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Lambinon C, le Roux T, Eikelboom RH, Bennett RJ. Impact of adult cochlear implantation on the partner relationship: a conceptual framework informed by cochlear implant recipient and partner perceptions. Disabil Rehabil 2024:1-15. [PMID: 39225085 DOI: 10.1080/09638288.2024.2396061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 08/19/2024] [Accepted: 08/20/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE (1) To understand the impact of adult cochlear implantation on the partner relationship, as perceived by adult cochlear implant (CI) recipients and their intimate partners. (2) To generate a conceptual framework for guiding future research and clinical adult cochlear implantation interventions. METHOD Concept mapping, a participatory, mixed-method approach, was used for data collection, analysis and interpretation. Participants attended sessions to generate, sort and rate statements describing the changes in their relationship due to cochlear implantation. Participants included 15 CI recipients (mean age: 51.6 years; SD: 8.2) and 12 partners (mean age: 50.9 years; SD: 8.2). RESULTS Five concepts emerged from the data, describing changes in the partner relationship following cochlear implantation: (1) Social Interactions, (2) Partner Involvement, (3) Communication, (4) Emotional Adjustment, and (5) Relationship Intimacy. The concept Relationship Intimacy was rated the highest in positivity and importance. Findings also underscored improved social interactions, communication dynamics, and emotional adjustment. CONCLUSIONS The Relationship Intimacy cluster emerged as pivotal, highlighting its essential role in improving post-implantation relationships. CI recipients experienced enhanced autonomy, while partners' roles evolved regarding assistance and support. The diverse effects of implantation on partner relationships highlight the importance of adopting a patient- and family-centered approach to audiological intervention.
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Affiliation(s)
- Ché Lambinon
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Talita le Roux
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Robert H Eikelboom
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Ear Science Institute Australia, Subiaco, Australia
- School of Medicine, Curtin University, Perth, Australia
- Centre for Ear Sciences, The University of Western Australia, Crawley, Australia
| | - Rebecca J Bennett
- Ear Science Institute Australia, Subiaco, Australia
- School of Medicine, Curtin University, Perth, Australia
- Centre for Ear Sciences, The University of Western Australia, Crawley, Australia
- National Acoustic Laboratories, Macquarie University, Sydney, Australia
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Malmberg M, Hagberg J. Short- and long-term effects of remote synchronous fine-tuning for first-time hearing aid users: a randomised controlled trial. Int J Audiol 2024:1-9. [PMID: 39030719 DOI: 10.1080/14992027.2024.2378798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 07/03/2024] [Indexed: 07/21/2024]
Abstract
OBJECTIVE To evaluate the short- and long-term effect of remote synchronous fine-tuning and follow-up visits on hearing-related problems and hearing aid (HA) benefits for first-time HA users. DESIGN A randomised controlled trial. STUDY SAMPLE Patients at public tax-funded HA clinics in Sweden due for aural rehabilitation (AR) were randomised to either an intervention group (n = 33) or a control group (n = 36). Both groups completed the conventional AR process, but the intervention group received synchronous remote fine-tuning of HAs and online follow-up visits. Outcome measures were used before and after intervention, and 6 months and 1 year after intervention. RESULTS Both groups improved hearing-related problems measured with the Hearing Handicap Inventory for the Elderly/Adults over time, and no significant differences were found between the groups. Such improvements were also found for the Abbreviated Profile of Hearing Aid Benefit except for the subscale aversiveness. Both groups decreased the use of HAs in hours/day over time. The intervention group reported significant improvements in activity limitation when measured directly after the intervention, compared to the control group. CONCLUSION Synchronous remote fine-tuning and follow-ups for first-time HA users did not influence the outcomes of hearing-related problems and HA benefits differently from standard care at our clinic.
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Affiliation(s)
- Milijana Malmberg
- Region Västra Götaland, Habilitation & Health, Hearing Organisation, Göteborg, Sweden
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Göteborg, Göteborg, Sweden
| | - Jennie Hagberg
- Region Västra Götaland, Habilitation & Health, Hearing Organisation, Göteborg, Sweden
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Malmberg M, Hagberg J. Synchronous remote fine-tuning and follow-up within aural rehabilitation: a randomised controlled trial. Int J Audiol 2024; 63:458-466. [PMID: 36971711 DOI: 10.1080/14992027.2023.2188437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/24/2023] [Accepted: 03/01/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVE The objective of the study was to evaluate the effect of including synchronous remote fine-tuning and follow-up as a part of the aural rehabilitation process. DESIGN A randomised controlled trial (RCT). STUDY SAMPLE Experienced hearing aid users who were due for renewed aural rehabilitation were randomised to either an intervention group (n = 46) or a control group (n = 49). Both groups underwent all stages of the conventional renewed aural rehabilitation process within our clinics, but the intervention group was also offered remote follow-up visits, including an opportunity for synchronous remote fine-tuning of hearing aids. The Hearing Handicap Inventory for the Elderly/Adults (HHIE/A), the Abbreviated Profile of Hearing Aid Benefit (APHAB), and the International Outcome Intervention for Hearing Aid Users (IOI-HA) were used as outcome measures. RESULTS Both groups improved in self-rated hearing difficulties and hearing aid benefits measured with HHIE/A and APHAB. No significant differences were found between the intervention and the control group. CONCLUSION Including synchronous remote follow-up and fine-tuning as a part of an aural rehabilitation process may effectively complement clinical visits. Additionally, the synchronous remote follow-up has the potential to further develop person-centred care by enabling hearing aid users to identify individual needs directly in an everyday environment.
