Browsing by Author "Arasa, Josephine"
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Item Correlation of psychosocial support concerns and depression in Deaf adults at Nairobi and Kajiado Counties, Kenya(2021-09-18) Ngugi, Joyce, Wangari; Basnight-Brown, Dana; Arasa, JosephineThe Deaf are considered persons with disabilities owing to societal stigma resulting in inequality and discrimination. The sequential mixed methodology utilized a cross-sectional approach, with interviews translated and administered in Kenyan Sign Language. The MMSE screened for mental status, while PHQ-9 assessed for depression and WSAS for Psychosocial Support Concerns (PSS) concerns. Researcher-designed in-depth interviews explored qualitative themes. In addition, Focus Group Discussions, ethnographic observation checklist, and mental health providers’ key informant interviews corroborated data. Deaf adults (N=100, 83% response rate) reported inadequate counseling access (62%) while 55% reported no depression. However, 45% depicted clinically significant depression levels, with a notable 28% of Deaf adults also indicating suicidality. Content analyses revealed family, socioeconomic welfare and stigma as the topmost PSS concerns. The study found a significant positive correlation between depression and overall PSS concerns at 0.225 (p=0.024), and home management PSS concern with depression at 0.253 (p=0.011). ANOVA analyses revealed statistically significant differences between the depression categories’ effects on PSS concerns, F = 3.22, p =.026. T-tests analyses indicated that means for None and Mild Depression (M=8.93, SD=8.80) were significantly lower than for Severe depression, t (13) = -3.16, p = .007, 95% CI [-15.15, -2.85]; and Moderately Severe (M=12.64, SD=7.40) were significantly lower than for Severe depression, t (13) -2.67, p = .019, 95% CI [-9.57, -1.00]. The study implications are to design Deaf-friendly assessments. The study recommends Deaf-centric interventions and for further study, national census on Deaf mental health and development of instruments normed for Kenyan Deaf populations.Item Methodological considerations of clinical research with Deaf adults in Kenya(2021-09-18) Ngugi, Joyce, Wangari; Basnight-Brown, Dana; Arasa, JosephineClinical research with adults who are Deaf in Kenya is nascent and with a loose array of methodological considerations detailed by various authors (Kakiri, 2019). Indeed, Deaf clinical research considerations are necessary for viable outcomes. A desk review of Deaf studies found that there are certain global sets of principles on ethical research and clinical practice considerations with Deaf populations. The document analysis method was used in this literature review, revealing the need for modifications to the standard protocol including the use of a visual-spatial language (Kenyan Sign Language) rather than a spoken language (English), as well as coding and procedural variations from the standardized protocol to fully accommodate Deaf culture. The use of Deaf research assistants or/and the researcher’s reflexivity as a Hearing signing researcher are certain key component of field research considerations. Since the Deaf are a marginalized sub-set of the population, paradigmatic as well as methodological considerations are recommended for effective clinical research in Kenya.