Understanding future anxiety and adaptive coping through a mixed-methods lens: experiences of female hard of hearing students in Saudi Arabia.

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Learn more: PMC Disclaimer | PMC Copyright Notice BMC Psychol . 2026 Mar 4;14:501. doi: 10.1186/s40359-026-04304-z Search in PMC Search in PubMed View in NLM Catalog Add to search Understanding future anxiety and adaptive coping through a mixed-methods lens: experiences of female hard of hearing students in Saudi Arabia Nourah Ibrahim Albash Nourah Ibrahim Albash 1 Special Education Department, College of Education, King Faisal University, Al-Ahsa, 31982 Saudi Arabia Find articles by Nourah Ibrahim Albash 1, ✉ Author information Article notes Copyright and License information 1 Special Education Department, College of Education, King Faisal University, Al-Ahsa, 31982 Saudi Arabia ✉ Corresponding author. Received 2025 Oct 29; Accepted 2026 Mar 2; Collection date 2026. © The Author(s) 2026 Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/ . PMC Copyright notice PMCID: PMC13067526  PMID: 41782141 Abstract Background Future anxiety is one of the most prominent psychological issues faced by female deaf and hard of hearing (DHH) students. It directly affects psychological stability and trajectories in education and career. Aim The present study aimed to identify the level of future anxiety and its dimensions, examine the factors influencing it, and explore the coping practices used to manage it among female hard-of-hearing (HOH) high school students in Saudi Arabia. Methodology Sequential explanatory design, a type of mixed-methods research, was employed in the study. Quantitative data were collected using a researcher-developed scale administered to 39 female HOH students to assess their levels of future anxiety and to identify the most prominent dimensions of future anxiety as indicated by the participants’ responses. Qualitative data were subsequently collected through individual in-depth interviews conducted with nine of the students who had completed the scale. Interview questions were designed to obtain deeper insights from this representative group regarding the factors affecting future anxiety and the coping mechanisms these students employ to deal with the future anxiety they experience. The quantitative findings guided the selection of the qualitative sample and informed the analysis in the qualitative phase; participants with the highest scores on the scale were purposefully recruited for the qualitative interviews. Quantitative data were analyzed using frequency, means, and standard deviation to examine the level of future anxiety and its key dimensions. Qualitative data were analyzed using thematic analysis. Results Quantitative results revealed these participants exhibit a high level of future anxiety, with academic anxiety being the most prevalent dimension. Five subthemes of factors influencing future anxiety were identified in the qualitative data, which were psychological and social, linguistic, family, educational, and economic. The results also revealed this population employs certain coping practices to manage their future anxiety, which include faith in and reliance on God, researching and exploring future opportunities, making decisions at the right time, developing self-confidence and self-esteem, engaging in positive distraction, and receiving family and social support. Conclusions Strengthening coping strategies was found to play a pivotal role in mitigating future anxiety and promoting resilience among female HOH students in Saudi high schools. In particular, enhancing psychological support, family involvement, and educational guidance may help these students better manage concerns about academic and career futures, and improve their overall emotional well-being and sense of security regarding the future. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-026-04304-z. Keywords: Future anxiety scale, Anticipatory anxiety, Hard of hearing students, Auditory difficulties, Hearing loss, Mixed-methods research Introduction It is estimated that approximately 1.5 billion people worldwide experience some degree of hearing or auditory difficulty, a figure projected to rise to 2.5 billion by 2050 [ 1 ]. Within educational contexts, researchers have consistently found that Deaf and Hard of Hearing (DHH) students encounter greater academic and developmental challenges than their hearing peers, including slower academic progress and higher dropout rates [ 1 ]. Disabilities related to hearing affect not only access to auditory input, but also linguistic, cognitive, and social development; this combination of factors complicates the ability of DHH students to participate in even inclusive learning environments [ 2 , 3 ]. Another factor affecting linguistic and cognitive development in DHH individuals is early language deprivation [ 4 ]. These types of developmental delays extend beyond academic learning to influence emotional well-being and psychological adjustment [ 5 ]. Studies show that the DHH are also more vulnerable than hearing populations to mental health issues, such as emotional and anxiety disorders, particularly during adolescence [ 6 – 8 ]. Among these challenges, future anxiety emerges as particularly impactful to DHH students. Also referred to as anticipatory anxiety, future anxiety refers to the cognitive–emotional state that arises when an individual’s expectations and interpretations of major life-stage events, including high school graduation, entering university, or pursuing a career generate fear, uncertainty, and apprehension [ 9 ]. Thus, the traits of the condition differ from those of general anxiety or academic stress. For DHH students in particular, future anxiety is often linked to concerns about educational achievement, employment opportunities, social relationships, and independence in adulthood [ 10 – 12 ]. These concerns may be intensified by irrational beliefs, negative self-perceptions, and maladaptive coping patterns, which further undermine self-esteem and psychological stability [ 10 ]. However, future anxiety among the DHH cannot be explained solely by their level or type of hearing itself. Rather, it is shaped by a complex interaction of developmental and contextual factors, including early language deprivation, limited access to appropriate educational and medical services, and persistent social barriers [ 13 , 14 ]. Social experiences such as stigma, marginalization, and overprotection have been shown to exacerbate feelings of helplessness and psychological distress [ 15 – 17 ]. In this regard, the concept of Language Deprivation Syndrome has been introduced to describe the long-term psychological and cognitive consequences of early language deprivation [ 18 ]. Supporting this view [ 19 ], found that language anxiety is closely associated with lower linguistic competence, highlighting the interdependence between communication difficulties and emotional vulnerability. Moreover, the persistence of social stereotypes that assume intellectual inferiority among DHH individuals reinforces prejudice and social exclusion. Adolescence represents a particularly sensitive developmental stage for DHH students, as it involves identity formation, increased academic demand, and future-oriented life planning [ 20 ]. During this period, individuals become more aware of social expectations and institutional constraints, which may intensify uncertainty about their future roles and opportunities. However, research has demonstrated that adaptive coping strategies, such as psychological flexibility, resilience, and positive reinterpretation, can mitigate the impact of anxiety and support emotional adjustment [ 21 – 24 ]. Individuals with higher resilience are better able to regulate negative emotions, reduce over-thinking stressors and/or decisions, and maintain psychological balance when facing uncertainty [ 25 , 26 ]. Consequently, there is a growing need for culturally sensitive psychological interventions that alleviate future anxiety and foster adaptive functioning among DHH individuals [ 12 ]. The current study seeks to address this need by identifying the level of future anxiety among the specific subset of the larger DHH population termed Hard of Hearing (HOH). Individuals in this category have hearing in the range of 35 dB to 68 dB and therefore experience difficulty understanding speech [ 27 ]. The factors that influence future anxiety were examined and coping practices used to alleviate it were explored. This research focus is supported by the findings of authors such as [ 20 ], who advocate for greater involvement of DHH individuals in research through bilingual teams to ensure equitable participation and effective communication. Literature review Quality of life and other social impacts The nature of hearing-related disabilities has been shown to have profound impact on DHH individuals’ quality of life, with the potential to drive social isolation, emotional withdrawal, and vulnerability to depression and anxiety [ 28 ]. Social stigma, rooted in fear of negative social evaluation and a common challenge experienced by the DHH, is closely linked to social appearance anxiety, a condition that undermines self-esteem and heightens emotional vulnerability [ 29 ]. Beyond concerns related to appearance or social judgment, DHH individuals encounter persistent communication barriers that extend across personal, educational, and professional contexts, restricting effective social participation and creating loneliness, reduced life satisfaction, and compromised mental health [ 7 , 30 , 31 ]. Early language/communication factors