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Affiliation(s)
- Milijana Malmberg
- Region Västra Götaland, Habilitation & Health, Hearing Organization, Gothenburg, Sweden
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jennie Hagberg
- Region Västra Götaland, Habilitation & Health, Hearing Organization, Gothenburg, Sweden
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Bennett RJ, Larsson J, Gotowiec S, Ferguson M. Refinement and Validation of the Empowerment Audiology Questionnaire: Rasch Analysis and Traditional Psychometric Evaluation. Ear Hear 2024; 45:583-599. [PMID: 38082487 PMCID: PMC11008442 DOI: 10.1097/aud.0000000000001449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 10/22/2023] [Indexed: 04/13/2024]
Abstract
OBJECTIVES Empowerment is the process through which individuals with hearing-related challenges acquire and use knowledge, skills and strategies, and increase self-efficacy, participation, and control of their hearing health care, hearing solutions, and everyday lives. The aim was to refine and validate the Empowerment Audiology Questionnaire (EmpAQ), a hearing-specific measure of empowerment. This was achieved through (1) refinement via Rasch analysis (study 1), and (2) traditional psychometric analysis of the final survey structure (study 2). DESIGN In study 1, 307 adult hearing aid owners completed the initial empowerment measure (33 items) online. To inform an intended item reduction, Rasch analysis was used to assess a range of psychometric properties for individual items. The psychometric properties included analysis of individual items (e.g., response dependency, fit to the polytomous Rasch model, threshold ordering) and the whole EmpAQ (e.g., dimensionality). Item reduction resulted in a 15-item version (EmpAQ-15) and a short-form 5-item version (EmpAQ-5), validated using modern (Rasch), and traditional (Classical Test Theory) psychometric analysis (study 2). In study 2, 178 adult hearing aid owners completed the EmpAQ-15 and EmpAQ-5, alongside 5 questionnaires to measure related constructs. These included two hearing-specific questionnaires (Social Participation Restrictions Questionnaire and Self-Assessment of Communication), two general health-related questionnaires (Patient Activation Measure and World Health Organization Disability Assessment Schedule 2.0), and a general empowerment questionnaire (Health Care Empowerment Questionnaire). Modern (Rasch) and traditional psychometric analysis techniques (internal consistency, construct validity, and criterion validity) were used to assess the psychometric properties of the EmpAQ-15 and EmpAQ-5. RESULTS Rasch analysis of the initial 33-item measure of empowerment identified 18 items with high response dependency, poor fit to the Rasch model, and threshold disordering, which were removed, resulting in a long-form (EmpAQ-15) hearing-specific measure of empowerment. A short-form (EmpAQ-5) version was developed for use in the clinic setting. Validation of the two EmpAQ measures using Rasch analysis showed good item fit to the Rasch model, appropriate threshold targeting, and the existence of unidimensionality. Traditional psychometric evaluation showed that both questionnaires had high internal consistency and positive correlations with the hearing-specific questionnaires. However, in contrast with our hypotheses, correlations with general health questionnaires were stronger than with hearing-specific questionnaires; all questionnaires were correlated with the EmpAQ and in the direction hypothesized. Taken together, these findings support the construct validity of the EmpAQ-15 and EmpAQ-5. CONCLUSIONS The EmpAQ-15 and EmpAQ-5 are the first self-report measures to be developed specifically for the measurement of empowerment. The EmpAQ-15 and EmpAQ-5 were found to meet the Rasch model criteria for interval-level measurements. Traditional psychometric evaluation supports the construct validity of both measures. The EmpAQ measures have the potential to be used in both research and clinical practice to evaluate empowerment along the hearing journey. The next stage of this research will be to further validate these measures by assessing their responsiveness, minimal clinically important difference, and clinical interpretability in a clinical population.
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Affiliation(s)
- Rebecca J. Bennett
- Brain and Hearing, Ear Science Institute Australia, Perth, Australia
- Curtin enAble Institute, Curtin enAble Institute, Curtin University, Perth, Australia
- School of Medicine, The University of Western Australia, Perth, Australia
- National Acoustic Laboratories, Sydney, Australia
| | | | | | - Melanie Ferguson
- Curtin enAble Institute, Curtin enAble Institute, Curtin University, Perth, Australia
- School of Allied Health, Curtin University, Perth, Australia
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Sarangi L, Johnson J. Impact of patient attributes on the relationship between hearing handicap and readiness to pursue audiologic rehabilitation. Int J Audiol 2024:1-9. [PMID: 38587097 DOI: 10.1080/14992027.2024.2332773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 03/08/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE This study explored whether select patient attributes were significant predictors of readiness to pursue hearing aids (HAs) and estimated the impacts of hearing aid self-efficacy (HASE) and emotional states, on the relationship between perceived hearing handicap and readiness to pursue HAs. DESIGN & STUDY SAMPLE Sixty-two adults with self-reported hearing difficulties and no previous experience with HAs self-reported their hearing handicap, HASE, personality, emotional states in varying contexts, and readiness to pursue HAs. RESULTS Individuals with greater hearing handicap and who had experienced hearing loss for a shorter duration were more ready to pursue HAs. Having higher HASE, more positive emotional states in "Social" situations, higher scores for the Agreeableness, and having lower Conscientiousness personality trait scores also independently predicted readiness. Neither HASE nor reported emotional states had a significant impact on the relationship between perceived hearing handicap and readiness to pursue HAs. CONCLUSIONS Certain patient characteristics independently motivate people towards or away from pursuing HAs. However, it remains unclear whether targeted modification of these attributes would directly facilitate behaviour change. Future research should further explore these questions to facilitate a more individualised audiologic rehabilitation.
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Affiliation(s)
- Lipika Sarangi
- Department of Audiology and Speech-Language Pathology, College of Health Professions, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jani Johnson
- School of Communication Sciences and Disorders, University of Memphis, Memphis, TN, USA
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Prieur Chaintré A, Couturier Y, Nguyen TT, Levasseur M. Influence of Hearing Loss on Social Participation in Older Adults: Results From a Scoping Review. Res Aging 2024; 46:72-90. [PMID: 37157996 PMCID: PMC10666503 DOI: 10.1177/01640275231174561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
This study aimed to provide a comprehensive understanding of the influence of hearing loss on social participation in older adults and including its facilitators and barriers. Following the rigorous methodological framework of scoping studies, nine multidisciplinary databases were searched with 44 keywords. Published mainly in the last decade, 41 studies using primarily a quantitative cross-sectional design were selected. Older adults with hearing loss have been found to have difficulty maintaining relationships and social activities. While social support and engaged-coping strategies were major facilitators of social participation, barriers included greater hearing loss, communication difficulties, comorbidities and reduced mental health. To better promote the social participation of older adults, early detection of hearing loss, holistic assessment, and interprofessional collaboration must be considered. Future research is necessary to better address the stigma related to hearing loss in older adults and challenges of early detection, and to propose innovative solutions to develop interprofessional collaboration.
