Suicidal Behaviors and Help-Seeking Attitudes Among Deaf and Hard-of-Hearing College Students

Antenatal depression and drug use among deaf and hard-of-hearing birthing parents: results from a U.S. National Survey

PURPOSE

This study aimed to investigate antenatal depression and drug use among deaf and hard-of-hearing (DHH) birthing parents who use American Sign Language (ASL), spoken English, or bilingually both ASL and English.

METHODS

DHH participants in the United States responded to the Survey on Pregnancy Experiences of Deaf and Hard-of-Hearing Women. Respondents self-reported their antenatal depression diagnoses and drug use (i.e., pain relievers, cannabis, or illicit drugs) during their last pregnancy. Poisson regression models were used to estimate prevalence ratios, adjusting for age, race/ethnicity, education, marital status, and parity.

RESULTS

The average age of respondents (n = 587) was 35 years. Respondents were predominantly non-Hispanic white (80%), college educated (60%), and married (74%). Relative to DHH English-speakers, DHH ASL-users had lower prevalence of reporting antenatal depression diagnosis (aPR = 0.40, 95% CI: 0.23 to 0.72). DHH people who reported antenatal depression diagnosis had higher prevalence of reporting antenatal drug use (PR = 2.34, 95% CI: 1.65 to 3.33). There were no significant associations between preferred language and antenatal drug use.

CONCLUSIONS

DHH ASL-users are less likely to report receiving an antenatal depression diagnosis compared to DHH English-speakers. Given well-documented patient-provider communication barriers among DHH ASL-users, it is unclear if the lower prevalence observed in this study is the result of inadequate or inaccessible screening during pregnancy. Future work should consider universal use of linguistically appropriate screening tools for DHH birthing parents in both clinical and research settings.

Emergency department patient-centred care perspectives from deaf and hard-of-hearing patients

BACKGROUND

Deaf and hard-of-hearing (DHH) patients are a priority population for emergency medicine health services research. DHH patients are at higher risk than non-DHH patients of using the emergency department (ED), have longer lengths of stay in the ED and report poor patient-provider communication. This qualitative study aimed to describe ED care-seeking and patient-centred care perspectives among DHH patients.

METHODS

This qualitative study is the second phase of a mixed-methods study. The goal of this study was to further explain quantitative findings related to ED outcomes among DHH and non-DHH patients. We conducted semistructured interviews with 4 DHH American Sign Language (ASL)-users and 6 DHH English speakers from North Central Florida. Interviews were transcribed and analysed using a descriptive qualitative approach.

RESULTS

Two themes were developed: (1) DHH patients engage in a complex decision-making process to determine ED utilization and (2) patient-centred ED care differs between DHH ASL-users and DHH English speakers. The first theme describes the social-behavioural processes through which DHH patients assess their need to use the ED. The second theme focuses on the social environment within the ED: patients feeling stereotyped, involvement in the care process, pain communication, receipt of accommodations and discharge processes.

CONCLUSIONS

This study underscores the importance of better understanding, and intervening in, DHH patient ED care-seeking and care delivery to improve patient outcomes. Like other studies, this study also finds that DHH patients are not a monolithic group and language status is an equity-relevant indicator. We also discuss recommendations for emergency medicine.

PATIENT OR PUBLIC CONTRIBUTION

This study convened a community advisory group made up of four DHH people to assist in developing research questions, data collection tools and validation of the analysis and interpretation of data. Community advisory group members who were interested in co-authorship are listed in the byline, with others in the acknowledgements. In addition, several academic-based co-authors are also deaf or hard of hearing.

Reporting Ethical Procedures in Suicide Prevention Research: Current Status and Recommendations

OBJECTIVE

Ethical concerns frequently arise in suicide prevention research regarding participant safety and confidentiality. Despite a substantial literature on managing and navigating ethical concerns in suicide research, little attention has been paid to the reporting of ethical procedures. Furthermore, standard procedures for reporting ethical risk management procedures have not been developed.