From a developmental perspective, communication access plays a critical role in shaping emotional regulation and future-oriented thinking. Emotional regulation and planning for the future are higher-order competencies that depend heavily on early and sustained exposure to language and auditory input. Consequently, limited auditory stimulation during early developmental stages can hinder the acquisition of emotional, linguistic, and social skills. For instance, researchers have demonstrated that families who lack effective communication strategies for their DHH children tend to raise individuals with lower quality of life, poorer social adjustment, and fewer emotional coping resources [ 7 ]. From a metacognitive standpoint, these outcomes can be understood through deficits in the DHH individual’s ability to monitor and regulate their own cognitive and emotional processes, which are essential for adaptive functioning [ 32 ]. In this sense, communication barriers do not merely restrict language acquisition, they also constrain the development of emotional self-regulation and psychological resilience, thereby reinforcing cycles of anxiety, self-doubt, and low self-esteem. Anxiety and other mental health challenges A growing body of empirical research indicates that DHH individuals exhibit higher levels of anxiety than their hearing peers, suggesting that anxiety constitutes a central emotional feature within this population. For example [ 33 ], found that anxiety disorders among deaf individuals in Iran are strongly associated with low emotional awareness and difficulties in identifying and regulating emotions. These findings align with broader evidence that emotional dysregulation is a common consequence of early language deprivation and limited social interaction. When focusing specifically on future anxiety, existing research highlights its distinct and multifaceted nature among DHH populations [ 34 ]. reported that deaf adolescents experience significantly higher levels of future anxiety compared to hearing adolescents. Similarly [ 35 ], found that deaf children demonstrated elevated anxiety within the family domain, reflecting heightened concerns about relational stability and social acceptance. In [ 36 ], a pattern of existential and anticipatory anxiety among deaf individuals was identified, characterized by fear of uncertainty and limited control over future outcomes. Social anxiety has also been shown to be more pronounced among deaf individuals and closely linked to maternal bonding and peer relationships [ 37 ]. Moreover [ 38 ], demonstrated that gender plays a moderating role, with female adolescents displaying greater sensitivity to social anxiety and interpersonal stressors. Within familial and social contexts, the quality of parental and peer relationships plays a crucial role in shaping emotional experiences. In a study conducted in Saudi Arabia [ 39 ], found that young DHH women about to get married emphasized the anxiety and stress caused by social factors, such as stigma, lack of understanding regarding the causes of hearing-related disabilities, fear of social rejection, and family interference in life decisions. These stressors contribute to elevated future anxiety related to marital and familial stability. In educational and occupational domains [ 40 ], documented high levels of academic and occupational future anxiety among deaf high school students, largely driven by uncertainty about career prospects, limited vocational guidance, and restricted access to education. Synthesizing the findings across these studies, it becomes evident that anxiety, in its various forms, constitutes a pervasive feature of the emotional and psychological profile of DHH individuals. Furthermore, among its manifestations, future anxiety emerges as one of the most complex and multifaceted types, given its deep connections to familial dynamics, educational opportunities, and social acceptance. Statement of the problem Future anxiety has been widely documented in the literature as a significant psychological concern among DHH students, particularly due to its association with low self-confidence, academic difficulties, and challenges in social adjustment [ 7 , 31 ]. Compared to their hearing peers, DHH students tend to experience higher levels of anxiety, which negatively affects their psychological well-being and social functioning [ 41 , 42 ]. These concerns are further intensified by structural challenges, such as limited access to higher education, restricted employment opportunities, and difficulties in forming stable marital relationships [ 36 ]. From a theoretical perspective, this study is grounded in Erikson’s psychosocial development theory, which conceptualizes human development as a series of stages characterized by psychosocial crises. Two stages are particularly relevant to the phenomenon of future anxiety. In Stage Five (Identity vs. Role Confusion), individuals attempt to construct a coherent identity through academic and vocational choices; failure to achieve this may increase uncertainty and future-oriented anxiety [ 40 , 43 ]. In Stage Six (Intimacy vs. Isolation), individuals seek emotional closeness and stable relationships, and difficulties in this domain may lead to feelings of isolation and further exacerbate anxiety [ 44 ]. Together, these stages provide a theoretical framework for understanding why adolescents and young adults, particularly those facing communication barriers, may be especially vulnerable to future anxiety. Empirically, previous research has shown that inadequate psychological and institutional support systems increase the risk of emotional and learning difficulties among DHH students, which in turn negatively influence their academic performance and life trajectories [ 20 , 45 ]. Moreover, while adaptive coping practices have been consistently recognized as effective in reducing anxiety and promoting psychological adjustment [ 12 , 22 – 24 ], their systematic application among female HOH students in high school remains limited. This is particularly true within Arab cultural contexts, and more specifically in Saudi Arabia. Research gap and purpose of the study Despite the extensive literature on anxiety among DHH and HOH populations, several gaps remain. Most existing studies are either culturally nonspecific or rely predominantly on single-method quantitative designs. There is a notable lack of research that adopts culturally grounded, mixed-methods approaches to examine future anxiety and coping mechanisms specifically among female HOH students within Arab and Saudi contexts. Consequently, there remains limited understanding of how these students interpret their futures, what contextual factors shape their anxieties, and how they actively negotiate these concerns through adaptive coping strategies. This gap underscores the need for the present study, which seeks to integrate quantitative assessment with qualitative exploration to provide a more comprehensive and culturally situated understanding of future anxiety among this population. From a contextual standpoint and based on professional experience in the field of DHH education, the researcher has observed that many female HOH students exhibit persistent concerns about their academic futures, career opportunities, and social integration. These observations, however, are treated in this study not as evidence in themselves, but as contextual motivation for systematically investigating the phenomenon. Accordingly, the present study seeks to address these gaps by examining future anxiety using a sequential explanatory mixed-methods design. While quantitative data are used to identify the level and dimensions of future anxiety, qualitative inquiry is employed to explore the subjective meanings, contextual factors, and coping mechanisms underlying these patterns. This integrative approach allows for a more comprehensive understanding of future anxiety as both a measurable psychological construct and a lived, contextually embedded experience. The study contributes to enriching the theoretical literature on future anxiety among female HOH students by examining the interplay between anxiety and related psychological factors. Practically, it aims to assist educators and decision-makers in adopting the proposed adaptive strategies as a model to reduce future anxiety among these students, enhance positive thinking and realistic planning, and ultimately improve their mental health and quality of life in Saudi schools. Based on the stated problem and to ensure methodological coherence, the study seeks to answer the following research questions, which are organized according to data type and analytic purpose: Research questions Quantitative research questions What is the level of future anxiety among female HOH students? What are the most prevalent dimensions of future anxiety among female HOH students? Qualitative research questions 3. What factors influence future anxiety among female HOH students? 