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Affiliation(s)
- Agathe Prieur Chaintré
- Faculty of Letters and Social Sciences, Université de Sherbrooke, Quebec, Canada
- Research Center on Aging, Health and Social Services Centre, University Institute of Geriatrics of Sherbrooke, Quebec, Canada
| | - Yves Couturier
- Faculty of Letters and Social Sciences, Université de Sherbrooke, Quebec, Canada
| | - T.H. Trang Nguyen
- Faculty of Letters and Social Sciences, Université de Sherbrooke, Quebec, Canada
- Research Center on Aging, Health and Social Services Centre, University Institute of Geriatrics of Sherbrooke, Quebec, Canada
| | - Mélanie Levasseur
- Research Center on Aging, Health and Social Services Centre, University Institute of Geriatrics of Sherbrooke, Quebec, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Quebec, Canada
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Karlsson E, Mäki-Torkko E, Granberg S, Widén S, Manchaiah V, Swarnalatha Nagaraj V, Pichora-Fuller KM, Selb M, Swanepoel DW, Yerraguntla K, Gustafsson J. Hearing and Functioning in Everyday Life Questionnaire: Development and Validation of an ICF-Based Instrument. Ear Hear 2023; 44:1498-1506. [PMID: 37340534 DOI: 10.1097/aud.0000000000001391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
OBJECTIVES Self-assessment instruments are commonly used in audiological rehabilitation. However, several studies highlight the lack of multidimensionality in existing outcome measures, with the consequence that they only partially capture aspects of functioning in everyday life for people living with hearing loss. This study aimed to develop and investigate the content validity of a self-assessment instrument based on the validated Brief International Classification of Functioning, Disability, and Health Core Set for Hearing Loss. DESIGN The design was a two-part instrument development study. The first part focused on the item-generation process of the instrument, named the Hearing and Functioning in Everyday Life Questionnaire (HFEQ) during an experts' workshop. The second part focused on international content validation of the instrument using group interviews. Strategic sampling was used and 30 adults with hearing loss from India, South Africa, and the United States participated in the group interviews. RESULTS The expert's workshop resulted in the first version of the HFEQ containing 30 items. The results from group interviews show that the content of the HFEQ was considered to be valid concerning its relevance, comprehensiveness, and comprehensibility. A majority (73%) of the HFEQ items were perceived by the participants as relevant and easy to comprehend. For the remaining 27% of the items, the content was perceived to be relevant in all countries, but some terms and expressions were reported to require rewording or clearer examples. These modifications will be made in the next step of the development process. CONCLUSION Content validation of the HFEQ demonstrates promising results, with participants perceiving the content as relevant and comprehensible. Further psychometric validation is required to investigate other psychometric properties, such as construct validity and reliability. The HFEQ has the potential to become a valuable new instrument for assessing everyday functioning in people with hearing loss in audiological rehabilitation and in research.
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Affiliation(s)
- Elin Karlsson
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Swedish Institute of Disability Research (SIDR), Örebro University, Örebro, Sweden
| | - Elina Mäki-Torkko
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Sarah Granberg
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Stephen Widén
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Vinaya Manchaiah
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, Colorado, USA
- Virtual Hearing Lab, Collaborative Initiative Between University of Colorado School of Medicine and University of Pretoria, Aurora, Colorado, USA
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Vinay Swarnalatha Nagaraj
- Audiology Group, Institute of Neuromedicine and Movement Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Melissa Selb
- ICF Research Branch and Swiss Paraplegic Research, Nottwil, Switzerland
| | - De Wet Swanepoel
- Virtual Hearing Lab, Collaborative Initiative Between University of Colorado School of Medicine and University of Pretoria, Aurora, Colorado, USA
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Krishna Yerraguntla
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Johanna Gustafsson
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Bennett RJ, Bucks RS, Saulsman L, Pachana NA, Eikelboom RH, Meyer CJ. Use of the Behaviour Change Wheel to design an intervention to improve the provision of mental wellbeing support within the audiology setting. Implement Sci Commun 2023; 4:46. [PMID: 37131257 PMCID: PMC10153035 DOI: 10.1186/s43058-023-00427-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 04/05/2023] [Indexed: 05/04/2023] Open
Abstract
OBJECTIVE This study describes the development of an intervention to increase the frequency of audiologists' asking about and providing information regarding mental wellbeing within adult audiology services. DESIGN The Behaviour Change Wheel (BCW), an eight-step systematic process, was followed to develop the intervention. Reports describing the first four steps are published elsewhere. This report describes the final four steps and details the intervention developed. RESULTS A multifaceted intervention was developed to change audiologists' behaviours relating to providing mental wellbeing support to adults with hearing loss. Specifically, three behaviours were targeted: (1) asking clients about their mental wellbeing, (2) providing general information on the mental wellbeing impacts of hearing loss, and (3) providing personalised information on managing the mental wellbeing impacts of hearing loss. A variety of intervention functions and behaviour change techniques were incorporated into the intervention, including instruction and demonstration, information about others approval, adding objects to the environment, use of prompts/cues, and endorsement from credible sources. CONCLUSION This study is the first to use the Behaviour Change Wheel to develop an intervention targeting mental wellbeing support behaviours in audiologists and confirms the usability and usefulness of the approach in a complex area of clinical care. The systematic development of the Ask, Inform, Manage, Encourage, Refer (AIMER) intervention will facilitate a thorough evaluation of its effectiveness in the next phase of this work.
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Affiliation(s)
- Rebecca J Bennett
- Ear Science Institute Australia, 1 Salvado Road, Subiaco, WA, Australia.
- Centre for Ear Sciences, The University of Western Australia, Perth, Australia.
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia.
