Perception of quality of life for adults with hearing impairment in the LGBT community

Quality of Life among LGBTQ Older Adults in the United States: A Systematic Review

BACKGROUND

Sexual and gender minorities constitute a rapidly growing part of the older adult population in the United States and may face quality of life (QOL) challenges in older adulthood. Research on quality of life among lesbian, gay, bisexual, transgender, and queer (LGBTQ) older adults has increased dramatically since 2010. Common findings indicate that LGBTQ older adults face challenges related to personal experiences of discrimination, anticipated discrimination in health care settings, and lack of family support. Research designs were primarily nonprobability surveys, with a small number of qualitative designs and surveys using representative probability samples.

AIM

To identify and summarize research on QOL among LGBTQ older adults conducted in the United States between January 1, 2000 and December 31, 2020.

METHOD

Four scholarly databases were searched to identify studies addressing QOL in LGBTQ older adult populations.

RESULTS

The database search produced a total 568 unique results. Of these, 54 research articles were identified that met all inclusion criteria for the review. Appraisal of evidence was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology.

CONCLUSIONS

Care for mental health of LGBTQ older adults should be sensitive to issues including lifetime history of discrimination, anxiety about anticipated discrimination from health care providers, and potential lack of family support. Focus can also be given to common areas of strength, including strengthening nonfamily social networks.

Sex-Linked Biology and Gender-Related Research Is Essential to Advancing Hearing Health

There is robust evidence that sex (biological) and gender (behavioral/social) differences influence hearing loss risk and outcomes. These differences are noted for animals and humans-in the occurrence of hearing loss, hearing loss progression, and response to interventions. Nevertheless, many studies have not reported or disaggregated data by sex or gender. This article describes the influence of sex-linked biology (specifically sex-linked hormones) and gender on hearing and hearing interventions, including the role of sex-linked biology and gender in modifying the association between risk factors and hearing loss, and the effects of hearing loss on quality of life and functioning. Most prevalence studies indicate that hearing loss begins earlier and is more common and severe among men than women. Intrinsic sex-linked biological differences in the auditory system may account, in part, for the predominance of hearing loss in males. Sex- and gender-related differences in the effects of noise exposure or cardiovascular disease on the auditory system may help explain some of these differences in the prevalence of hearing loss. Further still, differences in hearing aid use and uptake, and the effects of hearing loss on health may also vary by sex and gender. Recognizing that sex-linked biology and gender are key determinants of hearing health, the present review concludes by emphasizing the importance of a well-developed research platform that proactively measures and assesses sex- and gender-related differences in hearing, including in understudied populations. Such research focus is necessary to advance the field of hearing science and benefit all members of society.

Iridescent Life Course: LGBTQ Aging Research and Blueprint for the Future - A Systematic Review

BACKGROUND

LGBTQ* (lesbian, gay, bisexual, trans, and queer) older adults are demographically diverse and growing populations. In an earlier 25-year review of the literature on sexual orientation and aging, we identified four waves of research that addressed dispelling negative stereotypes, psychosocial adjustment to aging, identity development, and social and community-based support in the lives of LGBTQ older adults.

OBJECTIVES

The current review was designed to develop an evidence base for the field of LGBTQ aging as well as to assess the strengths and limitations of the existing research and to articulate a blueprint for future research.

METHODS

Using a life course framework, we applied a systematic narrative analysis of research on LGBTQ aging. The review included 66 empirical peer-reviewed journal articles (2009-2016) focusing on LGBTQ adults aged 50 years and older, as well as age-based comparisons (50 years and older with those younger).

RESULTS

A recent wave of research on the health and well-being of LGBTQ older adults was identified. Since the prior review, the field has grown rapidly. Several findings were salient, including the increas-ed application of theory (with critical theories most often used) and more varied research designs and methods. While -existing life course theory provided a structure for the investigation of the social dimensions of LGBTQ aging, it was limited in its attention to intersectionality and the psychological, behavioral, and biological work emerging in the field. There were few studies addressing the oldest in these -communities, bisexuals, gender non-binary older adults, intersex, -older adults of color, and those living in poverty. -Conclusions: The Iridescent Life Course framework highlights the interplay of light and environment, creating dynamic and fluid colors as perceived from different angles and perspectives over time. Such an approach incorporates both queering and trans-forming the life course, capturing intersectionality, fluidity over time, and the psychological, behavioral, and biological as well as social dimensions of LGBTQ aging. Work is needed that investigates trauma, differing configurations of risks and resources over the life course, inequities and opportunities in representation and capital as LGBTQ adults age, and greater attention to subgroups that remain largely invisible in existing research. More depth than breadth is imperative for the field, and multilevel, longitudinal, and global initiatives are needed.

Improvement of older-person-specific QOL after hearing aid fitting and its relation to social interaction

PURPOSE

This study aimed to investigate whether hearing aids use is associated with improvement of older-person-specific QOL and whether social interactions modify the association.