4. What adaptive coping strategies are used by female HOH students to deal with the future anxiety they experience? Integration (mixed-methods) question 5. How do the qualitatively identified contextual factors shape the levels and dimensional structure of future anxiety measured quantitatively among female HOH students? Methodology Methods A mixed-methods design, sequential explanatory research design, was deemed the most appropriate for the purposes of the present study. Specifically, the nature of the research questions necessitated moving beyond the initial quantitative findings into a more in-depth qualitative inquiry in the second phase. This specific design is a research approach commonly used in the human, behavioral, and health sciences, in which the researcher collects both quantitative and qualitative data, integrates the two types of data, and then develops interpretations based on the strengths of each data source in order to better understand a research problem or issue [ 46 ]. The design consists of two phases: an initial phase in which the quantitative method is used to obtain preliminary data, followed by a second phase in which the qualitative method is employed to obtain a deeper interpretation of the results based on the findings of the first phase. Integration of the two methods occurs during the participant selection stage and again during the interpretation of results [ 46 ]. Mixed-methods research designs may take different forms and are selected to address three main aspects of a study: sequence, priority (weight), and integration. The sequence dimension determines when quantitative and qualitative data are collected and used within a given study. The priority dimension refers to the level of importance and emphasis assigned to quantitative and qualitative data in answering the research questions. The integration dimension, in turn, concerns where and how quantitative and qualitative data are combined [ 46 ]. Based on these design traits and the objectives of the study, it was determined that sequential explanatory design was the most appropriate design for the current study, with particular emphasis on the research questions, as they served as the primary guide for these methodological decisions. Since the purpose of the quantitative data was to provide an overall picture of the study context, to facilitate the selection of participants for qualitative data collection, and to develop the interview questions for the qualitative follow-up, quantitative data were collected first [ 47 , 48 ]. Given that answering the main research questions required a deeper understanding of participants’ perspectives and perceptions of the phenomenon under investigation, greater priority was assigned to the qualitative data. Finally, quantitative and qualitative data were integrated during the interpretation phase, after the research questions had been addressed. The study proceeded through two phases: first, identification of the level of future anxiety and its most prominent dimensions was achieved through the quantitative phase; second, the key factors influencing this anxiety and the most important coping mechanisms used to reduce it were identified through the qualitative phase. In this way, quantitative and qualitative data were combined and analyzed to interpret the study findings. Figure 1 shows the design scheme of the study. Fig. 1. Open in a new tab The study design scheme Participants and setting The study sample was recruited from high schools for girls implementing inclusive education programming in the Al-Ahsa Governorate, which is a primarily rural area in the Eastern Province. This setting was chosen for the following reasons: (a) underexplored context : the region is less frequently studied than those typically selected for research in Saudi Arabia, providing an important and underexplored perspective for DHH and HOH research, (b) gender-based accessibility : segregation by gender in Saudi Arabian education limits direct researcher accessibility to opposite-gender participants, therefore schools for females were selected to ensure that all who participated in the quantitative phase could potentially participate in face-to-face interviews with a female researcher; and (c) choice of high stage : high school students were the focus as this developmental period represents the transition from adolescence to adulthood, often characterized by heightened anxiety, the emergence of sexual drives, and aspirations for independence [ 49 ]. It is recognized that the choices of setting and demographic characteristics limit generalizability. Thus, these factors were considered during interpretation and the results are presented as representative of the accessible context rather than of the entire national population of high school-aged female HOH students. A total of 49 female HOH students were enrolled in the high schools in the region for AY2025; of this accessible population, 39 consented to participate in the quantitative portion of the study. This participation rate of 79.59% enhances the descriptive validity of the quantitative findings. The absence of full participation is attributed to a number of practical constraints such as student availability, disapproval of participation, and/or communication barriers, which may have introduced minor non-response effects. In the qualitative phase, a purposive subsample of nine participants was selected from the quantitative group. A number of factors informed this decision, including (a) the sensitive nature of the research topic, (b) the difficulty of conducting interviews with all 39 students who had participated in the first phase, who were distributed amongst several of the high schools in the governorate, (c) the desire to conduct interviews with individuals who had scored on the higher end of the author-developed Future Anxiety Scale, (d) participants were selected to reflect variation in age, Type of Hearing Device, and communication methods, ensuring sufficient diversity within the small sample, and (e) the vulnerability of the population mean that limiting the qualitative sample size allowed for in-depth engagement while minimizing participant burden and ethical risk. Data collection continued until no substantially new themes emerged, indicating that thematic saturation had been reached. Tables 1 and 2 present the characteristics of the participants. Table 1. Characteristics of the HOH students who completed the quantitative instrument Variable n % Grade level High School Grade 1 11 28.21 High School Grade 2 13 33.33 High School Grade 3 15 38.46 Assistive technology status Hearing aid 21 53.85 Cochlear implant 9 23.08 None 9 23.08 Preferred communication method Verbal only 12 30.77 Signed only 0 0.00 Bilingual (both verbal and signed language) 27 69.23 Open in a new tab In this study, the term “bilingual” is used to refer to those students who use both a spoken language and a signed language N = 39 Table 2. Characteristics of the HOH students who participated in the qualitative interviews Participant High school year Assistive device Preferred method of communication Post-high future plans P1 Grade 1 Hearing aid Bilingual Attend university P2 Grade 1 Cochlear implant Bilingual Attend university P3 Grade 2 Hearing aid Bilingual Attend university P4 Grade 2 Cochlear implant Spoken language Attend university P5 Grade 2 Hearing aid Bilingual Attend university P6 Grade 3 Cochlear implant Spoken language Attend university while also working P7 Grade 3 Cochlear implant Bilingual Attend university P8 Grade 3 Hearing aid Spoken language Attend university while also working P9 Grade 3 Hearing aid Spoken language Attend university Open in a new tab In this study, the term “bilingual” is used to refer to those students who use both a spoken language and a signed language N = 9 Study instruments Two main tools were employed in the study, both of which were designed to align with the research objectives and the characteristics of the target group. Researcher-developed future anxiety scale Validity and reliability of scale The primary instrument used in this study was a Future Anxiety Scale, developed by the researcher to assess the level of future anxiety among female HOH students. The scale was constructed after a review of previous instruments designed to measure future anxiety among DHH individuals and other relevant literature [ 10 , 40 , 50 ]. To establish content validity, the preliminary version of the scale was reviewed by five experts in special education and psychology who evaluated the appropriateness, clarity, and representativeness of the items for the target population. Revisions were made according to their feedback to enhance face and content validity. To verify internal consistency, Pearson correlation coefficients were calculated based applying the instrument with a pilot sample of 10 female HOH high school students who were not part of the main study sample. The correlation coefficients ranged between 0.3189 and 0.8254, all statistically significant at p = 0.01 or p = 0.05, confirming internal validity. The reliability of the scale was further verified using Cronbach’s Alpha, yielding a coefficient of 0.894, indicating a high level of reliability. The suitability of the data for factor analysis was assessed using the Kaiser–Meyer–Olkin (KMO) measure and Bartlett’s Test of Sphericity (see Table 3 ). The KMO value was 0.366, which is considered low according to conventional statistical criteria; however, this result can be attributed to the small sample size ( N = 39) and the specificity of the target population. In contrast, Bartlett’s test was statistically significant ( p < 0.001), indicating that the correlation matrix was appropriate for factor analysis. The communalities showed that most items were adequately represented within the factor structure, with the majority exceeding the recommended threshold of 0.50. Although a small number of items displayed lower communalities, they were retained for theoretical consistency. The analysis yielded five factors with eigenvalues greater than 1, accounting for approximately 59% of the total variance, which is acceptable for multidimensional psychological scales. After Varimax rotation, most items loaded strongly on a single factor, with relatively low cross-loadings. Conceptually, the extracted factors were