- Medical School, Curtin University, Bentley, Australia.
| | - Romola S Bucks
- The Raine Study, School of Population and Global Health, The University of Western Australia, Perth, Australia
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Lisa Saulsman
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | - Robert H Eikelboom
- Ear Science Institute Australia, 1 Salvado Road, Subiaco, WA, Australia
- Centre for Ear Sciences, The University of Western Australia, Perth, Australia
- Medical School, Curtin University, Bentley, Australia
- Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Carly J Meyer
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Laird EC, Bryant CA, Barr CM, Bennett RJ. Conversations about mental illness and health in adult audiological rehabilitation. Int J Audiol 2023; 62:253-260. [PMID: 35148212 DOI: 10.1080/14992027.2022.2034060] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To understand the nature of mental health discussions in audiological rehabilitation, specifically, the types of conversations, when and how they are initiated, and the participant factors associated with discussing mental health. DESIGN A cross-sectional descriptive survey including quantitative (multiple choice) and qualitative (free-text) questions regarding mental health discussions between audiologists and clients. STUDY SAMPLE A convenience sample of 118 Australian audiologists working in adult audiological rehabilitation. RESULTS The majority of participants (95.8%) reported having engaged in discussions with clients about mental illness and health at some point throughout their career. The frequency of these discussions varied across participants: 7% rarely discuss, 50% discuss occasionally, 30% discuss with about half their clients and 13% have discussions with most clients. Many participants (85.6%) reported that clients would initiate these conversations, most often via disclosing the impacts of hearing loss on clients' lives. CONCLUSIONS Most audiologists will encounter clients with mental health concerns, and many will engage in conversations about psychological symptoms, therefore, training audiologists to recognise and address verbal and non-verbal cues regarding mental health may help to promote person-centred care and potentially improve outcomes.
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Affiliation(s)
- Emma C Laird
- Department of Audiology and Speech Pathology, University of Melbourne, Melbourne, Australia
| | - Christina A Bryant
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Caitlin M Barr
- Department of Audiology and Speech Pathology, University of Melbourne, Melbourne, Australia.,Soundfair Australia Ltd, Mount Waverley, Australia
| | - Rebecca J Bennett
- Ear Science Institute Australia, Subiaco, Australia.,School of Human Sciences, The University of Western Australia, Crawley, Australia
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Galvin KL, Timmer BHB, Tomlin D, Cleaver Z. Designing a Hearing Health Care Smartphone App With Ecological Momentary Assessment: A Qualitative Study of Audiologists' Perspectives. Am J Audiol 2022; 31:1247-1259. [DOI: 10.1044/2022_aja-22-00054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose:
The purpose of this study was to explore the perspectives of audiologists to provide input into development of a smartphone application (app) to document the real-life listening difficulties and the listening environment of hearing aid candidates and users.
Method:
Two focus groups were conducted. Facilitators utilized a topic guide to generate participants' input and perspectives. The focus groups were audio-recorded and transcribed verbatim. The transcripts were then qualitatively analyzed using content analysis.
Study Sample:
The study samples were 10 audiologists (seven females) with 2- to 10-plus years of hearing aid fitting experience.
Results:
Three main categories were identified: (a) The mobile device app could provide meaningful information to help audiologists to counsel their clients, (b) the app could give clients an insight into their hearing difficulties, and (c) the app could help clients to self-manage their hearing condition.
Conclusion:
These findings suggest that audiologists may better understand their clients' real-life listening difficulties through the use of a mobile device app; however, further research is required to harness the benefits of such an app.
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Affiliation(s)
- Karyn L. Galvin
- Department of Audiology and Speech Pathology, School of Health Sciences, The University of Melbourne, Victoria, Australia
| | - Barbra H. B. Timmer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Sonova AG, Stäfa, Switzerland
| | - Dani Tomlin
- Department of Audiology and Speech Pathology, School of Health Sciences, The University of Melbourne, Victoria, Australia
| | - Zuzana Cleaver
- Department of Audiology and Speech Pathology, School of Health Sciences, The University of Melbourne, Victoria, Australia
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Allen D, Hickson L, Ferguson M. Defining a Patient-Centred Core Outcome Domain Set for the Assessment of Hearing Rehabilitation With Clients and Professionals. Front Neurosci 2022; 16:787607. [PMID: 35592258 PMCID: PMC9110701 DOI: 10.3389/fnins.2022.787607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background A variety of outcome domains are currently measured for the assessment of hearing rehabilitation. To date, there is no consensus about which outcome domains should be measured, when they should be measured, and how they should be measured. In addition, most studies seeking to develop core outcome sets and measures for hearing rehabilitation services have primarily focussed on the opinions and expertise of researchers, and, to a lesser extent, clinicians, rather than also involving clients of those services. The principles of experience-based co-design suggest that health services, researchers, and policymakers should come together with clients and their families to design health services and define what metrics should be used for their success. Objectives This study aimed to seek views and consensus from a range of key stakeholders to define which client-centred self-report outcome domains should be measured, when they should be measured, and how they should be measured, in a national publicly funded hearing rehabilitation scheme. In addition, the study aimed to identify current and future potential mechanisms and systems to standardise the collection of data and reporting of outcomes, to enable comparison across clients and hearing service providers. Methods Two stakeholder groups participated in a three-round online Delphi process: (1) 79 professional stakeholders involved in the delivery of hearing services in Australia, and (2) 64 hearing rehabilitation services’ clients identified by not-for-profit consumer organisations. An initial set of in-person workshops scoped the key issues upon which to develop the initial open-ended questions and subsequent Likert-scale statements addressing these issues. These statements were then distributed to both groups in an online survey. The respondent ratings were summarised, and the summary was returned to respondents along with a second round of the survey. This process was then repeated once more. The five most important outcome domains from both groups were then combined, and a consensus workshop of seven professionals and three client advocates agreed on the top four ranked domains. Results A range of potential outcome domains were identified as relevant indicators of successful hearing rehabilitation. Communication ability, personal relationships, wellbeing, and participation restrictions were identified as a core outcome domain set that should be measured as a minimum for patients receiving hearing rehabilitation. There was little agreement on the preferred timepoints for collection of outcome measures, with respondents expressing the view that this should be established by research once a set of outcome measures has been selected. However, there was broad agreement that measurements of these domains should be collected at baseline (before the provision of hearing rehabilitation) and no earlier than 3 months following the completion of rehabilitation. Potential benefits and issues with the development of a national outcomes database/collection system were also identified and prioritised, with participants highlighting the importance of valid, high-quality, trustworthy, and comprehensive data collection. Conclusion These results provide a Core Outcome Domain Set for the self-reported evaluation of hearing rehabilitation and provide important background information for the design of methods to implement them across hearing healthcare systems. However, the wide range of outcome domains identified as potentially providing important additional information and the lack of specific measures to address these domains strongly suggest that there is still more research to be done. Ongoing stakeholder engagement will continue to be vital for future implementation. In addition, further research is required to determine the optimal time following hearing rehabilitation to utilise any particular outcome measure.