METHODS

The WHOQOL-OLD questionnaire was answered by 105 older adults aged 60 to 90 years who were newly fitted hearing aids on the day of fitting and at 2 - 6 months afterward. The associations between the daily hours of hearing aid usage and social relations with changes in the WHOQOL-OLD total score after hearing aids fitting were estimated adjusting for possible confounders.

RESULTS

Older persons with hearing loss experienced significant increases in WHOQOL-OLD total score after hearing aid fitting. Regular use of hearing aid was associated with a greater increase in the total score. The combined categorical variable of social relations and hearing aid usage revealed no separate effects of these two variables, but a combined effect; only those with frequent social interactions who used their hearing aid regularly had a significantly greater increase in WHOQOL-OLD total score.

CONCLUSION

This study's findings indicate that hearing aid fitting may be associated with a subsequent improvement in older-person-specific QOL by improvements in hearing due to the hearing aid, and possibly enhanced communication opportunities.

Relationship between quality of life and unprotected anal intercourse among Chinese men who have sex with men: a cross-sectional study

Background

The prevalence of unprotected anal intercourse (UAI) is high among Chinese men who have sex with men (MSM). As important aspects of quality of life (QOL), psychological health and social relationships have been found to be associated with UAI among MSM, which was of great concern for intervening on UAI.

Methods

We conducted a cross-sectional study in Zhengzhou, Henan province, and in Huludao, Liaoning province, China, to measure quality of life (QOL) using the brief version of the World Health Organization Quality of Life (WHOQOL-BREF). Cronbach's α coefficient was used to test the internal consistency of the questionnaire items, and construction validity was assessed by exploratory factor analysis. T-test, chi-square test and multivariate logistic analysis were carried out to test the relationship between quality of life and unprotected anal intercourse.

Results

The questionnaires of 320 of the 373 men who have sex with men that were surveyed met our validity criteria (response rate: 85.8 %). A total of 161 subjects (50.3 %) reported having unprotected anal sex in the last 6 months. The results of univariate analysis indicated that having unprotected anal sex was significantly associated with psychological health (PSYCH), social relationships (SOCIL), age, and marital status (P-value <0.05). The 3 items (“Negative feelings”, “Hopeness on your life”, and “Be able to concentrate”) in the PSYCH subscale were associated with UAI significantly (P-value <0.05). Multivariate analysis showed that psychological health (adjusted odd ratio (AOR) 0.979, 95 % confidence interval (CI) 0.961-0.998) was independent factor affecting the likelihood of having UAI in the population of Chinese MSM, and participants who aged 45 or more had higher odds of UAI (AOR 3.986, 95 % CI 1.199-13.255).

Conclusions

WHOQOL-BREF was acceptable for evaluating the quality of life of MSM. Psychological health, as one important aspect of quality of life, was negatively associated with unprotected anal intercourse. The finding underscored the needs to incorporate the strategies on improving psychological health into the UAI intervention to reduce the HIV transmission among MSM.

Understanding and Measuring LGBTQ Pathways to Health: A Scoping Review of Strengths-Based Health Promotion Approaches in LGBTQ Health Research

Health research traditionally has focused on the health risks and deficits of lesbian, gay, bisexual, transgender, and queer (LGBTQ) populations, obscuring the determinants that can promote health across the life course. Recognizing, appropriately measuring, and rendering visible these determinants of health is paramount to informing appropriate and engaging health policies, services, and systems for LGBTQ populations. The overarching purpose of this article is to provide an overview of the findings of a scoping review aimed at exploring strengths-based health promotion approaches to understanding and measuring LGBTQ health. Specifically, this scoping review examined peer-reviewed, published academic literature to determine (a) existing methodological frameworks for studying LGBTQ health from a strengths-based health promotion approach, and (b) suggestions for future methodological approaches for studying LGBTQ health from a strengths-based health promotion approach. The findings of this scoping review will be used to inform the development of a study aimed at assessing the health of and improving pathways to health services among LGBTQ populations in Nova Scotia, Canada.

Hearing aid and hearing assistance technology use in Aotearoa/New Zealand

OBJECTIVE

The purpose of this study was to describe factors that are related to hearing aid and hearing assistance technology ownership and use in Aotearoa/New Zealand.

DESIGN

Adults with hearing impairment living in New Zealand were surveyed regarding health-related quality of life and device usage. Audiometric data (hearing sensitivity and speech in noise) were collected.

STUDY SAMPLE

Data were obtained from 123 adults with hearing impairment: 73 reported current hearing-aid use, 81 reported current hearing assistance technology use.

RESULTS

In both analyses, device users had more difficulty understanding speech in background noise, had poor hearing in both their better and worse hearing ears, and perceived more consequences of hearing impairment in their everyday lives (both emotionally and socially) than non-hearing-aid users. Discriminant analyses showed that the social consequences of hearing impairment and the better ear hearing best classified hearing aid users from non-users but social consequences and worse ear hearing best classified hearing assistance technology users from non-users.

CONCLUSIONS

Quality of life measurements and speech-in-noise assessments provide useful clinical information. Hearing-impaired adults in New Zealand who use hearing aids also tend to use hearing assistance technology, which has important clinical implications.