A Culturally and Linguistically Specific Deaf Depression Screener

描述(申请人提供)：拟议的研究将利用定性(焦点小组；深度访谈)和定量(实地测试；计算灵敏度和特异度)的方法来开发一种在美国手语光盘上的文化和语言上可访问的抑郁症筛查。抑郁症是初级保健中最常见的心理健康状况。抑郁症导致相当大的工作时间损失和功能状态下降，导致的残疾程度与重大疾病相当。幸运的是，早期识别和适当的治疗大大减少了大多数患者抑郁的负面影响。尽管初级保健中的普通患者可以使用几种抑郁症筛查工具，但对于将美国手语作为第一语言也是最舒服的语言的聋人患者来说，在初级保健中进行抑郁症筛查即使不是不可能，也是困难的。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，一项初步研究表明，文化上失聪的人与筛查仪器的开发者所持的抑郁症概念并不相同。因此，即使有手语翻译器来翻译英语屏幕，也可能不会产生有意义的结果。聋人在寻求心理健康筛查和治疗方面存在文化障碍，进一步处于不利地位。这款抑郁症筛查器将符合DSM-IV标准，将满足聋人特定的语言和文化需求。它还将满足初级保健医生、急诊室医生和其他护理聋人的卫生和服务机构工作人员对这种抑郁症筛查的需求。与公共健康相关：抑郁症是美国最常见的精神疾病，与重大的身体疾病相比，它会导致残疾和工作时间损失。在服务不足的人群中，如聋人，在寻求初级保健时发现抑郁症是一项公共卫生优先事项。拟议的项目将开发一种文化和语言上特定的美国手语抑郁症筛查器，用于初级保健和其他卫生和服务环境。

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.