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Affiliation(s)
- David Allen
- National Acoustic Laboratories, Sydney, NSW, Australia.,Department of Linguistics, Macquarie University, Sydney, NSW, Australia
| | - Louise Hickson
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Melanie Ferguson
- National Acoustic Laboratories, Sydney, NSW, Australia.,Ear Science Institute Australia, Perth, WA, Australia.,Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
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12
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Brown J, Lengyel M. Psychotherapists' efforts to increase awareness of social privilege. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Jason Brown
- Faculty of Education University of Western Ontario London Ontario Canada
| | - Marguerite Lengyel
- Faculty of Education University of Western Ontario London Ontario Canada
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13
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Nickbakht M, Meyer CJ, Saulsman L, Pachana NA, Eikelboom RH, Bucks RS, Bennett RJ. Barriers and facilitators to asking adults with hearing loss about their emotional and psychological well-being: a COM-B analysis. Int J Audiol 2022:1-9. [PMID: 35436178 DOI: 10.1080/14992027.2022.2056090] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To explore the barriers and facilitators faced by hearing healthcare clinicians (HHCs) with respect to asking adults with hearing loss (HL) about their emotional well-being. DESIGN This qualitative study was conducted using semi-structured individual interviews and focus groups. The interview topic guide was developed based on the COM-B model. STUDY SAMPLE Fifteen HHCs of a single hearing services organisation in Western Australia across 13 clinic locations participated. RESULTS Barriers and facilitators that may influence HHCs' behaviour of routinely asking adults about their emotional well-being include having the knowledge and skills to ask about emotional well-being, forgetting to ask, awareness of the emotional impacts of HL, time and tools for asking, clients' reactions to being asked, supportive peers, normalisation of discussions relating to emotional well-being, presence of significant others, emotions associated with asking, being in the habit of asking, reminders, beliefs about consequences and confidence or capabilities, and scope of audiology practice. CONCLUSIONS Application of the COM-B model identified barriers in capabilities (e.g. knowledge), opportunities (e.g. tools), and motivation (e.g. beliefs about benefits of asking about emotions) that need to be addressed for HHCs to ask their clients about their emotional well-being.
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Affiliation(s)
- Mansoureh Nickbakht
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Carly J Meyer
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia.,Department of Clinical, Educational and Health Psychology, Centre for Behaviour Change, University College London, London, UK
| | - Lisa Saulsman
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, St Lucia, Australia
| | - Robert H Eikelboom
- Ear Science Institute Australia, Subiaco, Australia.,Ear Sciences Centre, The University of Western Australia, Crawley, Australia.,Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Romola S Bucks
- School of Psychological Science, The University of Western Australia, Perth, Australia.,School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Rebecca J Bennett
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia.,Ear Science Institute Australia, Subiaco, Australia.,Ear Sciences Centre, The University of Western Australia, Crawley, Australia
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14
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Malmberg M, Anióse K, Skans J, Öberg M. A randomised, controlled trial of clinically implementing online hearing support. Int J Audiol 2022; 62:472-480. [PMID: 35436174 DOI: 10.1080/14992027.2022.2059712] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: The research-oriented objective of this study was to document the effectiveness of online support for hearing aid (HA) users compared with traditional support.Design: This study is a randomised controlled trial with parallel group design. The research-oriented objectives were evaluated using the Hearing Handicap Inventory for the Elderly (HHIE) and the Communication Strategies Scale (CSS) at baseline and immediately postintervention.Study sample: Selected clients at five different clinics were randomised to an intervention group (n = 78) that took part in online hearing support and a control group (n = 58) that received standard care.Results: The analyses (intention-to-treat) showed statistically significant improvements in the HHIE-total and Emotional subscale scores for the intervention group compared with the control group. The intervention group also showed significantly greater improvement in the CSS-total and Verbal and Nonverbal subscale scores. A subgroup analysis was performed including two groups: HA use <1 year and HA use >1 year. A statistically significant improvement was found for the HA users >1 year compared with HA use <1 year.Conclusions: It is effective to clinically include online hearing support for HA users when addressing self-perceived hearing difficulties and to sharpen communication strategy skills.
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Affiliation(s)
- Milijana Malmberg
- Research and Development, Region Västra Götaland, Habilitation & Health, Göteborg, Sweden.,Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Göteborg, Göteborg, Sweden
| | - Katja Anióse
- Region Västra Götaland, Habilitation & Health, Hearing Organization, Göteborg, Sweden
| | - Johanna Skans
- Region Västra Götaland, Habilitation & Health, Hearing Organization, Göteborg, Sweden
| | - Marie Öberg
- Department of Otorhinolaryngology in Linköping, and Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication, Linköping University, Linköping, Sweden
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15
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Heffernan E, Maidment DW, Ferguson MA. A qualitative study showing that a telecare tool can have benefits before and during the initial hearing assessment appointment. Int J Audiol 2022; 62:295-303. [PMID: 35195487 DOI: 10.1080/14992027.2022.2041740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To examine patient and audiologist experiences and perspectives of using a patient-centred telecare tool, the Ida Institute's Why Improve My Hearing? (WIMH) Tool, before and during the initial hearing assessment appointment.Design: A qualitative study comprising individual semi-structured interviews using a maximum variation sampling strategy. The data were analysed using an established thematic analysis technique.Study sample: Fifteen participants, including ten patients (i.e. adults with hearing loss) and five audiologists, were recruited from Adult Audiology Services within the United Kingdom's publicly-funded National Health Service (NHS).Results: Three themes described the impact of using the WIMH Tool. Theme 1 (i.e. enhanced preparation before the appointment): the Tool helps patients to better understand and accept their hearing difficulties in advance of their first appointment. Theme 2 (i.e. enriched discussion during the appointment): the tool can enhance patient-centred communication, as well as the efficiency of the appointment. Theme 3 (i.e. varied impact on outcomes following the appointment): the Tool can improve patient motivation, readiness, and involvement in decision-making, though it may have limited impact on additional outcomes, such as adherence.Conclusion: The WIMH Tool can be successfully implemented in audiological practice, resulting in benefits before and during the initial hearing assessment appointment.