broadly consistent with the theoretical structure of the Future Anxiety Scale, reflecting dimensions related to Future self, Social, Academic, Occupational, and Family future anxiety. Although the factor structure did not perfectly replicate the original theoretical model at the item level, the overall pattern supports a coherent five-factor structure. Overall, the results suggest that the scale demonstrates an acceptable level of construct validity within the limitations of the current sample. Table 3. Results of the exploratory factor analysis of the scale Factor Eigenvalue Explained variance (%) Cumulative variance (%) 1 6.953 23.177 23.177 2 3.894 12.981 36.158 3 2.602 8.673 44.832 4 2.422 8.074 52.905 5 1.868 6.226 59.131 Open in a new tab Scale Structure Based on the procedures described in Sect. 3.3.1.1 , the final version of the scale consisted of two sections. Section I comprised four items to obtain demographic information on grade level, type, if any, of assistive device, preferred communication method, and future plans after high school. The main section of the scale, Section II, contained 30 items distributed across the five dimensions of Personal Future Anxiety (Items 1–9), Social Future Anxiety (Items 10–14), Academic Future Anxiety (Items 15–20), Occupational Future Anxiety (Items 21–25), and Family Future Anxiety (Items 26–30). Each of these 30 items was rated on a 3-point Likert scale where 1 = Disagree , 2 = Neutral , 3 = Agree (see Appendix A). Although a 3-point Likert scale may reduce variability and statistical sensitivity, it was deliberately chosen to accommodate the characteristics of the study population, ensuring clarity, ease of understanding, and more accurate responses from HOH students. Scoring Procedure The total score was calculated as follows: Positive items (2, 5, 7, 8, 9, 11, 12, 13, 14, 15, 16, 17, 19, 21, 22, 25, 26, 27, 28) were scored as: (1 = Disagree , 2 = Neutral , 3 = Agree ). Negative items (1, 3, 4, 6, 10, 18, 20, 23, 24, 29) were reverse-scored as: (3 = Disagree , 2 = Neutral , 1 = Agree ). The mean score for each participant ranged from 1.00 to 3.00 (see Table 4 ). Table 4. Ranges for interpretation of level of future anxiety Mean score Level of future anxiety 1.00 − 1.66 Low 1.67–2.33 Moderate 2.34–3.00 High Open in a new tab Individual interviews The semi-structured individual interview was the main qualitative data collection tool for this study. Semi-structured interviews were employed to obtain rich, detailed data from participants, allowing flexibility to modify questions as needed [ 51 ]. The interviews included both main and sub-questions focusing on the participants’ experiences and perceptions regarding the following domains: The main issues that cause anxiety when thinking about the future (e.g., education, work, marriage, and societal expectations). The factors influencing future anxiety. The adaptive coping practices used to manage or alleviate future anxiety. The semi-structured interviews were conducted with nine participants who had previously completed the Future Anxiety Scale (see Appendix B). Each interview lasted approximately 50–60 min. Field notes were taken during and immediately after each interview to capture contextual information, non-verbal cues, and initial analytical reflections. Each session was audio-recorded with participants’ consent and later transcribed verbatim for analysis. Data collection Quantitative After obtaining the necessary ethical and administrative approvals, visits were conducted to the selected schools, and informed consent was obtained first from the students. the researcher administered the study instruments. First, the scale was distributed in a paper-based to all 49 female HOH high school students in the Al-Ahsa Governorate. A total of 39 responses were obtained; remaining students could not be reached due to absence or lack of willingness to participate. Qualitative After reviewing and analyzing the 39 responses, individual students were purposively selected based on the established criteria in the participant selection section (see Sect. 3.2 ). The qualitative phase followed certain steps. First, the preparation stage involved review and validation of the interview questions by qualitative research specialists. Next, data collection was carried out, followed by data analysis. During the interviews, the researcher adapted procedures of data collection to the communication needs of the participants. For example, communication method was determined based on each participant’s stated preference and assistive device status and participants were permitted and encouraged to select a preferred mode of communication, when necessary. Additionally, to ensure participant privacy and comfort during the interviews, these sessions were conducted in a quiet setting, face-to-face, using a semi-structured interview guide to promote psychological comfort and encourage open, accurate responses. Data collection was continued until no substantially new themes emerged, indicating that thematic saturation had been reached. Importantly, participants in the qualitative phase were selected from those who scored highest on the Future Anxiety Scale, ensuring alignment between the quantitative patterns and the qualitative exploration. This strategy strengthened the explanatory function of the sequential design by enabling the qualitative data to directly interpret the most salient quantitative findings. Data analysis Quantitative data were analyzed using SPSS (Version 20). Frequencies, means, and standard deviations were calculated to determine the total scores of students on the Future Anxiety Scale in its various dimensions. Qualitative data were analyzed using Thematic Analysis, an approach that goes beyond descriptive reporting by emphasizing the generation of meaning through identifying connections within the data, examining it from multiple perspectives, exploring relationships, and producing interpretive explanations that lead to deeper insights [ 52 ]. This type of analysis includes, according to [ 53 ], six phases of thematic analysis to guide researchers in applying the method in a step-by-step manner (see Table 5 ). Table 5. Phases of thematic analysis in the current study No. Phase Description 1 Familiarising oneself with the data Familiarisation was achieved through transcribing all interviews, converting them into electronic files, and repeatedly reading the data while noting initial ideas. This phase facilitated immersion in the data and the development of a general understanding of meanings and contexts. 2 Generating initial codes Initial codes were generated inductively through manual coding using Microsoft Word, without reliance on a predefined coding framework. Each sentence or phrase relevant to the research questions was coded to preserve participants’ original meanings. 3 Searching for themes Themes were identified by grouping similar codes, examining relationships among them, and integrating them into main and sub-themes. This process continued until theoretical saturation was reached and no new meaningful themes emerged. 4 Reviewing themes This phase involved checking the internal coherence of each theme and its consistency with the original data, while merging or excluding themes of limited relevance. A thematic “map” of the analysis was also developed. 5 Defining and naming themes Themes were clearly defined and named to reflect their content and enhance analytical clarity. Direct quotations from participants were used to support interpretations and minimize researcher bias. 6 Producing the report This final phase involved selecting compelling data extracts, conducting the final analysis, linking findings to the research questions and relevant literature, and producing a rigorous scholarly report. Open in a new tab Note. Adapted from [ 53 ] Thematic analysis is one of the most widely used approaches for analyzing qualitative data, where the analyst identifies categories based on the data in relation to the research focus and, in some cases, the research questions [ 54 ]. This approach relies on codes derived from textual data and field notes, providing a theoretical foundation for understanding the data and enabling potential theoretical contributions to the relevant literature. This type of analysis is considered integral to qualitative analytical approaches, such as grounded theory and case study research [ 55 ]. Moreover, it is a flexible method that can be applied within different theoretical frameworks, allowing themes to be identified inductively without prior specification. This study is grounded in a clear methodological and philosophical coherence between epistemology, the adopted research approach, and the interpretation of findings. From an epistemological perspective, the study is based on the assumption that knowledge is constructed through understanding human experiences and interpreting the meanings individuals attribute to their experiences within their social and cultural contexts [ 46 , 52 ]. emphasized that understanding the significance of qualitative research in the educational field first requires a thorough awareness of its philosophical and epistemological foundations, which determine the nature of knowledge and the mechanisms through which it is constructed. The constructivist perspective underpinning qualitative research methodologies assumes that absolute objective truth is not fully attainable; rather, the knowledge generated represents subjective constructions arising from individuals’ interactions with their social and cultural contexts. Accordingly, realities are viewed as social constructions formed through social