Elaine G. Jones

Challenges in Language, Culture, and Modality: Translating English Measures Into American Sign Language

Background: Few health-related questionnaires have been translated into American Sign Language (ASL), precluding Deaf adults from full participation in health-related research. Objectives: To translate self-report measures (written English) into sign language and to evaluate the equivalence of the ASL versions to the original English versions of the measures. Methods: A descriptive-comparative design with a derived etic (outsider) perspective was used to evaluate equivalency between the English version of the Self-Rated Abilities for Health Practices (SRAHP) and an ASL version. Both versions were administered to 24 bilingual (English and ASL) adults. Analysis included correlation between total scores and comparison of internal consistency of both versions; psychometric properties of the signed SRAHP were computed for 105 Deaf adults who participated in a study of the Deaf Heart Health Intervention (DHHI). Results: The correlation between total scores on ASL and English versions was .92, item-to-total correlations ranged from .08 to .80 on the English version and from .33 to .80 on the ASL version. Cronbachs alpha was .91 for the English version and .90 for the ASL version. Mean scores on the ASL version were significantly lower for the all-Deaf DHHI sample (n = 105) than for the bilingual subjects (n = 24) although internal consistency remained high (Cronbachs alpha of .93 and item-to-total correlation of .38-.74) for the new ASL version. Discussion: The use of an adapted translation model resulted in a sound ASL version of a health-related measure. Results support use of the derived etic strategy for translating measures from their original language into new languages. The approach is also appropriate for changing modalities from written form to other modalities, such as the visual-manual modality of ASL.

Body image perceptions in men with prostate cancer

PURPOSE/OBJECTIVES To describe changes in body image among men with prostate cancer who were either prescribed androgen-deprivation therapy (ADT) or were ADT naive and to explore the relationship of age, duration of therapy, and body mass index with body image perception. DESIGN Exploratory and descriptive. SETTING Ambulatory care clinic of a large urban Veterans Affairs medical center. SAMPLE 132 men 60 years of age or older with prostate cancer recruited from the oncology and urology outpatient departments. METHODS Participants completed a demographic survey and the Body Image Scale (BIS), an instrument developed to measure changes in body image. Descriptive and inferential statistics were used to explore body image dissatisfaction. MAIN RESEARCH VARIABLES Body image and ADT. FINDINGS A significant difference in body image dissatisfaction existed between men who had received ADT and men who were ADT naive. No relationship was identified between age and body image dissatisfaction or between duration of therapy and body image dissatisfaction. A significant positive relationship was found between body mass index and body image dissatisfaction for the sample overall. CONCLUSIONS A greater degree of body image dissatisfaction existed in the men who received ADT as compared to those who were ADT naive. IMPLICATIONS FOR NURSING Patients receiving ADT for prostate cancer may be at greater risk of body image dissatisfaction. The psychometric performance of the BIS lends support to its continued use in this population.

Evaluating the Success of Deaf Parents

Nineteen parent-child pairs completed the Parental Strengths and Needs Inventory (PSNI) and were interviewed about their relationships. Parent and child scores on the PSNI were above average, with parents expressing high interest in information about childrearing. Interviews revealed issues specific to deaf parents, such as using children as interpreters and frustration when children had poor sign language skills. Children with good sign language skills said they were generally willing to interpret for their parents, except during conflict situations. Children also reported advantages to having deaf parents: they enjoyed being bilingual and their parents tolerated noise and loud music. Study results underscore the importance of triangulation strategies in cross-cultural research.

Foster Parents' Early Adaptation to the Placement of a Child With Developmental Disabilities in Their Home

Eight foster parents of children with developmental disabilities (DD) were interviewed about their early adaptation to placement of the child in their homes. Analysis using a grounded theory methodology showed important adaptations in the physiological, role function, interdependence, and self-concept modes of adaptation. Parents described less attention to their own physical health, dominance of the parenting role over all other roles, decreased social interactions, and a sense of personal satisfaction in response to placement of a child with DD in their homes. Implications for nursing practice are included.

Deaf and Hearing Parents' Interactions with Eldest Hearing Children

Observational methods were used to gather data from 54 individuals in 9 Deaf-parented families and 9 hearing-parented families whose eldest hearing children were aged 7 to 11 years old. Transcripts of parent/child dyadic interactions during a vacation planning activity were analyzed using Condon, Cooper and Grotevants (1984) Individuation Code. Repeated measures ANOVAS were conducted with the independent variables of the parents gender (mother versus fathers) and group membership (Deaf-parented versus hearing-parented families) on the percentage of communication that reflected self-assertion, separateness, permeability, and mutuality. There were no significant differences between children from Deaf-parented families versus children from hearing-parented families. There was a significant main effect for parents in communication reflecting self-assertion; namely hearing parents had a higher percentage of self-assertive communication than Deaf parents.