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Affiliation(s)
- Eithne Heffernan
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK.,Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.,Discipline of General Practice, Clinical Science Institute, School of Medicine, National University of Ireland, Galway, Ireland
| | - David W Maidment
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK.,Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Melanie A Ferguson
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK.,Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.,Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia.,Ear Science Institute Australia, Perth, Australia
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16
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Heffernan E, Withanachchi CM, Ferguson MA. ‘The worse my hearing got, the less sociable I got’: a qualitative study of patient and professional views of the management of social isolation and hearing loss. Age Ageing 2022. [DOI: 10.1093/ageing/afac019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Social isolation is a major consequence of hearing loss. It includes an objective component (e.g. small social network) and a subjective component (e.g. loneliness).
Objective
To examine the perspectives of key stakeholders regarding (i) the relationship between hearing loss and social isolation and (ii) interventions to address hearing loss and social isolation.
Design
A phenomenological qualitative study.
Setting
A UK research centre with a role to engage patients and clinicians.
Participants
Hearing healthcare professionals (n = 7) and adults with hearing loss (n = 6) were recruited via maximum variation sampling.
Methods
Individual (n = 3) and group (n = 3) semi-structured interviews were conducted. Inductive thematic analysis was performed.
Results
Five themes were identified. Theme 1 (experience of isolation and hearing loss): hearing loss can cause people to feel disconnected at social events or to cease attending them. Theme 2 (complexity of isolation and hearing loss): the various causes of isolation (e.g. hearing loss, retirement, comorbidities) are difficult to disentangle. Theme 3 (downstream effects of isolation and hearing loss): hearing loss and/or isolation can lead to mental health problems, stigmatisation, fatigue and unemployment. Theme 4 (preferred components of an isolation intervention): an isolation intervention should be patient-led and patient-centred and take place in the community. Theme 5 (challenges to implementing an isolation intervention): barriers to implementing an isolation intervention include a lack of time, training and continuity.
Conclusion
This study demonstrated that social isolation arising from hearing loss is a substantial, complex problem and provided novel insights on implementing an intervention to address this issue.
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Affiliation(s)
- Eithne Heffernan
- Discipline of General Practice, Clinical Science Institute, School of Medicine, National University of Ireland, Galway, Ireland
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Christine M Withanachchi
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Melanie A Ferguson
- Nottingham University Hospitals NHS Trust, Queens Medical Centre, Nottingham, UK
- Curtin enAble Institute, School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Ear Science Institute Australia, Perth, Australia
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17
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Bennett RJ, Kosovich E, Cohen S, Lo C, Logan K, Olaithe M, Eikelboom R. Hearing Aid Review Appointments: Attendance and Effectiveness. Am J Audiol 2021; 30:1058-1066. [PMID: 34709951 DOI: 10.1044/2021_aja-21-00004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE This study aimed to (a) identify participant factors associated with hearing aid review (HAR) appointment attendance, (b) investigate whether the completion of self-report survey identifying hearing aid-related problems affects HAR appointment attendance, and (c) investigate whether hearing aid problems and hearing aid management deficiencies are adequately addressed during HAR appointments. METHOD A prospective cohort study of adult hearing aid owners recruited from a single hearing clinic in Western Australia. Potential participants were invited to an annual HAR appointment via postal letter. The invitation included a paper-based self-report survey evaluating either (a) hearing aid problems, (b) hearing aid management skills, or (c) hearing aid outcomes, depending on which intervention/control group the potential participants were assigned to, and a reply paid addressed envelope. Two months later, potential participants were sent all three paper-based self-report surveys, irrespective of whether they had attended or not attended an HAR appointment. RESULTS (a) There was no significant difference in gender or source of funding for hearing services between HAR appointment attendees and nonattendees. HAR nonattendees lived a greater distance from their clinic and were younger than attendees. (b) Survey completion did not influence HAR appointment attendance rates. (c) A significant reduction in individuals' self-reported hearing aid problems was recorded following the attendance at the HAR appointment. No significant changes in hearing aid management skills or overall hearing aid outcomes were detected. CONCLUSIONS Long travel distances may be a barrier to attendance at review appointments. HAR appointments appear to be effective in improving hearing aid problems.
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Affiliation(s)
- Rebecca J. Bennett
- Ear Science Institute Australia, Subiaco, Western Australia
- Ear Sciences Centre, The University of Western Australia, Nedlands, Australia
| | - Erin Kosovich
- Ear Science Institute Australia, Subiaco, Western Australia
- Ear Sciences Centre, The University of Western Australia, Nedlands, Australia
| | - Steff Cohen
- Ear Science Institute Australia, Subiaco, Western Australia
- Ear Sciences Centre, The University of Western Australia, Nedlands, Australia
| | - Cara Lo
- Ear Science Institute Australia, Subiaco, Western Australia
- Ear Sciences Centre, The University of Western Australia, Nedlands, Australia
| | - Kevin Logan
- Ear Science Institute Australia, Subiaco, Western Australia
- Ear Sciences Centre, The University of Western Australia, Nedlands, Australia
| | - Michelle Olaithe
- School of Psychology, The University of Western Australia, Nedlands, Australia
| | - Robert Eikelboom
- Ear Science Institute Australia, Subiaco, Western Australia
- Ear Sciences Centre, The University of Western Australia, Nedlands, Australia
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
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18
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Bennett RJ, Donaldson S, Kelsall-Foreman I, Meyer C, Pachana NA, Saulsman L, Eikelboom RH, Bucks RS. Addressing Emotional and Psychological Problems Associated With Hearing Loss: Perspective of Consumer and Community Representatives. Am J Audiol 2021; 30:1130-1138. [PMID: 34670097 DOI: 10.1044/2021_aja-21-00093] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Hearing loss causes emotional distress and can contribute to the development of psychological difficulties, yet emotional and psychological issues are not addressed within current audiology services. The purpose of this study was to use focus groups with consumer and community representatives to explore how we might improve the provision of support for clients experiencing emotional and psychological issues in relation to their hearing loss. PARTICIPANTS Adults with hearing loss (n = 19) and their significant others (n = 9), as well as 10 hearing health care professionals (n = 4 hearing health care clinicians, n = 4 reception staff, and n = 2 clinical managers), participated in consumer and community engagement focus groups. METHOD Consumer and community representatives were tasked with (a) identifying the stakeholders involved in supporting adults experiencing emotional or psychological difficulties on account of their hearing loss, (b) describing the behaviors undertaken by each stakeholder group, and (c) selecting target behavior(s) that could optimally form the basis of an intervention program to improve the quality and frequency of support provided to people experiencing emotional and psychological problems in the audiology setting. RESULTS Participants identified 12 stakeholder groups involved in supporting adults with hearing loss experiencing emotional and psychological problems. The three behaviors voted by participants to be the most promising for a behavioral intervention included the clinician (a) asking about, (b) providing information on, and (c) delivering therapeutic intervention for emotional and psychological well-being within audiological service provision. CONCLUSION Consumer and community stakeholder representatives indicate a general desire for hearing health care clinicians to deliver support for the emotional and psychological issues that arise relating to hearing loss.
