC3041910 DOI: 10.1007/s13187-010-0144-4] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The Medical Students, Cancer Control, and the Deaf Community Training program (DCT) intended to create physicians who were culturally competent to care for deaf patients were evaluated. DCT medical students (n = 22), UCSD medical faculty (n = 131), and non-DCT medical students (n = 211) were anonymously surveyed about their perceptions related to deaf patients, deaf cultural competency, and interpreter use. The faculty and non-DCT medical students displayed less knowledge than the DCT students. These findings suggest that training medical students in deaf cultural competency can significantly increase their capacity to care for community members and reduce the health disparities experienced by this community.
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Affiliation(s)
- Lisa Hoang
- Moores UCSD Cancer Center, 3855 Health Sciences Drive #0850, La Jolla, CA 92093-0850 USA
| | - Sheila F. LaHousse
- Moores UCSD Cancer Center, 3855 Health Sciences Drive #0850, La Jolla, CA 92093-0850 USA
| | - Melanie C. Nakaji
- Moores UCSD Cancer Center, 3855 Health Sciences Drive #0850, La Jolla, CA 92093-0850 USA
| | - Georgia Robins Sadler
- Moores UCSD Cancer Center, 3855 Health Sciences Drive #0850, La Jolla, CA 92093-0850 USA
- UCSD School of Medicine, 3855 Health Sciences Drive #0850, La Jolla, CA 92093-0850 USA
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Goldstein MF, Eckhardt EA, Joyner-Creamer P, Berry R, Paradise H, Cleland CM. What do deaf high school students know about HIV? AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2010; 22:523-537. [PMID: 21204628 DOI: 10.1521/aeap.2010.22.6.523] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Deaf adolescents who use American Sign Language (ASL) as their main communication mode are, like their hearing age peers, at risk for acquiring HIV. Many sources of HIV information (radio and television) are not accessible to these adolescents. Little is known about HIV knowledge base and risk behaviors of this group. The objective of this study was to develop and administer, on laptop computer, an HIV knowledge and risk survey in ASL. Findings among 700 deaf adolescent participants attending high schools for the deaf throughout the United States showed that, on average, students knew correct answers to approximately half (x = 7.2) of 14 knowledge items (median: 7.0; range: 0-14; sd = 3.8) on a highly reliable knowledge scale (α = .83). Knowledge score was found in multivariable analysis to be strongly related to receiving HIV information in school. This population is clearly in need of linguistically and culturally accessible HIV prevention education delivered in school.
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Abstract
Culturally Deaf adults lost hearing at early ages, communicate primarily in American Sign Language (ASL), and self-identify as culturally Deaf. Communication barriers lead to isolation, low self-esteem, abuse, and inadequate health care. Screening Deaf patients for depressive symptoms poses challenge. Nurses are rarely familiar with ASL, and depression screening tools aren't easily translated from English to ASL. Consequently, Deaf adults are not adequately screened for depression. Qualitative interviews were conducted with culturally Deaf adults, and certified interpreters helped to enhance understanding. Text was generated from interview transcriptions and researcher observations. No novel depressive symptoms were described. Various ASL signs were used to represent depression; two participants used a unique gesture that had no meaning to others. Childhood experiences leading to depression included sexual or physical abuse, feeling ostracized from family and like a burden. Suicidal gestures communicated severity of depression. Adults felt interpreters were unwelcome during mental health encounters. No participants were asked about depressive symptoms despite frank manifestations of depression. Study describes antecedents and consequences of depressive symptoms among Deaf adults. Understanding symptom manifestations and challenges experienced by Deaf patients helps identify those at risk for depression, thereby reducing morbidity and mortality.
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Affiliation(s)
- K Sheppard
- Division of Health Sciences, Orvis School of Nursing, MS 0134/University Nevada Reno, Reno, NV 89557, USA.
