Effectiveness of publicity campaign encouraging earlier referral of hearing loss in adults

The Role of the General Practitioner in Managing Age-Related Hearing Loss: A Scoping Review

Purpose The purpose of this review was to examine the research activity relating to the role of the general practitioner (GP) in managing age-related hearing loss in older adults. Method A literature search of peer-reviewed journal articles published in English was conducted in online bibliographic databases using multiple variations of the keywords "general practitioner" and "hearing." Results The search strategy identified 3,255 articles. The abstracts of all articles were screened with 124 full-text records subsequently assessed for eligibility. Forty-nine articles met the inclusion criteria and were included in this review. Conclusions For people with hearing loss, the GP can play an instrumental role in guiding appropriate and timely choices for addressing hearing concerns. There are a range of quick, easy, and sensitive methods available to GPs to assist the objective evaluation of hearing. The evidence suggests that implementing hearing screening programs targeting older adults will increase rates of hearing loss detection and subsequently increase the number of patients receiving hearing loss intervention. Education and training appear key to improving GPs' screening, management, and referral of patients with hearing loss in the primary health care setting.

[Tetanus vaccination. Evaluation of a program of health promotion in a family medicine unit]

OBJECTIVE

To assess the effectiveness of a tetanus immunization poster at a medical clinic in encouraging patients to request immunization against tetanus with d2T5.

DESIGN

Quasi-experimental study.

SETTING

The Family Medicine Unit (F.M.U.) at the Centre hospitalier de l'Université Laval (C.H.U.L.), a tertiary hospital in the region of Quebec City.

PARTICIPANTS

All patients over 7 years of age at CHUL's FMU between February 22 and March 19, 1993.

INTERVENTIONS

Poster promoting tetanus immunization displayed in waiting room during test weeks 2 and 4 and withdrawn during control weeks 1 and 3.

MAIN OUTCOME MEASURE

Proportion of patients vaccinated with d2T5.

RESULTS

The proportion of patients vaccinated during the test weeks was the same as the proportion vaccinated during the control weeks. Week 1: 1/507 (0.20); Week 2: 1/394 (0.25); Week 3: 1/441 (0.23); Week 4: 1/486 (0.21).

CONCLUSION

The presence of the posters in the waiting room had no impact on tetanus immunization at CHUL's FMU.

Prevalence of hearing loss among people aged 65 years and over: screening and hearing aid provision

The aim of this study was to assess the prevalence of hearing loss among people aged 65 years and over and to offer hearing aids where necessary. The study was carried out in a large health centre practice in Birmingham with a computerized record system. All patients aged 65 years, and a 20% random sample of patients aged 66 years and over were invited for interview. They were questioned about hearing loss and examined audiometrically. All patients with a hearing loss in the better ear of 35 decibels or more over the speech frequencies (0.5-4 kHz) were offered a hearing aid. A total of 322 patients attended (72% of those invited) and of these 34 patients already had a hearing aid. A further 142 patients were identified for whom an aid was recommended and 69 of these accepted. The acceptance rate was higher among men than women (57% compared with 43%). Sixty one patients (19% of those screened) had an asymmetrical hearing loss and of these 24 required consultant assessment; none had serious underlying pathology. There is a large unmet need for hearing aid provision. Simple audiometric assessment in health centres provides an opportunity to meet this need.

Referrals to a hearing aid clinic: scope for improvement

This study followed on from a recent national publicity campaign aiming to get earlier provision of hearing aids for elderly people, improve both patient and general practitioner awareness of hearing impairments and increase knowledge of alternative environmental aids among sufferers. The study intended to examine present patterns of patient presentation and general practitioner management within a major Scottish city. A random sample of patients over the age of 55 years referred to a hearing aid clinic were questioned on the nature of their hearing difficulty. Patients who attended their general practitioner at the suggestion of a relative were less likely to be referred at their initial visit and significantly less likely to have had their ears syringed than those who were self-motivated. Respondents had little knowledge of alternatives to hearing aids, although these are relevant to the disability experienced by the majority of these subjects.

Health education using video recordings in a general practice waiting area: an evaluation

With the help of a patient participation group video recordings of health education programmes were shown in the waiting area of a health centre. Patients could choose whether or not to watch the programmes. When asked their views on the project 87% of patients responded positively, and 50% of those who watched could recall specific facts presented. There were no significant differences in age or sex between those who chose and chose not to watch the video recordings. However, unemployed patients and those in social classes 4 and 5 were significantly less likely to watch the programmes than those in social classes 1-3. The use of video recordings in both primary care and hospital waiting areas and the possible role of the health education authority as a central resource is discussed. This system could provide a useful means of extending health education, although further research is needed on the response of different social classes to different forms of health education.