interaction. Based on this view, the social constructivist paradigm assumes that the qualitative researcher must understand individuals’ perceptions and lived experiences within the natural context of the phenomenon under study in order to access and interpret meaning more deeply. This orientation is consistent with interpretive epistemological foundations, particularly symbolic interactionism and social action theory, which emphasize the importance of understanding the meanings individuals assign to their actions and social interactions. Consequently, these methodological perspectives diverge from the assumptions of logical positivism that underpin purely quantitative research. Building on this epistemological stance, the research methodology was selected to align with the nature of the knowledge being sought, as it focuses on in-depth exploration of phenomena and on understanding their dimensions and meanings from the participants’ own perspectives, rather than relying solely on quantitative measurement or statistical generalization. At the level of data interpretation, an interpretive approach was adopted that is sensitive to context and reflects the interactive relationship between the researcher and the data. This ensures that interpretations emerge from the same epistemological framework and remain consistent with the chosen methodology, thereby enhancing the credibility and coherence of the research findings. Therefore, thematic analysis was considered an appropriate analytical approach for the present study. It provided the researcher with a flexible and accessible means of analyzing and interpreting qualitative data through an inductive process, in which themes and categories were generated from the data rather than being predetermined. Despite the systematic organization of the analytical stages in the present study, the process was not linear. Rather, it involved iterative movement between interconnected phases, including revisiting the data, reflecting on earlier stages, and refining interpretations. Trustworthiness and credibility: qualitative data The objectivity and accuracy of the qualitative findings were verified following the procedures suggested by [ 51 ] and [ 52 ]. First, triangulation was implemented to enhance validity by diversifying data sources and minimizing bias. Data were collected from two sources: the Future Anxiety Scale and the individual interviews. Next, expert review was employed. Specifically, five faculty members from Saudi universities specializing in education reviewed the interview questions, and revisions were made based on their feedback. Their suggestions included removing or rewording some questions and adding more detailed ones. Systematic coding was also utilized. For this, the researcher maintained coded notes throughout the analysis process to systematically record and preserve emerging ideas. Finally, participant validation was obtained. To ensure data accuracy, participants were provided with complete written transcripts of their interviews and were asked to review and confirm their validity (member-checking). Results Results related to the first research question To answer this question, the means and standard deviations of the students’ total scores on the Future Anxiety Scale were calculated (see Table 6 ). Table 6. Values of participants’ total scores on the Future Anxiety Scale Statistic Value Mean 2.371 Standard deviation 0.209 Minimum 2.00 Maximum 2.97 Open in a new tab The mean score of future anxiety among the participants was 2.37, which falls within the range of (2.34–3.00). This indicates that the level of future anxiety is high among HOH students. The high level of future anxiety observed among female HOH students carries important functional implications. A mean score within the upper range of the scale suggests that students experience persistent and intrusive concerns regarding their futures. Functionally, this level of anxiety may manifest in heightened cognitive load, reduced concentration, difficulty in decision-making, and increased emotional vulnerability, all of which can negatively affect students’ academic engagement and long-term planning abilities. From a risk perspective, sustained high future anxiety may place HOH students at greater susceptibility to academic disengagement, lowered self-efficacy, and avoidance of future-oriented opportunity. This indicates that future anxiety for this group is not merely an emotional state, but a potential developmental risk factor that may influence educational trajectories, career aspirations, and psychological well-being. Results related to the second research question To address this question, the means and standard deviations of the students’ total scores were calculated for each of the five dimensions of the scale (see Table 7 ). Table 7. Means and standard deviations of the total scores across five dimensions of the Future Anxiety Scale Dimension M SD Min Max Future self-anxiety 2.307 0.258 1.78 2.89 Social future anxiety 1.979 0.518 1.00 3.00 Academic future anxiety 2.645 0.308 1.83 3.00 Occupational future anxiety 2.564 0.250 2.20 3.00 Family future anxiety 2.359 0.449 1.40 3.00 Open in a new tab N = 39 The mean scores of the five dimensions of future anxiety ranged between 2.64 and 1.97, with academic future anxiety being the most prevalent dimension among the students, while social future anxiety was the least prevalent. Functionally, the predominance of academic future anxiety suggests that students’ primary concerns are centered on educational achievement, access to higher education, and future career opportunities. Conversely, lower levels of social future anxiety indicate relatively fewer concerns related to social acceptance and interpersonal relationships. Results related to the third research question To answer the third research question, the Concept Analysis Method (CAM) was employed to analyze participants’ responses. The qualitative findings were used to interpret and expand the quantitative results by identifying the contextual factors shaping future anxiety among female HOH students. Five main subthemes emerged. Psychological and social factors All participants agreed that several psychological and social factors directly affect their feelings of future anxiety, either negatively or positively, particularly through difficulties in emotional expression, self-perception, and sensitivity to social evaluation. Participants described persistent internal tension and rumination that intensified their uncertainty about the future. One participant stated: “I have a problem expressing my feelings and needs to others… When I put my head on the pillow, I think about everything and cannot sleep easily” (P3). Another participant linked anxiety to physical appearance and repeated medical procedures, noting: “I don’t have an outer ear, so I cannot hear. Every now and then, I undergo surgery where they take a part of my body and add it to the ear area. Each time, I get nervous and very anxious before entering the operation, and I also worry about how others look at me” (P6). However, this psychological vulnerability was not uniformly translated into social anxiety, as some participants reported high levels of social acceptance due to their ability to communicate verbally. Therefore, they did not consider society a major source of anxiety. As one participant explained: “I speak normally, so I don’t worry about facing problems with my classmates, at work, with my manager, or even with my future husband” (P8). This variation suggests that future anxiety is mainly experienced internally, while its social impact depends on communication abilities and perceived social acceptance. Linguistic factors Linguistic factors were strongly associated with future anxiety, with language barriers being perceived as the root cause of many challenges the HOH experience. For example, language barriers shaped participants’ perceptions of academic competence and social participation. Several participants described constant reliance on others for clarification, which generated fears of exclusion and dependency. One participant explained: “I always need someone to explain what I hear… especially if the speech is fast or quiet. This makes me very anxious because I fear that others will avoid me” (P5). These experiences frame language not only as a communication difficulty, but as a symbolic indicator of future limitation, particularly in educational and professional contexts, which leads to fear of failure. Nevertheless, this pattern was not universal. A minority of participants reported minimal linguistic challenges and expressed confidence in spoken communication, indicating that linguistic anxiety varies according to the individual’s perceived and real communication competency, which may be linked to their type of assistive technology, other resources, and institutional support. Family factors Factors related to family emerged as a major influence on future anxiety, with participants indicating that positive family support enhances their emotional security, motivation, and perceptions of self-worth. Participants described their families as a primary source of encouragement and reassurance. One stated, “My family believes in me and my abilities… This makes me less anxious that they will blame me if I fail” (P9). Another participant emphasized that having other HOH family members normalized her experience, stating “I have a brother and a sister who are HOH, so my situation is completely normal” (P5). These accounts suggest that family acts as an emotional buffer; however, such support was not uniform across all participants. Those without similar family experiences