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Middleton A, Turner GH, Bitner-Glindzicz M, Lewis P, Richards M, Clarke A, Stephens D. Preferences for communication in clinic from deaf people: a cross-sectional study. J Eval Clin Pract 2010; 16:811-7. [PMID: 20557411 DOI: 10.1111/j.1365-2753.2009.01207.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To explore the preferences of deaf people for communication in a hospital consultation. METHODS Design--cross-sectional survey, using a structured, postal questionnaire. Setting--survey of readers of two journals for deaf and hard of hearing people. Participants--999 self-selected individuals with hearing loss in the UK, including those who use sign language and those who use speech. Main outcome measures--preferred mode of communication. RESULTS A total of 11% of participants preferred to use sign language within everyday life, 70% used speech and 17% used a mixture of sign and speech. Within a clinic setting, 50% of the sign language users preferred to have a consultation via a sign language interpreter and 43% indicated they would prefer to only have a consultation directly with a signing health professional; 7% would accept a consultation in speech as long as there was good deaf awareness from the health professional, indicated by a knowledge of lip-reading/speech-reading. Of the deaf speech users, 98% preferred to have a consultation in speech and of this group 71% indicated that they would only accept this if the health professional had good deaf awareness. Among the participants who used a mixture of sign language and speech, only 5% said they could cope with a consultation in speech with no deaf awareness whereas 46% were accepting of a spoken consultation as long as it was provided with good deaf awareness; 30% preferred to use an interpreter and 14% preferred to have a consultation directly with a signing health professional. CONCLUSIONS The hospital communication preferences for most people with deafness could be met by increasing deaf awareness training for health professionals, a greater provision of specialized sign language interpreters and of health professionals who can use fluent sign language directly with clients in areas where contact with deaf people is frequent.
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Affiliation(s)
- Anna Middleton
- Institute of Medical Genetics, School of Medicine, Cardiff University, Cardiff, UK.
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Berman BA, Streja L, Guthmann DS. Alcohol and other substance use among deaf and hard of hearing youth. JOURNAL OF DRUG EDUCATION 2010; 40:99-124. [PMID: 21133326 DOI: 10.2190/de.40.2.a] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Little research has focused on alcohol and illicit drug use among deaf and hard of hearing youth. Findings are reported from survey data collected among high school students at two phases of a program of research primarily focusing on tobacco use [Phase 1: (1999/2000) n = 226, Phase 2: (2004) n = 618). Evidence of considerable ever (lifetime) drinking (59.1%, 42.6%) and other substance use (21.1%, 18.9%) was found. Gender, age, race/ethnic, grade, school type (mainstream vs. school for the deaf), age when deafened, and aspects of self-perception were examined for their possible association with substance use. Current use rates are reported, and study findings are discussed in relation to national data. Understanding these use patterns is critical to developing interventions for this culturally and linguistically unique population.
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Freire DB, Gigante LP, Béria JU, Palazzo LDS, Figueiredo ACL, Raymann BCW. [Access by hearing-disabled individuals to health services in a southern Brazilian city]. CAD SAUDE PUBLICA 2009; 25:889-97. [PMID: 19347215 DOI: 10.1590/s0102-311x2009000400020] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2008] [Accepted: 10/21/2008] [Indexed: 11/22/2022] Open
Abstract
This cross-sectional study aimed to compare access to health services and preventive measures by persons with hearing disability and those with normal hearing in Canoas, Rio Grande do Sul State, Brazil. The sample included 1,842 individuals 15 years or older (52.9% of whom were females). The most frequent income bracket was twice the minimum wage or more, or approximately U$360/month (42.7%). Individuals with hearing disability were more likely to have visited a physician in the previous two months (PR = 1.3, 95%CI: 1.10-1.51) and to have been hospitalized in the previous 12 months (PR = 2.1, 95%CI: 1.42-3.14). Regarding mental health, individuals with hearing disability showed 1.5 times greater probability of health care due to mental disorders and 4.2 times greater probability of psychiatric hospitalization as compared to those with normal hearing. Consistent with other studies, women with hearing disability performed less breast self-examination and had fewer Pap smears. The data indicate the need to invest in specific campaigns for this group of individuals with special needs.