METHOD

A review of the current literature was performed to examine the current state of reporting of ethical procedures within suicide research. Articles published in 2020 (N = 263) from three suicide-focused publications were screened and then coded (n = 131) to identify reporting of procedures for the ethical conduct of research and suicide risk management steps taken by the research teams.

RESULTS

The majority of articles reported ethical review or approval (84.7%) and reported the use of an informed consent process (77.9%). Only 28.2% included risk mitigation procedures. Of those 29.7% of those articles reported conducting risk evaluation, 66.7% reported resource dissemination, and 51.4% reported an intervention.

CONCLUSION

As empirical support for brief interventions accrues, suicide prevention researchers should consider establishing standards for the reporting of procedures to ensure the safety of participants with suicidal risk.HighlightsReporting suicide safety protocols helps ensure high ethical standards in research.Fewer than 1/3 of articles reviewed reported risk mitigation procedures in 2020.Standard procedures for reporting safety protocols in suicide research are needed.

Acculturative Stress, Mental Health, and Well-Being among Deaf Adults

Acculturative stress is associated with negative mental health among culturally diverse individuals. Deaf and Hard-of-Hearing (DHH) individuals experience acculturative stress as they navigate within and between the Hearing and Deaf communities, yet, research has not examined the relationship between deaf acculturative stress and psychological functioning. This study examined the relationships between deaf acculturative stress, well-being, and symptoms of depression and anxiety. One hundred and ten DHH adults (71.6% female, 82.7% White, median age = 30-39) completed an online survey including the Multidimensional Inventory of Deaf Acculturative Stress (MIDAS), demographic questions, and measures of psychological functioning. After controlling for relevant sociodemographic factors, the MIDAS Stress from the Deaf and Hearing Community scales emerged as significant predictors of well-being and symptoms of anxiety and depression. Findings are discussed within the context of DHH sociocultural experiences, and suggestions for future research are offered to inform clinical work with DHH individuals.

Use of Routine Emergency Department Care Practices with Deaf American Sign Language Users

BACKGROUND

Deaf individuals who communicate using American Sign Language (ASL) seem to experience a range of disparities in health care, but there are few empirical data.

OBJECTIVE

To examine the provision of common care practices in the emergency department (ED) to this population.

METHODS

ED visits in 2018 at a U.S. academic medical center were assessed retrospectively in Deaf adults who primarily use ASL (n = 257) and hearing individuals who primarily use English, selected at random (n = 429). Logistic regression analyses adjusted for confounders compared the groups on the provision or nonprovision of four routine ED care practices (i.e., laboratories ordered, medications ordered, images ordered, placement of peripheral intravenous line [PIV]) and on ED disposition (admitted to hospital or not admitted).

RESULTS

The ED encounters with Deaf ASL users were less likely to include laboratory tests being ordered: adjusted odds ratio 0.68 and 95% confidence interval 0.47-0.97. ED encounters with Deaf individuals were also less likely to include PIV placement, less likely to result in images being ordered in the ED care of ASL users of high acuity compared with English users of high acuity (but not low acuity), and less likely to result in hospital admission.

CONCLUSION

Results suggest disparate provision of several types of routine ED care for adult Deaf ASL users. Limitations include the observational study design at a single site and reliance on the medical record, underscoring the need for further research and potential reasons for disparate ED care with Deaf individuals.

Nursing Students Facilitating the Transition from Suicidal Ideation to Action in the Rural: A Qualitative Study

OBJECTIVE

This study aims to increase understanding of the process of nursing students at risk of completing suicide attempts that facilitates the transition from suicidal ideation to action. And The Central Bureau of Statistics, there were 812 suicide cases throughout Indonesia.

METHODS

The qualitative research involved 15 nursing students who were selected purposively. data collection in rural East Java Data were collected through semi-structured interviews and analyzed using the Colaizzi phenomenological method.

RESULTS

We identified six main themes; 1 (the dimension of individual history). 2 (socio-cultural dimension) describes the problems experienced by nursing students on campus and off campus. 3 (interpersonal dimension). 4 (intrapersonal dimension); Factors of family conflict, peer conflict, and psychiatric and/or medical disorders. 5 (emotional dimension). 6. (be a good listener).