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Affiliation(s)
- Rebecca J. Bennett
- Ear Science Institute Australia, Subiaco, Western Australia
- Ear Sciences Centre, The University of Western Australia, Perth, Australia
| | - Sara Donaldson
- Ear Sciences Centre, The University of Western Australia, Perth, Australia
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - India Kelsall-Foreman
- Ear Sciences Centre, The University of Western Australia, Perth, Australia
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Carly Meyer
- Department of Clinical, Educational and Health Psychology, University College London, United Kingdom
| | - Nancy A. Pachana
- School of Psychology, The University of Queensland, St. Lucia, Australia
| | - Lisa Saulsman
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Robert H. Eikelboom
- Ear Science Institute Australia, Subiaco, Western Australia
- Ear Sciences Centre, The University of Western Australia, Perth, Australia
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
| | - Romola S. Bucks
- School of Psychological Science, The University of Western Australia, Perth, Australia
- The Raine Study, The University of Western Australia, Crawley, Australia
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19
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Kanji A, Watermeyer J, Ismail M. Audiology students’ clinical communication and information giving practices during initial consultations: The impact of a brief intervention. SPEECH, LANGUAGE AND HEARING 2021. [DOI: 10.1080/2050571x.2021.2008175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Amisha Kanji
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, South Africa
| | - Jennifer Watermeyer
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, South Africa
| | - Mishkah Ismail
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, South Africa
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20
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Smartphone-Connected Hearing Aids Enable and Empower Self-Management of Hearing Loss: A Qualitative Interview Study Underpinned by the Behavior Change Wheel. Ear Hear 2021; 43:921-932. [PMID: 34653030 DOI: 10.1097/aud.0000000000001143] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To identify patient-reported barriers and facilitators to using smartphone-connected hearing aids, using the Behavior Change Wheel (BCW) to understand experiences and how these can be addressed. DESIGN A single-center, prospective, observational study. Eight hearing aid users (new = 1, existing = 7; mean age = 71.75 years, SD = 5.23, range = 65 to 81 years) were identified through convenience sampling from 44 participants who took part in a 7-week evaluation of smartphone-connected hearing aids controlled by a prototype app. The app allowed users to manually control settings such as gain, noise reduction, and microphone directionality, preset, and customized programmes. Participants were assigned to one of two focus groups following trial of the app. RESULTS Focus group transcripts were thematically analyzed and underpinned by the COM-B (Capability, Opportunity, Motivation-Behavior) model and Theoretical Domains Framework to identify barriers and facilitators to using smartphone-connected hearing aids (the target behavior). Mapping of themes to the BCW allowed use of the Behavior Change Technique Taxonomy (version 1) to identify behavior change techniques that audiologists could implement in clinical practice to address the barriers and facilitators. Capability: The app increased participants' knowledge of hearing aid controls, encouraging use of the app for improved hearing loss self-management. However, barriers to using the app included perception of insufficient digital literacy skills for smartphone-connected hearing aid use and an increased cognitive load caused by decisions over which controls to use. Opportunity: Perceived smartphone norms (i.e., acceptable occasions to use smartphones) and differing listening contexts acted as both facilitators and barriers. Motivation: The ability to control hearing aid settings in any listening situation (e.g., to reduce noise) empowered users to successfully self-manage their hearing loss, leading to greater confidence and participation in everyday life. The app also reduced hearing aid-related and self-stigma, and the ability to self-adjust hearing aids benefitted both participants and communication partners. It was the adjustability and interaction afforded by the app that empowered users, rather than the hearing aid technology itself. Perceived beliefs and knowledge about digital literacy skills, and specifically abilities to use a smartphone, were perceived to be barriers in this typically older population, particularly when they compared themselves to younger generations. Using the Behavior Change Technique Taxonomy (version 1), behavior change techniques that could be used by audiologists to address these barriers included enablement, goal setting, reframing perceptions toward technology, and addressing patient educational needs. CONCLUSIONS Smartphone-connected hearing aids, when used in their everyday lives, were viewed positively by participants across a range of domains, empowering them and enabling hearing loss self-management. Audiologists should consider smartphone-connected hearing aid candidacy for all who have access to smartphones and are willing to use one. Use of the BCW has identified that modifiable barriers to using smartphone-connected hearing aids exist. Audiologists could use these evidence-based behavior change techniques to support patients in adopting and using these technologies to successfully self-manage hearing loss. Overall, by reframing smartphone technologies as a tool to remain connected with society, smartphone-connected hearing aids could shift the power of managing hearing loss from clinician to patient.
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21
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Bennett RJ, Kelsall-Foreman I, Donaldson S, Olaithe M, Saulsman L, Badcock JC. Exploring Current Practice, Knowledge, and Training Needs for Managing Psychosocial Concerns in the Audiology Setting: Perspectives of Audiologists, Audiology Reception Staff, and Managers. Am J Audiol 2021; 30:557-589. [PMID: 34139126 DOI: 10.1044/2021_aja-20-00189] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Purpose The purpose of this study was to explore the current practices and training requirements for supporting clients experiencing psychosocial concerns in the audiology setting, from the perspectives of audiology clinicians, managers, and reception staff. Method Convenience sampling was used to recruit audiologists, reception staff, and clinic managers (N = 13, M age = 32.2 ± 8.1, range: 25-47 years, 11 female) through a large hearing services provider in Western Australia. A semistructured focus group was used to elicit participant views regarding current experiences relating to clients who express psychosocial concerns in the audiology setting, familiarity with psychosocial interventions, and training requirements for delivery of psychosocial interventions in the audiological setting. Results Twenty-four subthemes were identified across six themes: (1) awareness of psychosocial well-being, (2) the role of others, (3) identifying client's psychosocial needs, (4) managing client's psychosocial needs, (5) barriers to providing psychosocial support, and (6) broadening audiological services to include psychosocial support. Conclusions Participants reported an awareness of their clients' psychosocial challenges within the audiology setting, yet they described uncertainty in how best to respond in providing support and whether this was within their scope of practice. A majority of audiology staff expressed desire and motivation to broaden the scope of their service in order to better address their clients' hearing loss-related psychosocial needs.