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Thomas C, Cromwell J, Miller H. Community Mental Health Teams' perspectives on providing care for Deaf people with severe mental illness. J Ment Health 2009. [DOI: 10.1080/09638230600700300] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Wilson JAB, Wells MG. Telehealth and the deaf: a comparison study. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2009; 14:386-402. [PMID: 19398534 DOI: 10.1093/deafed/enp008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Within the deaf population, an extreme mental health professional shortage exists that may be alleviated with videoconferencing technology-also known as telehealth. Moreover, much needed mental health education within the deaf population remains largely inaccessible. Researchers have warned that the deaf population may remain underserved if significant changes do not take place with traditional service delivery methods. This article evaluated the efficacy of telehealth in teaching psychoeducational objectives, with special emphasis given to its application to the deaf population. Results indicate that telehealth can be regarded as an efficacious and cost-effective option in delivering health care to the deaf population. Participants also indicated satisfaction with the telehealth technology. The use of printed transcripts for educational purposes is encouraged given the significant findings in this article. The findings also have implications for the literature on single-session interventions.
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Zazove P, Meador HE, Reed BD, Sen A, Gorenflo DW. Cancer prevention knowledge of people with profound hearing loss. J Gen Intern Med 2009; 24:320-6. [PMID: 19132325 PMCID: PMC2642565 DOI: 10.1007/s11606-008-0895-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2008] [Revised: 11/12/2008] [Accepted: 11/25/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Deaf persons, a documented minority population, have low reading levels and difficulty communicating with physicians. The effect of these on their knowledge of cancer prevention recommendations is unknown. METHODS A cross-sectional study of 222 d/Deaf persons in Michigan, age 18 and older, chose one of four ways (voice, video of a certified American Sign Language interpreter, captions, or printed English) to complete a self-administered computer video questionnaire about demographics, hearing loss, language history, health-care utilization, and health-care information sources, as well as family and social variables. Twelve questions tested their knowledge of cancer prevention recommendations. The outcome measures were the percentage of correct answers to the questions and the association of multiple variables with these responses. RESULTS Participants averaged 22.9% correct answers with no gender difference. Univariate analysis revealed that smoking history, types of medical problems, last physician visit, and women having previous cancer preventive tests did not affect scores. Improved scores occurred with computer use (p = 0.05), higher education (p < 0.01) and income (p = 0.01), hearing spouses (p < 0.01), speaking English in multiple situations (p < 0.001), and in men with previous prostate cancer testing (p = 0.04). Obtaining health information from books (p = 0.05), physicians (p = 0.008), nurses (p = 0.03) or the internet (p = 0.02), and believing that smoking is bad (p < 0.001) also improved scores. Multivariate analysis revealed that English use (p = 0.01) and believing that smoking was bad (p = 0.05) were associated with improved scores. CONCLUSION Persons with profound hearing loss have poor knowledge of recommended cancer prevention interventions. English use in multiple settings was strongly associated with increased knowledge.
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Affiliation(s)
- Philip Zazove
- Department of Family Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
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Samady W, Samady W, Sadler GR, Nakaji M, Malcarne VL, Trybus R, Athale N. Translation of the multidimensional health locus of control scales for users of American sign language. Public Health Nurs 2008; 25:480-9. [PMID: 18816365 PMCID: PMC2567123 DOI: 10.1111/j.1525-1446.2008.00732.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This paper describes the translation of the Multidimensional Health Locus of Control (MHLC) scales into American Sign Language (ASL). Translation is an essential first step toward validating the instrument for use in the Deaf community, a commonly overlooked minority community. This translated MHLC/ASL can be utilized by public health nurses researching the Deaf community to create and evaluate targeted health interventions. It can be used in clinical settings to guide the context of the provider-patient dialogue. The MHLC was translated using focus groups, following recommended procedures. 5 bilingual participants translated the MHLC into ASL; 5 others back-translated the ASL version into English. Both focus groups identified and addressed language and cultural problems before the final ASL version of the MHLC was permanently captured by motion picture photography for consistent administration. Nine of the 24 items were directly translatable into ASL. The remaining items required further discussion to achieve cultural equivalence with ASL expressions. The MHLC/ASL is now ready for validation within the Deaf community.