Factors associated with depressive symptoms in older Taiwanese adults in a long-term care community

BACKGROUND This study was to examine culturally based factors as potential predictors of depressive symptoms in older Taiwanese adults living in eight long-term care institutions in southern Taiwan. METHOD A cross-sectional, exploratory design study was used with a purposive sample of 156 participants with a mean age of 79.80 ± 7.14 years. Measurements included filial responsibility expectation questions, two questions about degrees of acceptance of institutionalization, Perceived Stress Scale, Self-Transcendence Scale, and Geriatric Depression Scale. RESULTS An elders willingness to be institutionalized, an elders willingness to remain institutionalized, perceived stress, and self-transcendence were significantly associated with depressive symptoms (r = -0.35; -0.49; 0.60; and -0.67, respectively). Although no evidence for the relationship between filial responsibility and depressive symptoms was found in this study, there was evidence that filial responsibility was highly valued. Self-transcendence was the strongest predictor of depressive symptoms, accounting for 45% of the variance. CONCLUSION These findings provide insight into the cultural factors associated with depressive symptoms and support the need of timely interventions for institutionalized Taiwanese elderly population.

Perceived Stress Among Deaf Adults

The present article describes the effectiveness of stress management classes in decreasing perceived stress among Deaf adults. Deaf adults may experience unique stressors, in addition to circumstances associated with increased stress in the general population. The Perceived Stress Scale (S. Cohen, Kamarck, & Mermelstein, 1983) was used as a pretest and posttest measure for participants in a study of the Deaf Heart Health Intervention. Results indicated that (a) some Deaf adults may have higher levels of perceived stress than the general population, and (b) culturally appropriate stress management interventions are promising as a means of assisting Deaf adults to decrease levels of perceived stress, and hence decrease risk for stress-related illnesses. Future research will focus on obtaining a larger, more diverse sample of Deaf adults and refining the intervention for maximum effectiveness.

Deaf Children's Knowledge of Internal Human Anatomy

The purpose of this study was to investigate deaf childrens knowledge of internal human anatomy. A static group comparison design was used to gather data from 80 deaf children and 190 hearing children who attended either a local public school for the deaf and the blind, or the regular public schools. Children were assigned to three groups according to age: 5–7 years, 8–11 years, and 12–15 years. Differences in deaf and hearing childrens scores on the Draw-A-Person Test of general abilities were not statistically significant. Childrens knowledge of internal body parts was assessed using a projective drawing test. Results indicated that (a) deaf children in successively older age groups knew more internal body parts than the younger subjects, and (b) deaf children in all three age groups knew significantly less about internal body parts than subjects in their normally hearing cohort.

Nurse practitioner perceptions of barriers and facilitators in providing health care for deaf American Sign Language users: A qualitative socio-ecological approach

BACKGROUND AND PURPOSE Nurse practitioners (NPs), as well as all healthcare clinicians, have a legal and ethical responsibility to provide health care for deaf American Sign Language (ASL) users equal to that of other patients, including effective communication, autonomy, and confidentiality. However, very little is known about the feasibility to provide equitable health care. The purpose of this study was to examine NP perceptions of barriers and facilitators in providing health care for deaf ASL users. DATA SOURCES Semistructured interviews in a qualitative design using a socio-ecological model (SEM). CONCLUSIONS Barriers were identified at all levels of the SEM. NPs preferred interpreters to facilitate the visit, but were unaware of their role in assuring effective communication is achieved. A professional sign language interpreter was considered a last resort when all other means of communication failed. Gesturing, note-writing, lip-reading, and use of a familial interpreter were all considered facilitators. IMPLICATIONS FOR PRACTICE Interventions are needed at all levels of the SEM. Resources are needed to provide awareness of deaf communication issues and legal requirements for caring for deaf signers for practicing and student NPs. Protocols need to be developed and present in all healthcare facilities for hiring interpreters as well as quick access to contact information for these interpreters.

Deaf and hearing mothers' interactions with normally hearing infants and toddlers

The purpose of this study was to compare the interactions between Deaf mothers and their normally hearing infants and toddlers with the interactions between hearing mothers and their normally hearing infants and toddlers. The Nursing Child Assessment Teaching Scale (NCATS), modified to credit Deaf mothers and their children for both spoken and signed communications, was used to assess mother-child interactions. There were no statistically significant differences in scores on the NCATS Parent subscales, NCATS Child subscales, or in total NCATS scores of the Deaf mother/child dyads compared with the hearing mother/child dyads. Implications for clinical practice are discussed.