reported higher perceived pressure, indicating that family understanding is contingent on shared lived experience. Educational factors The findings from the interviews indicate that the role of educational institutions in shaping future anxiety is more ambiguous, with these organizations being described as being both sources of empowerment as well as psychological neglect. Some participants described the positive impact of supportive teachers on their academic confidence. One participant stated, “One teacher played a big role in improving my academic level…especially in Arabic. it is reduced my university-related anxiety a lot because I felt that my level had improved” (P7). In contrast, others perceived limited psychological engagement from educators, as one participant explained: “Teachers don’t usually get involved in psychological issues like anxiety” (P3). These contrasting experiences suggest that institutional influence on anxiety is highly individualized and dependent on the teacher’s personal characteristics rather than systemic educational structures. Economic factors Economic factors generated a form of structural future anxiety rooted in perceived labor market exclusion and long-term financial dependency. Participants expressed concern about limited employment opportunities and restricted university majors. One participant stated, “Our fate is sealed. The majors available to us are not needed in the job market, and that makes us afraid of not finding a suitable job” (P1). Another emphasized uncertainty about future independence, “I think about this a lot. My family supports me financially now, but until when?” (P4). These concerns reflect not personal pessimism, but rational interpretations of systemic constraints, positioning economic anxiety as a socially produced rather than individually constructed phenomenon. Results related to the fourth research question To answer the fourth research question, the researcher again employed the Concept Analysis Method (CAM) to analyze participants’ responses. The findings revealed several coping practices used by female HOH students to manage their future anxiety. These practices were categorized into six subthemes, as shown below: Faith in and reliance on God Faith emerged as the primary emotional and cognitive regulator through which participants managed anxiety. Participants described prayer and spiritual reliance as sources of reassurance and psychological stability. One participant stated, “When I pray, I feel a great sense of relief” (P4), while another noted, “The closer I am to God, the more peaceful I feel, and the more I stay away from thoughts that exhaust me” (P3). Faith thus functioned as a culturally embedded coping system, providing meaning, emotional containment, and relief of anxiety. Researching and exploring future opportunities Several participants stated that seeking out information on available opportunities following their graduation from high school and exploring these future options in-depth helps reduce anxiety. By actively searching for answers, the participants indicated they gain a sense of control. One participant shared: “When I think too much about something, I go and search about it online. For example, regarding university, I look up which universities in Saudi Arabia accept us and what majors are available for us… This makes me feel a bit better” (P9). However, others avoided doing such research due to emotional overload. One participant explained: “Usually, I avoid thinking about the things that make me anxious. I don’t even try to search for them or go into details, because when I do, I get more distracted and start realizing things I wasn’t aware of before” (P6). This dual pattern indicates that exploration can either empower or overwhelm, depending on individual tolerance for anxiety. Making decisions at the right time Some participants reported that they deal with anxiety by making proactive decisions to improve their situation. One participant explained, “I decided to move to a regular school to increase my chances to enroll in a medical program” (P2). Such decisions reflect attempts to regain control over uncertain futures for this group. Self-confidence and self-esteem development Positive self-concept played a central role in resilience and adaptive meaning-making. Participants reframed disability as difference rather than deficiency. One participant stated, “I’m no different from others. I can study, work, and get married just like everyone else” (P1). Another remarked that being HOH can even offer unexpected advantages: “Hearing impairment can be a positive thing. I see that universities are more lenient with hearing-impaired students and make admission procedures easier than for hearing students. Two of my sisters are hearing, and they couldn’t get into university, while my cousin, who is hard of hearing, was admitted” (P4). These narratives indicate that self-esteem may function as a psychological shield against anxiety. Positive distraction Engaging in positive distraction was described by some of those interviewed as serving as emotional regulation through attentional redirection, essentially keeping busy with enjoyable activities to divert attention from anxious thoughts. One participant stated, “I try to distract myself with something else, like exercising or walking around the house. This helps me think less” (P8), while another noted, “Cooking helps me forget my worries” (P1). These practices reduced cognitive rumination rather than addressing anxiety directly. Receiving family and social support Family and social support operated as a relational buffer against anxiety. One participant explained, “My family supports me in everything. I’ve learned to work hard to achieve my goals for my family. it reduces feelings of guilt or anxiety” (P5). Another emphasized societal inclusion, “I haven’t faced any problems in society. On the contrary, people always support and help us solve our problems… I don’t feel that my hearing loss is a problem” (P3). Together, these accounts suggest that family and social support function as key protective factors that transform future anxiety into a shared and manageable experience, rather than an isolated psychological burden. However, this protective role appears to depend on the quality and consistency of support, as not all participants reported the same level of understanding or emotional availability within their social environments. This indicates that social support is not uniformly accessible but varies according to interpersonal dynamics and contextual conditions. Results related to the fifth research question The integration of quantitative and qualitative findings allowed for the development of a comprehensive explanation of how future anxiety is constructed and experienced among female HOH students. Quantitatively, the results revealed a high overall level of future anxiety, with academic future anxiety emerging as the most dominant dimension. The qualitative findings extend and contextualize these results by uncovering the underlying mechanisms through which contextual factors shape both the intensity and structure of future anxiety. Linguistic factors were found to play a foundational role in shaping academic future anxiety. Participants’ accounts highlight persistent difficulties in understanding spoken language, reliance on others for clarification, and fear of miscommunication, all of which contribute to feelings of inadequacy and academic uncertainty. These experiences help explain why academic anxiety was the most salient dimension quantitatively, as linguistic barriers directly influence students’ perceptions of their academic competence and future educational trajectories. Educational factors further intensified academic future anxiety by limiting students’ access to supportive learning environments. Participants described inconsistent teacher support, lack of specialized instructional strategies, and restricted university majors available to HOH students. These institutional constraints generate a perception of limited future opportunities, which aligns with the high quantitative scores observed in the academic and occupational anxiety dimensions. Psychological and social factors were found to shape future anxiety at a deeper cognitive and emotional level. Difficulties in emotional expression, fear of social judgment, and concerns about physical appearance influence students’ self-concepts and heighten their vulnerability to future-oriented worry. These factors interact with academic stressors, increasing repetitive thinking and uncertainty, which is reflected in the high overall anxiety levels. Family factors emerged as a critical moderating influence. Supportive family environments were found to reduce anxiety by enhancing students’ sense of security, self-worth, and motivation. Conversely, the absence of HOH family members with similar experiences increased pressure and fear of failure. This explains variations within the quantitative results, particularly in the family and self-related anxiety dimensions. Economic factors were found to contribute to the occupational dimension of future anxiety by shaping students’ expectations regarding employment opportunities and financial independence. Participants expressed concerns about job scarcity, high living costs, and dependency on family support, which intensified anxiety about long-term autonomy and quality of life. Taken together, these findings demonstrate that future anxiety among female HOH students is not merely an individual psychological state, but a contextually embedded phenomenon constructed through the interaction of