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Bartlett G, Blais R, Tamblyn R, Clermont RJ, MacGibbon B. Impact of patient communication problems on the risk of preventable adverse events in acute care settings. CMAJ 2008; 178:1555-62. [PMID: 18519903 DOI: 10.1503/cmaj.070690] [Citation(s) in RCA: 272] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Up to 50% of adverse events that occur in hospitals are preventable. Language barriers and disabilities that affect communication have been shown to decrease quality of care. We sought to assess whether communication problems are associated with an increased risk of preventable adverse events. METHODS We randomly selected 20 general hospitals in the province of Quebec with at least 1500 annual admissions. Of the 145,672 admissions to the selected hospitals in 2000/01, we randomly selected and reviewed 2355 charts of patients aged 18 years or older. Reviewers abstracted patient characteristics, including communication problems, and details of hospital admission, and assessed the cause and preventability of identified adverse events. The primary outcome was adverse events. RESULTS Of 217 adverse events, 63 (29%) were judged to be preventable, for an overall population rate of 2.7% (95% confidence interval [CI] 2.1%-3.4%). We found that patients with preventable adverse events were significantly more likely than those without such events to have a communication problem (odds ratio [OR] 3.00; 95% CI 1.43-6.27) or a psychiatric disorder (OR 2.35; 95% CI 1.09-5.05). Patients who were admitted urgently were significantly more likely than patients whose admissions were elective to experience an event (OR 1.64, 95% CI 1.07-2.52). Preventable adverse events were mainly due to drug errors (40%) or poor clinical management (32%). We found that patients with communication problems were more likely than patients without these problems to experience multiple preventable adverse events (46% v. 20%; p = 0.05). INTERPRETATION Patients with communication problems appeared to be at highest risk for preventable adverse events. Interventions to reduce the risk for these patients need to be developed and evaluated.
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Affiliation(s)
- Gillian Bartlett
- Department of Family Medicine, McGill University, Montréal, Que.
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Bachman SS, Tobias C, Master RJ, Scavron J, Tierney K. A Managed Care Model for Latino Adults With Chronic Illness and Disability. JOURNAL OF DISABILITY POLICY STUDIES 2008. [DOI: 10.1177/1044207307311304] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The authors evaluated a managed care model developed for use by community-based providers to improve health care outcomes for low-income Latinos with disabilities and chronic illnesses. Through this model, Medicaid enrollees with special health care needs were identified and received enhanced primary care, on-site mental health and addiction services, care coordination, and support services based on their levels of need. The goal of the demonstration was to determine whether capitation would be a catalyst to transform typical primary care delivery processes to provide enhanced, culturally competent care to patients with complex health care and psychosocial needs. Despite a significant investment in outpatient services, the intervention was cost effective due to a dramatic decline in inpatient care for a few enrollees. For most enrollees, care was slightly more expensive due to enhanced outpatient medical and mental health care. Enrollees expressed high satisfaction with the intervention.
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Affiliation(s)
| | - Carol Tobias
- Health and Disability Working Group, Boston, Massachusetts
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Munro L, Knox M, Lowe R. Exploring the potential of constructionist therapy: deaf clients, hearing therapists and a reflecting team. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2008; 13:307-323. [PMID: 18303009 DOI: 10.1093/deafed/enn001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This article explores the use of constructionist therapy with a reflecting team of hearing therapists seeing deaf clients. Using findings from two in-depth interviews, postsession reflections and a review of the literature, we propose that this model has the potential to cater to the diversity of the lived experiences of deaf people and also to address issues of power and tensions between medical, social, and cultural models of deafness. The interviews found there was real value in sharing multiple perspectives between the reflecting team of hearing therapists and these deaf clients. In addition, the clients reported feeling safe and comfortable with this model of counseling. Other information that emerged from the interviews supports previous findings regarding consistency in interpreting and the importance of hearing therapists having an understanding of the distinctions between Deaf and hearing worlds. As the first investigation of its kind in Australia, this article provides a map for therapists to incorporate reflecting teams with interpreters, deaf clients, and hearing therapists. The value of this article also lies in providing a much needed platform for future research into counseling outcomes and the efficacy of this constructionist model of therapy.
