Experiences of Health Care Workers Regarding Maintenance of Confidentiality Concerning Hearing Challenged People in Selected Public Health Facilities in eThekwini District, South Africa

Communication between a health care provider and a patient is a pre-requisite for any intervention to occur in the process of health care. Deaf patients depend on interpreters when seeking health care. Confidentiality is an issue since interpreters are involved in the Deaf community. Health care workers (HCWs) are tasked to ensure that the delivery of information to the patient is accurate and kept confidential. A descriptive exploratory qualitative design was used to explore the experiences of HCWs regarding the maintenance of confidentiality for hard of hearing patients. The study population comprised HCWs who worked with hearing challenged patients. Purposive sampling, which is a type of non-probability sampling, was utilized to select the study participants from the population. This research study was conducted at two hospitals in eThekwini District. Structured interviews, using an interview schedule, were used to collect data. The actual sample size was 10 participants. Data was analysed using Tesch’s eight steps of thematic analysis. Six major themes emerged from the data analysis namely training of health care workers, communication preferences for hard of hearing patients, communication challenges, health care worker-patient relationship, involvement of family members as interpreters and measures to maintain confidentiality. Majority of participants experienced communication challenges with patients who are hard of hearing since only few HCWs are trained in sign language. The findings of this study will contribute to addressing issues related to the maintenance of confidentiality of hard of hearing patients. This study does not claim to exhaust the subject but to raise awareness of new investigations in other realities. Further research in the larger representative population of HCWs and hard of hearing patients is necessary to make the health care system more accessible and communication with HCWs more satisfying and effective.

Romantic involvement and mental health in sexual and gender minority emerging adults assigned female at birth

We examined whether romantic relationship involvement, a well-established protective factor against mental health problems among heterosexual adults, is also protective for sexual and gender minority emerging adults assigned female at birth (SGM-AFAB), a group at high risk for mental health issues. Using cross-sectional data from a community sample of 222 SGM-AFAB ages 18–20 years, we assessed associations between current relationship involvement and five mental health variables: depressive symptoms, anxiety symptoms, alcohol use problems, cannabis use problems, and illicit drug use. There were no differences by romantic involvement in problematic cannabis use or other illicit drug use. Overall, participants in a relationship reported fewer depressive symptoms, fewer anxiety symptoms, and less problematic alcohol use than participants who were single. Some associations differed, however, by participant gender identity, sexual orientation identity, and partner gender. Specifically, relationship involvement was associated with fewer depressive and anxiety symptoms for cisgender female participants ( n = 154) but not for gender minority participants ( n = 68) and for lesbian participants ( n = 38) but not for bisexual/pansexual participants ( n = 134) or those with other sexual orientation identities ( n = 50). Participants romantically involved with a cisgender female partner ( n = 43) had fewer depressive and anxiety symptoms than single participants ( n = 100), those with a cisgender male partner ( n = 56), and those with a gender minority partner (n = 23). Together, these findings suggest that romantic involvement may promote mental health for many, but not all, SGM young adults, highlighting the importance of attending to differences among SGM subgroups in research and efforts to reduce mental health and substance use disparities.

Prevalence of Romantic Experiences and Competencies Among 14 to 17 Year Olds: Implications for the Primary Care Setting

Using data from 600 adolescents (14-17 years old) from the 2015 National Survey of Sexual Health and Behavior, we examined the prevalence and demographic correlates of adolescents’ romantic activities (ie, group dating, dyadic dating, and relationship involvement) and their confidence in avoiding unwanted romantic experiences. Overall, 55.8% of adolescents had engaged in at least one romantic activity. More adolescents reported having gone on dyadic (42.1%) and group (37.3%) dates than had been involved in romantic relationships (32.9%). Age and gender were the most consistent correlates of each romantic activity. Each type of romantic activity becomes more common as adolescents mature. Female adolescents were less likely to report romantic activities. Approximately 25.7% of adolescents were not confident that they could turn down unwanted dates, and 34.3% were not confident that they could end a relationship they no longer wanted to be in. Clinicians can draw on our results when discussing romantic development with their adolescent patients.

Patient Views on Advance Care Planning in Cirrhosis: A Qualitative Analysis

Aim. To investigate patient experiences and perceptions of advance care planning (ACP) process in cirrhosis. Methods. Purposive sampling was used to identify and recruit participants (N = 17) from discrete patient groups: compensated with no prior decompensation, decompensated and not yet listed for transplant, transplant wait listed, medical contraindications for transplant, and low socioeconomic status. Review and discussion of local ACP videos, documents, and experiences with ACP occurred in two individual interviews and four focus groups. Data were analyzed using inductive content analysis including iterative processes of open coding, categorization, and abstraction. Results. Three overarching categories emerged: (1) lack of understanding about disease trajectories and ACP processes, (2) roles of alternate decision makers, and (3) preferences for receiving ACP information. Most patients desired advanced care-planning conversations before the onset of decompensation (specifically hepatic encephalopathy) with a care provider with whom they had a trusting, preexisting relationship. Involvement of the alternate decision makers was of critical importance to participants, as was the use of direct, easy to understand patient education tools that address practical issues. Conclusion. Our findings support the need for early advance care planning in the outpatient setting. Outpatient clinicians may play a key role in facilitating these discussions.

Relationship Role Transitions and Problem Alcohol Use in Emerging Adulthood

Normative reductions in problematic drinking behavior throughout emerging adulthood are often described as “maturing out.” Theories of maturing out most often implicate developmental role changes as a primary determinant of this process—particularly relationship roles. Previous work has commonly focused on macro-level role changes (e.g., marriage, parenthood) and larger timescales, examining roles that change from year to year. Smaller, shorter term changes (i.e., incremental changes) in roles that likely evolve during young adulthood seldom have been tested. Accordingly, the current study examined short-term, temporally proximal associations among incremental relationship transitions and problematic drinking during the transition out of college. We found that incrementally deeper relationship involvement prospectively predicted problematic drinking reductions during this period and that this did not differ based on graduation status. Findings support the importance of incremental, microlevel changes in relationship involvement for drinking behavior in emerging adulthood.