CONCLUSION

The intrapersonal element is the most influential catalyst in the progression from suicidal ideation to action. As prospective targets for preventive interventions and practices with nursing students at risk of suicide, our findings suggest the need for specific measures addressing freshman recruitment during selection for faculty, emotional dysregulation, and feelings of invalidity and entrapment. Nursing students need intrapersonal training. Being a good listener for all students, lecturers and staff is important to create a support system for suicide prevention in the nursing environment.

Development of a Health Behavior Screening Tool for Deaf College Students

Young adults who are Deaf or Hard-of-Hearing (D/HH) face behavioral health risks similar to hearing adults. Despite the emphasis on health behavior screening in health care settings, a brief screening tool in American Sign Language (ASL) does not exist. This manuscript describes the development and pilot testing of an online survey in ASL called the Deaf Health Behavior Report. The Deaf Health Behavior Report includes standardized questions for general health, health behaviors, and psychosocial topics. We invited all D/HH students at a university in Southern California to complete the Deaf Health Behavior Report. A total of 31 D/HH students completed the survey. The most prevalent health risks were related to nutrition, stress, and binge drinking. The Deaf Health Behavior Report is a useful tool for health promotion efforts on college campuses and in general health settings.

Association between hearing loss and suicidal ideation among middle-aged and older adults

OBJECTIVES

Hearing loss (HL) is regarded as a major risk factor for late-life depression. This study aims to further examine the association between HL and suicidal ideation (SI) among middle-aged and older adults using a nationally representative sample.

METHOD

The study sample comprised 34,142 adults (aged 50+) drawn from the 2015 to 2018 National Survey on Drug Use and Health. SI was measured by response to the question, 'At any time in the past year, did you seriously think about trying to kill yourself?' HL was assessed by asking respondents whether they were deaf or had serious difficulty hearing. Multivariate logistic regression analyses were conducted to examine the association between HL and SI after adjusting for a comprehensive list of covariates.

RESULTS

Compared to those without HL, middle-aged and older adults with HL experienced significant health disparities regarding history of hospitalization, poor perceived health, higher prevalence of chronic diseases, depression, substance use, and SI. HL was positively associated with SI in the past year in both middle-aged (aOR = 1.59, 95% CI [1.14, 2.21], p < .001) and older adult groups (aOR = 1.58, 95% CI [1.07, 2.33], p < .001), controlling for depression, substance use, health status, and sociodemographic variables.

CONCLUSION

Given the high prevalence of hearing loss (HL) in aging populations, this study aimed to expand our knowledge of the relative strength of association between HL and SI. Findings implied that healthcare providers should consider screening for SI in those with HL.

Conceptual Model of Emergency Department Utilization among Deaf and Hard-of-Hearing Patients: A Critical Review

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.

Nationwide Analysis of Mortality Rates and Related Surgical Procedures in Hearing Disability Patients in South Korea

Background and Objectives

Hearing loss (HL) and its repercussions are major problems in today’s society. There are limited data on the relationship between degree of HL and otologic disorders. The aim of this study is to estimate mortality rates, rates of sudden idiopathic HL and related otologic surgical procedures in hearing disability patients in South Korea.

Subjects and Methods

Retrospective medical data for 160,205 patients with hearing disability was extracted. Mortality rates, rates of sudden idiopathic HL and related otologic surgical procedures were compared with a normal control group consisting of 865,475 people; approximately 5 times the number of hearing disability patients.

Results

According to the Korean National Disability Registry (NDR), 0.458% of the population in South Korea suffered from hearing disability in 2015. Higher rates of mortality and sudden idiopathic HL were reported in hearing disability patients, increasing up to a maximum of 1.594 times and 1,039.695 times, respectively, compared to the normal control group. Mastoidectomy surgery was 2.5 times more frequently performed and pressure equalizing (PE) tube insertion was about 15 times more frequently performed in hearing disability patients.

Conclusions

Hearing disability is related to higher risks of mortality, sudden idiopathic HL and otologic surgical procedures, including mastoidectomy and PE tubing.