A Culturally and Linguistically Specific Deaf Depression Screener

描述（由申请人提供）：拟议的研究将利用定性（焦点小组;深入访谈）和定量（现场测试;计算敏感性和特异性）的方法，以开发一个文化和语言上可访问的抑郁症筛选器的CD-ROM在美国手语。抑郁症是初级保健中最常见的心理健康状况。抑郁症导致大量的工作时间损失和功能状态下降，造成与重大医疗疾病相当的残疾程度。幸运的是，早期识别和适当的治疗显着减少抑郁症对大多数患者的负面影响。虽然有几种抑郁症筛查工具可用于初级保健的一般人群，但对于使用美国手语作为他们第一和最舒适语言的聋人患者来说，在初级保健中筛查抑郁症可能很困难，如果不是不可能的话。这些聋人往往缺乏足够的英语阅读技能来回答书面形式的问题。此外，一项试点研究表明，那些文化上失聪的人并不像筛查工具的开发者那样对抑郁症有相同的概念。因此，即使有一个手语翻译可以解释一个英语筛选可能不会产生有意义的结果。聋人在寻求精神健康筛查和治疗方面面临文化障碍，处境更为不利。这个抑郁症筛查工具将符合DSM-IV标准，将满足聋人的特定语言和文化需求。它还将满足初级保健医生、急诊室医生和其他照顾聋人的健康和服务机构工作人员对这种抑郁症筛查的需求。公共卫生相关性：抑郁症是美国最常见的精神疾病，导致残疾和工作时间损失，与重大身体疾病相当。在接受初级保健服务时，查明聋人等得不到充分服务的人群的抑郁症是公共卫生的一个优先事项。拟议的项目将开发一个文化和语言特定的抑郁症筛查在美国手语，用于初级保健和其他健康和服务环境。

DESCRIPTION (provided by applicant): The proposed research will utilize qualitative (focus groups; in-depth interviews) and quantitative (field testing; calculation of sensitivity and specificity) methods to develop a culturally and linguistically accessible depression screener on CD-ROM in American Sign Language. Depression is the most common mental health condition managed in primary care. Depressive illness results in considerable work time loss and functional status decline causing levels of disability comparable to that of major medical illness. Fortunately, early identification and proper treatment significantly decrease the negative impact of depression in most patients. Although several depression screening instruments are available for the general population of patients in primary care, for deaf patients who use American Sign Language as their first and most comfortable language, being screened for depression in primary care can be difficult, if not impossible. These deaf individuals often lack adequate English reading skills to answer the questions in written form. Furthermore, a pilot study has indicated that those who are culturally deaf do not share the same concept of depression as is held by the developers of screening instruments. Therefore even having a sign language interpreter available to interpret an English-language screener may not yield meaningful results. Deaf persons are further disadvantaged in having cultural barriers to seeking mental health screening and treatment. This depression screener which will be keyed to DSM-IV criteria, will meet the specific linguistic and cultural needs of deaf individuals. It will also meet the need for such a depression screener for primary care physicians, emergency room physicians and other health and service agency staff who care for deaf patients. PUBLIC HEALTH RELEVANCE: Depression is the most prevalent form of mental illness in the US, causing disability and loss of work time comparable to major physical illness. The identification of depression in underserved populations, such as the deaf population, at the time of visits to primary care is a public health priority. The proposed project will develop a culturally and linguistically specific depression screener in American Sign Language, for use in primary care and other health and service settings.