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Affiliation(s)
- Rebecca J. Bennett
- Ear Science Institute Australia, Subiaco, Western Australia
- Ear Sciences Centre, The University of Western Australia, Crawley, Australia
| | - India Kelsall-Foreman
- School of Psychological Science, The University of Western Australia, Crawley, Australia
| | - Sara Donaldson
- School of Psychological Science, The University of Western Australia, Crawley, Australia
| | - Michelle Olaithe
- School of Psychological Science, The University of Western Australia, Crawley, Australia
| | - Lisa Saulsman
- School of Psychological Science, The University of Western Australia, Crawley, Australia
| | - Johanna C. Badcock
- School of Psychological Science, The University of Western Australia, Crawley, Australia
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22
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Gotowiec S, Larsson J, Incerti P, Young T, Smeds K, Wolters F, Herrlin P, Ferguson M. Understanding patient empowerment along the hearing health journey. Int J Audiol 2021; 61:148-158. [PMID: 34032531 DOI: 10.1080/14992027.2021.1915509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Related to the hearing health journey, this study aimed to: (i) explore how empowerment manifests itself from individuals' first awareness of hearing loss through to hearing aid fitting and then to becoming an active hearing aid user, (ii) identify points when the different dimensions of empowerment are most relevant, and (iii) conceptualise empowerment. DESIGN A semi-structured interview study was conducted, followed by a template analysis of the data. STUDY SAMPLE Adult hearing aid users from Sweden (n = 8) and Australia (n = 10) who had worn hearing aids for between 6 and 36 months. RESULTS The themes that emerged from the transcripts were knowledge, skills and strategies, participation, self-efficacy, and control. CONCLUSIONS This study conceptualises empowerment along the hearing health journey as the process through which individuals with hearing-related challenges acquire and use knowledge, skills, and strategies, and increase self-efficacy, participation, and the feeling of control of their hearing health care, hearing solutions, and everyday lives. There are not specific points along the hearing health journey where any dimension is uniquely relevant, instead, each dimension is a dynamic component at all stages.
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Affiliation(s)
| | | | | | - Taegan Young
- National Acoustic Laboratories, Sydney, Australia
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23
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Bennett RJ, Barr C, Cortis A, Eikelboom RH, Ferguson M, Gerace D, Heffernan E, Hickson L, van Leeuwen L, Montano J, Preminger JE, Pronk M, Saunders GH, Singh G, Timmer BHB, Weinstein B, Bellekom S. Audiological approaches to address the psychosocial needs of adults with hearing loss: perceived benefit and likelihood of use. Int J Audiol 2020; 60:12-19. [PMID: 33176511 DOI: 10.1080/14992027.2020.1839680] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To explore the perceived benefit and likely implementation of approaches used by audiologists to address their adult clients' psychosocial needs related to hearing loss. DESIGN Adults with hearing loss and audiologists completed separate, but related, surveys to rate their perceived benefit and also their likely use of 66 clinical approaches (divided over seven themes) that aim to address psychosocial needs related to hearing loss. STUDY SAMPLE A sample of 52 Australian adults with hearing loss, and an international sample of 19 audiologists. RESULTS Overall, participants rated all of the approaches highly on both benefit and likelihood of use; the highest ranked theme was Providing Emotional Support. Cohort comparisons showed that audiologists ranked the approaches significantly higher than did adults with hearing loss. Overall, participants ranked the themes higher on benefit than on the likelihood to use scales. CONCLUSIONS Adults with hearing loss and audiologists recognise the importance of approaches that address the psychosocial impacts of hearing loss in audiological rehabilitation. However, both groups placed slightly greater value on the internal-based approaches (the clients own emotional response, empowerment, and responsibility), and slightly less emphasis on the external-based approaches (being supported by communication partners, support groups or other health professionals).
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Affiliation(s)
- Rebecca J Bennett
- Ear Science Institute Australia, Subiaco, WA, Australia.,Medical School, The University of Western Australia, Crawley, WA, Australia.,School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | | | - Alex Cortis
- Ear Science Institute Australia, Subiaco, WA, Australia.,Medical School, The University of Western Australia, Crawley, WA, Australia
| | - Robert H Eikelboom
- Ear Science Institute Australia, Subiaco, WA, Australia.,Medical School, The University of Western Australia, Crawley, WA, Australia.,Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Melanie Ferguson
- National Acoustic Laboratories, Macquarie University, Sydney, NSW, Australia
| | - Daniel Gerace
- Ear Science Institute Australia, Subiaco, WA, Australia.,Medical School, The University of Western Australia, Crawley, WA, Australia
| | - Eithne Heffernan
- Discipline of General Practice, Clinical Science Institute, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Louise Hickson
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Lisette van Leeuwen
- Department of Otolaryngology-Head and Neck Surgery, Ear & Hearing, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | - Jill E Preminger
- Program in Audiology, University of Louisville School of Medicine, Louisville, KY, USA.,Speech, Language and Hearing Sciences, San Diego State University, San Diego, CA, USA
| | - Marieke Pronk
- Department of Otolaryngology-Head and Neck Surgery, Ear & Hearing, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Gabrielle H Saunders
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK
| | - Gurjit Singh
- Phonak Canada, Mississauga, ON, Canada.,Department of Psychology, Ryerson University, Toronto, ON, Canada.,Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
| | - Barbra H B Timmer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.,Sonova AG, Staefa, Switzerland
| | | | - Sandra Bellekom
- Ear Science Institute Australia, Subiaco, WA, Australia.,Medical School, The University of Western Australia, Crawley, WA, Australia
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