linguistic, educational, psychological, familial, and economic conditions. The qualitative phase therefore provides a necessary interpretive layer that explains why certain quantitative dimensions, particularly academic future anxiety, are more prominent, and how institutional and cultural structures shape students’ future-oriented thinking. This integrative analysis strengthens the explanatory power of the mixed-methods design by moving beyond descriptive patterns to reveal the mechanisms through which future anxiety is produced, maintained, and potentially transformed within specific educational and sociocultural contexts. Discussion The findings of the present study indicate that female HOH students experience high levels of future anxiety, which is consistent with previous research showing elevated anxiety among DHH individuals compared to their hearing peers [ 10 – 12 ]. A systematic review by [ 42 ] supports these findings, reporting a lifetime prevalence of anxiety disorders among deaf individuals of 11.1%, with 15.4–31.3% exhibiting clinically significant symptoms. Similarly, studies by [ 33 , 41 , 56 ], and [ 57 ] found higher levels of social anxiety, school avoidance, and panic disorder among DHH adolescents, while [ 7 ] and [ 31 ] emphasized the role of communication barriers and social isolation in increasing vulnerability to anxiety and depression. The convergence of the present findings with these studies supports the robustness of future anxiety as a salient psychological concern within this population. Beyond confirming elevated anxiety levels, the current study contributes by identifying specific dimensions of future anxiety that are particularly salient among female HOH students. Personal (self-related) future anxiety was frequently reflected in participants’ responses, aligning with [ 17 , 29 ], who highlighted emotional difficulties such as fear, insecurity, and low self-esteem among DHH individuals. Social future anxiety was also evident, consistent with findings reported in [ 37 , 58 ], and [ 59 ], which documented higher social anxiety among deaf individuals, and with [ 60 ], who linked societal mistreatment to increased psychological distress. These patterns suggest that future anxiety in this group is not a uniform construct, but rather a multidimensional experience shaped by self-perception and social positioning. Notably, academic and occupational future anxiety emerged as the most prominent dimensions, with academic anxiety ranking highest. This finding resonates with [ 40 ], who identified education and employment as major sources of future anxiety among DHH individuals. As a result, students may resort to academic procrastination as a temporary avoidance strategy to alleviate emotional distress [ 61 , 62 ]. This interpretation is further supported by [ 45 ], who found that DHH university students experience heightened academic pressures and that anxiety predicts procrastination, while psychological resilience serves as a protective factor. Similarly [ 63 ], reported that future anxiety is negatively associated with optimism and academic achievement, suggesting that anxiety may undermine adaptive goal orientation. While many studies have focused on direct associations between anxiety and academic outcomes, recent research [ 64 – 66 ] emphasizes the importance of examining mediating variables such as executive functioning and psychological resilience. This finding highlights that academic anxiety is not merely an outcome, but a central dimension through which future uncertainty is cognitively organized by HOH students. Family-related future anxiety was also evident, consistent with [ 39 ] and [ 44 ], who found that marriage and family formation constitute significant concerns among deaf adolescent girls. This indicates that concerns about marriage and family are closely linked to feeling socially accepted and achieving expected life goals, rather than only personal readiness for these roles. The qualitative findings of the present study indicate that future anxiety among female HOH students is shaped by a set of interrelated contextual factors, including psychological and social factors, linguistic factors, family factors, educational factors, and economic factors. This is consistent with several scientific studies that have identified a range of factors influencing future anxiety among HOH people. In the Saudi context [ 39 ], highlighted the role of family, psychological, and social support as key protective factors influencing future anxiety among DHH students, indicating that psychological well-being is closely linked to the quality of family relationships and perceived social acceptance. This finding implies that emotional security is not merely an individual trait but is socially constructed through supportive interpersonal environments. In contrast [ 67 ], found that visible hearing devices may increase social appearance anxiety, suggesting that psychological and social dimensions of the disability-particularly self-perception and sensitivity to social evaluation-play a significant role in shaping how students emotionally anticipate their future. Together, these studies point to a dynamic interaction between internal emotional processes and external social meanings attached to disability. Linguistic factors have likewise been identified as critical in structuring future anxiety. Studies by [ 37 ] and [ 38 ] reported that limited linguistic competence intensifies social isolation and anxiety related to educational and occupational aspirations. Similarly [ 68 ], found that cognitive anxiety is associated with speech comprehension difficulties in noisy environments, indicating that perceptual and linguistic challenges constitute persistent sources of psychological strain. From a developmental perspective, these difficulties may undermine students’ perceived academic competence and communicative efficacy, thereby reinforcing uncertainty about future educational and professional success. Economic and educational concerns also emerged as an important dimension of future anxiety, which are, to varying degrees, associated with the educational opportunities available to HOH students [ 44 ]. found that financial independence and employability are among the primary anxieties of deaf adolescent girls, suggesting that future anxiety extends beyond internal emotional states to include broader social and economic constraints. In this sense, anxiety reflects not only personal fear or insecurity, but also rational responses to structural limitations related to labor market access, institutional support, and long-term financial stability. These dimensions reflect that future anxiety is not a singular emotional state, but a complex experience embedded within a network of personal and structural conditions that give rise to it that emerges from the ways students perceive their position, opportunities, and value within their broader social and institutional environments. In parallel, the qualitative findings also revealed a range of adaptive coping mechanisms through which participants attempt to manage and regulate their future anxiety. These included reliance on their faith in God, actively researching future opportunities, timely decision-making, strengthening self-confidence and self-esteem, engaging in positive distraction activities, and seeking family and social support. Together, these coping practices illustrate that students do not merely experience future anxiety passively but actively negotiate it through context-dependent strategies aimed at restoring emotional balance and perceived control over the future. These strategies reflect a combination of cognitive, emotional, behavioral, and relational forms of regulation, suggesting that coping is a dynamic and multidimensional process rather than a single response pattern. For instance, reliance on faith in God and positive thinking can be interpreted as forms of cognitive reappraisal, through which participants reinterpret uncertainty in a more meaningful or hopeful framework. Similarly, searching for opportunities and making timely decisions represent problem-focused coping, aimed at increasing perceived agency and reducing ambiguity about future pathways. In contrast, positive distraction appears to function as a form of emotion-focused regulation, allowing temporary relief from over-thinking without directly addressing the source of the anxiety. This interpretation is consistent with [ 69 ], who found that positive thinking contributes to emotional regulation even if it does not eliminate anxiety, and with [ 70 ], who reported a negative relationship between self-efficacy and future anxiety. The present findings extend the literature by showing that self-efficacy is not only an internal trait, but is actively constructed through social interaction, spiritual meaning-making, and engagement with realistic future planning. Moreover, studies by [ 12 , 71 ], and [ 72 ] demonstrated the effectiveness of psychological and religious counseling programs in reducing anxiety and enhancing emotional adjustment, which parallels the strong emphasis on spiritual and social resources observed in the present study. In this regard, the current findings are also aligned with previous studies [ 73 , 74 ] that emphasized the necessity of prioritizing students with disabilities by providing comprehensive support, and enhancing accessibility, and promoting their psychological well-being. Such an approach translates the principle of inclusion within schools into effective practice through the provision of diverse forms of psychological and emotional support tailored to the needs of these students. Importantly, the