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Affiliation(s)
- L Munro
- Queensland University of Technology, Beams Road, Carseldine, QLD 4034, Australia.
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Titus JC, Schiller JA, Guthmann D. Characteristics of youths with hearing loss admitted to substance abuse treatment. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2008; 13:336-350. [PMID: 18252698 DOI: 10.1093/deafed/enm068] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The purpose of this study is to provide a profile of youths with hearing loss admitted to substance abuse treatment facilities. Intake data on 4,167 youths (28% female; 3% reporting a hearing loss) collected via the Global Appraisal of Individual Need-I assessment was used for the analyses. Information on demographics, environmental characteristics, substance use behaviors, and symptoms of co-occurring psychological problems for youths with and without a hearing loss was analyzed via Pearson chi-square tests and effect sizes. The groups reported similar backgrounds and comparable rates of marijuana and alcohol use. However, youths in the hearing loss group reported substance use behaviors indicative of a more severe level of involvement. Across all measures of co-occurring symptoms, youths with hearing loss reported greater levels of distress and were more often victims of abuse. Results of this study will help inform treatment needs of youths with hearing loss and define a baseline for future research.
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Affiliation(s)
- Janet C Titus
- Chestnut Health Systems, 720 West Chestnut Street, Bloomington, IL 61701, USA.
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Horton HK, Silverstein SM. Cognition and functional outcome among deaf and hearing people with schizophrenia. Schizophr Res 2007; 94:187-96. [PMID: 17560083 PMCID: PMC3864919 DOI: 10.1016/j.schres.2007.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2006] [Revised: 04/07/2007] [Accepted: 04/12/2007] [Indexed: 11/15/2022]
Abstract
Recent research has highlighted the relationships between impairments in cognitive functioning and poorer functional outcomes among people with schizophrenia (PWS). The purpose of this study was to replicate and extend this work by testing the relationships between cognition and functional outcome among deaf adults with schizophrenia. Empirical findings from deafness-oriented research reveals enhanced abilities in certain aspects of visual-spatial processing compared to hearing people. Sixty-five PWS (34 deaf, 31 hearing) were assessed using measures of verbal and visual memory, attention, and visual processing. The first hypothesis tested whether cognition predicted functional outcome in a similar fashion for both deaf and hearing subjects (n=63). For all subjects, higher levels of cognitive ability were associated with higher levels of functional outcome, and the strongest predictors of outcome were verbal memory and visual-spatial memory (recall condition) (VSM recall). However, the deaf and hearing groups did show different patterns of relationships between cognition and functioning when all cognitive variables were examined. The second hypothesis was that deaf subjects would display superior performance in early visual processing, visual-spatial memory (copy condition) (VSM copy), and VSM recall. Deaf subjects displayed superior performance on each task; however, no significant differences emerged. Deaf subjects outperformed hearing subjects in an unexpected domain (word memory/recognition). This study extends prior work in the area of cognition and schizophrenia and indicates that deaf and hearing subjects may benefit from interventions that address different domains of cognition.
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Affiliation(s)
- Heather K Horton
- School of Social Welfare, University at Albany, Richardson Hall 280, 135 Western Avenue, Albany, NY 12203, USA.
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Denman L. Enhancing the accessibility of public mental health services in Queensland to meet the needs of deaf people from an Indigenous Australian or culturally and linguistically diverse background. Australas Psychiatry 2007; 15 Suppl 1:S85-9. [PMID: 18027143 DOI: 10.1080/10398560701701262] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this paper was to identify the accessibility barriers that deaf people from an Indigenous Australian or culturally and linguistically diverse background encounter when attempting to access public mental health services in Queensland. METHOD Consultation with key stakeholders was undertaken. RESULTS Many of the barriers that deter deaf Indigenous Australians from accessing public mental health services in Queensland, in addition to preventing them from having access to the same continuum of care available to hearing English-speaking people were identified. CONCLUSIONS Deaf Indigenous Australians encounter significant barriers when they seek to access public mental health services in Queensland. If these barriers are to be dissolved to ensure access to the same continuum of mental health care available to hearing English-speaking then a series of education and training, research and resource strategies need to be further addressed.