diversity of coping strategies identified suggests that adaptation to future anxiety among HOH students is not uniform, but varies according to individual psychological resources, family environments, and institutional support. While some strategies, such as information seeking and decision-making, may promote long-term resilience by strengthening agency and planning skills, others, such as distraction or avoidance, may primarily serve as short-term emotional relief, only. This highlights the need to distinguish between coping mechanisms that regulate anxiety temporarily and those that facilitate deeper psychological adjustment and future-oriented competence. Conceptually, the main contribution of this study lies in reframing future anxiety among female HOH students as developmentally situated, rather than as a generalized emotional disorder. This interpretation extends existing research by highlighting that future-oriented thinking is not solely driven by individual psychological dispositions, but is dynamically shaped by institutional opportunities, cultural norms, and perceived social boundaries that define which futures are seen as realistic, legitimate, or accessible for these students. Conclusion This study offers conceptual insights into how female HOH students think about their futures and construct meanings around uncertainty and aspiration. Rather than viewing future anxiety as a purely individual psychological state, the findings reveal it as a socially and institutionally shaped experience, grounded in students’ interpretations of their academic opportunities, linguistic resources, and perceived social positioning. The results demonstrate that coping mechanisms among HOH girls are not fixed or uniform strategies, but context-dependent processes that emerge through ongoing interactions with family expectations, school practices, and broader cultural norms regarding success, independence, and disability. Students’ future-oriented thinking is thus formed through a continuous process of meaning-making, in which hope, fear, self-regulation, and adaptation are negotiated within specific educational and societal structures. By integrating quantitative patterns with qualitative interpretations, the study contributes a more nuanced understanding of how future anxiety is cognitively and emotionally constructed, and how adaptive coping develops in relation to institutional constraints and cultural possibilities. This positions future anxiety not only as an outcome to be reduced, but as a lens through which the lived experiences of female HOH students can be theoretically understood within their sociocultural contexts. Recommendations and areas of future study Based on the empirical findings of this study, several recommendations can be proposed. Given that academic future anxiety emerged as the most prevalent quantitative dimension, and that qualitative findings highlighted linguistic and educational barriers as key sources of anxiety, it is recommended to design targeted training programs to be implemented during the high stage that focus on enhancing academic self-regulation, communication skills, and future planning abilities among HOH students. Furthermore, as qualitative results consistently emphasized the central role of family and social support in mitigating anxiety, intervention programs should explicitly incorporate family involvement and school-based support mechanisms. This may include structured workshops for parents and teachers aimed at fostering realistic expectations, emotional support, and adaptive communication practices. The prominence of coping strategies, such as faith-based meaning-making, positive distraction, and self-confidence development, suggests that future interventions should integrate culturally responsive psychological components, particularly those aligned with students’ lived experiences and value systems. Digital and interactive tools may be especially useful in facilitating these strategies within inclusive and special education contexts. In terms of future research, the context-specific and exploratory nature of the current findings highlights the need for studies involving larger and more diverse samples across different institutional settings, in order to examine whether similar patterns of future anxiety and coping emerge. Longitudinal designs would be particularly valuable for exploring how future-oriented thinking and coping mechanisms evolve over time. Finally, since the qualitative data revealed the importance of institutional and relational factors, future research should extend beyond individual-level variables to investigate the systemic roles of parents, teachers, and school policies in shaping students’ future anxiety and resilience. Such approaches would allow for more comprehensive theoretical and practical insights into the psychosocial development of HOH students. Limitations of the study While this study provides meaningful insights into how future anxiety is experienced and interpreted by female HOH students, several limitations should be acknowledged from a methodological and interpretive perspective. First, the study was based on a small and context-specific qualitative sample, which was intentionally selected to generate in-depth understanding rather than statistical representativeness. Accordingly, the findings are not intended to be generalized in a probabilistic sense, but rather to offer analytical and contextual insights into how future anxiety is constructed within a particular sociocultural and educational setting. Second, the study adopted a sequential explanatory mixed-methods design with a strong qualitative emphasis, focusing on interpretive depth rather than causal inference. While this approach allowed for rich exploration of participants’ meanings, perceptions, and coping processes, it does not support claims about causality or predictive relationships between variables. The results should therefore be understood as theoretically informative and contextually grounded, rather than as universal psychological patterns. Third, the analytical focus was limited to future anxiety as a central construct. Other potentially relevant psychological and social dimensions (e.g., self-efficacy, communicative agency, emotional regulation, or institutional trust) were not examined in depth. Including these constructs in future studies could provide a more holistic account of the developmental and emotional experiences of HOH students. Finally, the reliance on self-reported narratives may have shaped the findings through participants’ communicative preferences, cultural norms of emotional expression, and individual comfort with disclosure. Rather than viewing this solely as a methodological weakness, it should be recognized as an inherent feature of qualitative inquiry, which prioritizes participants’ subjective meaning-making as a legitimate source of knowledge. Future research may build on this work by expanding the range of institutional contexts, incorporating longitudinal perspectives, and exploring comparative cases to examine how future-oriented thinking and coping evolve across different educational and cultural environments. Supplementary Information Supplementary Material 1. (20.3KB, docx) Supplementary Material 2. (16.4KB, docx) Supplementary Material 3. (112.4KB, docx) Acknowledgements We would like to thank our participants who devoted their time to support this study. Authors’ contributions The author collected the data, analysed the data, and wrote the paper. Funding This work was supported by the Deanship of Scientific Research, Vice Presidency for Graduate Studies and Scientific Research, King Faisal University, Saudi Arabia [Grant No. KFU261084]. Data availability The data and materials presented in this study are available upon request from the author. Declarations Ethics approval and consent to participate The researcher ensured full compliance with ethical standards governing educational research. Formal approval was obtained from the Research Ethics Committee (REC) at King Faisal University [Reference number: [ETHICS3345], in addition to the necessary administrative permissions from relevant educational authorities. This study was conducted in strict accordance with the ethical principles outlined in the Declaration of Helsinki (World Medical Association) for research involving human participants. The research design was structured to minimize potential risks by ensuring anonymity and confidentiality. All participants provided informed consent by reading and signing an informed consent form that clearly stated their right to withdraw from the study at any time without penalty. As all participants were over 16 years of age, they signed the consent form themselves. Participants’ names were anonymized, and each was assigned a unique identification code. They were also assured that all collected data would be used exclusively for research purposes and handled with strict confidentiality throughout the study. Furthermore, the potential benefits of the study, such as advancing educational research, informing policy development, and improving practical interventions related to HOH students, were considered to outweigh any minimal risks associated with participation. Consent for publication This manuscript does not contain any individual person’s data in any form (including individual details, images, or videos). Therefore, consent for publication is not applicable. Competing interests The authors declare no competing interests. Footnotes Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. References 1. World report on hearing. 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