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Affiliation(s)
- Lara Denman
- Queensland Transcultural Mental Health Centre, QLD, Australia.
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Kaskowitz SR, Nakaji MC, Clark KL, Gunsauls DC, Sadler GR. Bringing prostate cancer education to deaf men. ACTA ACUST UNITED AC 2006; 30:439-48. [PMID: 17098377 DOI: 10.1016/j.cdp.2006.09.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2006] [Indexed: 11/23/2022]
Abstract
INTRODUCTION A review of the scientific literature yielded no examples of programs that were designed to give deaf men access to information about prostate cancer, early detection, and treatment. The community's diverse linguistic abilities, multiple preferences for receiving information, and the small size of the community, create additional challenges for health educators. MATERIALS AND METHODS A prostate cancer education program was adapted for deaf men (N=121), with the goal of creating a single program that could meet the educational needs of this diverse community. The program was evaluated using baseline, post-test, and two-month follow-up surveys, plus focus group discussions. RESULTS Overall, baseline knowledge about prostate cancer and awareness of the screening options for the early detection of prostate cancer increased significantly at post-test and this gain was maintained at the two-month follow-up. While prostate-specific antigen (PSA) screening and digital rectal exams also increased among men 50 and older, the increase was not statistically significant, possibly a consequence of the small sample size. Participants' reported their preferred methods of communication. Greater knowledge gains were demonstrated among those who preferred communications via American Sign Language (ASL) versus English-based communications. CONCLUSION Cancer education programs offered in ASL can help address health knowledge disparities and that in turn can contribute to alleviating these disparities. Clinicians and health educators can help raise the deaf community's health awareness through programs such as this one, which ultimately evolved into the Internet accessible ASL video: Prostate Cancer: Know Your Options.
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Affiliation(s)
- Sommer R Kaskowitz
- UCSD School of Medicine, UCSD School of Medicine's American Sign Language, Deaf Culture, and Cancer Control Program, Rebecca and John Moores UCSD Cancer Center, La Jolla, CA 92093-0658, USA.
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Steinberg AG, Barnett S, Meador HE, Wiggins EA, Zazove P. Health care system accessibility. Experiences and perceptions of deaf people. J Gen Intern Med 2006; 21:260-6. [PMID: 16499543 PMCID: PMC1828091 DOI: 10.1111/j.1525-1497.2006.00340.x] [Citation(s) in RCA: 136] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND People who are deaf use health care services differently than the general population; little research has been carried out to understand the reasons. OBJECTIVE To better understand the health care experiences of deaf people who communicate in American Sign Language. DESIGN Qualitative analyses of focus group discussions in 3 U.S. cities. PARTICIPANTS Ninety-one deaf adults who communicate primarily in American Sign Language. MEASUREMENTS We collected information about health care communication and perceptions of clinicians' attitudes. We elicited stories of both positive and negative encounters, as well as recommendations for improving health care. RESULTS Communication difficulties were ubiquitous. Fear, mistrust, and frustration were prominent in participants' descriptions of health care encounters. Positive experiences were characterized by the presence of medically experienced certified interpreters, health care practitioners with sign language skills, and practitioners who made an effort to improve communication. Many participants acknowledged limited knowledge of their legal rights and did not advocate for themselves. Some participants believed that health care practitioners should learn more about sociocultural aspects of deafness. CONCLUSIONS Deaf people report difficulties using health care services. Physicians can facilitate change to improve this. Future research should explore the perspective of clinicians when working with deaf people, ways to improve communication, and the impact of programs that teach deaf people self-advocacy skills and about their legal rights.
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Affiliation(s)
- Annie G Steinberg
- Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
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