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Koerber RM, Kokorelias KM, Sinha SK. The clinical use of personal hearing amplifiers in facilitating accessible patient-provider communication: A scoping review. J Am Geriatr Soc 2024. [PMID: 38299694 DOI: 10.1111/jgs.18784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/21/2023] [Accepted: 12/27/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Older adults with hearing loss struggle to communicate with care providers and experience higher mortality rates when hospitalized (Genther et al., 2015), even after controlling for age and comorbidities. Personal hearing amplifiers (PHAs), (e.g., Pocketalkers™), can improve communication with older patients. METHODS We conducted a scoping review to identify research gaps and summarize findings on the clinical use of PHAs with patients with hearing loss. After refining search terms relating to hearing loss and PHAs, we searched MEDLINE, Embase, PsycINFO, Cochrane Library, CINAHL Complete, Web of Science Core Collection, ERIC (Proquest), PubMed, ClinicalTrials.gov, International Clinical Trials Registry Platform, and the International Standard Randomised Controlled Trial Number Registry. We identified articles published in English between 1980 and 2022 that reported empirical outcomes relating to PHA use in clinical settings. Two reviewers independently extracted data from articles. We then organized data into an evidence map, and a narrative review summarizing outcomes. RESULTS From 4234 initially identified titles and abstracts, 12 met our criteria as full texts. These included three surveys on clinicians' awareness and use of PHAs, one evaluation of the acoustic output of a PHA, and eight interventions wherein PHAs were provided to patients with hearing loss. These papers used 10 different terms for PHAs and largely did not cite one another. Results showed high levels of satisfaction with PHAs, and consistently improved speech understanding. Despite this, care providers used devices inconsistently, with challenges around provider awareness, and device maintenance and location tracking. CONCLUSIONS PHAs have a consistent positive effect on patients' ability to understand their care providers despite hearing loss. Barriers and facilitators to their use in clinical settings should be further explored.
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Affiliation(s)
- Raphaelle M Koerber
- Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Toronto, Canada
- Department of Internal Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Kristina M Kokorelias
- Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Toronto, Canada
- Department of Occupational Sciences and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- National Institute on Ageing, Toronto Metropolitan University, Toronto, Canada
| | - Samir K Sinha
- Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Toronto, Canada
- National Institute on Ageing, Toronto Metropolitan University, Toronto, Canada
- Division of Geriatric Medicine, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Division of Geriatric Medicine and Gerontology, Hopkins University School of Medicine, Baltimore, Maryland, USA
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2
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Norin J. Hearing Loss: Insights for Home Care Clinicians. Home Healthc Now 2023; 41:248-255. [PMID: 37682737 DOI: 10.1097/nhh.0000000000001198] [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: 09/10/2023]
Abstract
Hearing loss is a common problem caused by aging, noise exposure, ototoxic medications, and illness. Given their frequent contact with older adults, home care clinicians are uniquely positioned to recognize the adverse effects of hearing loss on physical, social, and cognitive health. This article explores the factors that contribute to hearing loss, highlighting their cumulative effects on overall hearing ability. The consequences of untreated hearing loss support the urgency of early identification, prompt intervention, and proper management of hearing disability. This article also provides an overview of available treatment options, including traditional prescription hearing aids and recently approved over-the-counter devices. By incorporating components of awareness, treatment, and effective communication strategies, healthcare clinicians can take an integrated approach to improve the overall well-being and quality of life of individuals struggling with hearing loss.
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Affiliation(s)
- Julie Norin
- Julie Norin, AuD, CCC-A, is Clinical Assistant Professor, Department of Speech-Language Pathology and Audiology, Towson University, Towson, Maryland
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3
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Valentine KD, Vo H, Mancini B, Urman RD, Arias F, Barry MJ, Sepucha KR. Shared Decision Making for Elective Surgical Procedures in Older Adults with and without Cognitive Insufficiencies. Med Decis Making 2023; 43:656-666. [PMID: 37427547 PMCID: PMC10526885 DOI: 10.1177/0272989x231182436] [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: 07/11/2023]
Abstract
PURPOSE Older adults are prone to cognitive impairment, which may affect their ability to engage in aspects of shared decision making (SDM) and their ability to complete surveys about the SDM process. This study examined the surgical decision-making processes of older adults with and without cognitive insufficiencies and evaluated the psychometric properties of the SDM Process scale. METHODS Eligible patients were 65 y or older and scheduled for a preoperative appointment before elective surgery (e.g., arthroplasty). One week before the visit, staff contacted patients via phone to administer the baseline survey, including the SDM Process scale (range 0-4), SURE scale (top scored), and the Montreal Cognitive Assessment Test version 8.1 BLIND English (MoCA-blind; score range 0-22; scores < 19 indicate cognitive insufficiency). Patients completed a follow-up survey 3 mo after their visit to assess decision regret (top scored) and retest reliability for the SDM Process scale. RESULTS Twenty-six percent (127/488) of eligible patients completed the survey; 121 were included in the analytic data set, and 85 provided sufficient follow-up data. Forty percent of patients (n = 49/121) had MoCA-blind scores indicating cognitive insufficiencies. Overall SDM Process scores did not differ by cognitive status (intact cognition x ¯ = 2.5, s = 1.0 v. cognitive insufficiencies x ¯ = 2.5, s = 1.0; P = 0.80). SURE top scores were similar across groups (83% intact cognition v. 90% cognitive insufficiencies; P = 0.43). While patients with intact cognition had less regret, the difference was not statistically significant (92% intact cognition v. 79% cognitive insufficiencies; P = 0.10). SDM Process scores had low missing data and good retest reliability (intraclass correlation coefficient = 0.7). CONCLUSIONS Reported SDM, decisional conflict, and decision regret did not differ significantly for patients with and without cognitive insufficiencies. The SDM Process scale was an acceptable, reliable, and valid measure of SDM in patients with and without cognitive insufficiencies. HIGHLIGHTS Forty percent of patients 65 y or older who were scheduled for elective surgery had scores indicative of cognitive insufficiencies.Patient-reported shared decision making, decisional conflict, and decision regret did not differ significantly for patients with and without cognitive insufficiencies.The Shared Decision Making Process scale was an acceptable, reliable, and valid measure of shared decision making in patients with and without cognitive insufficiencies.
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Affiliation(s)
- K D Valentine
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Ha Vo
- Massachusetts General Hospital, Boston, MA, USA
| | | | - Richard D Urman
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Franchesca Arias
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Michael J Barry
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Karen R Sepucha
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Beasley JM, Johnston EA, Sevick MA, Jay M, Rogers ES, Zhong H, Zabar S, Goldberg E, Chodosh J. Study protocol: BRInging the Diabetes prevention program to GEriatric Populations. Front Med (Lausanne) 2023; 10:1144156. [PMID: 37275370 PMCID: PMC10232977 DOI: 10.3389/fmed.2023.1144156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/24/2023] [Indexed: 06/07/2023] Open
Abstract
In the Diabetes Prevention Program (DPP) randomized, controlled clinical trial, participants who were ≥ 60 years of age in the intensive lifestyle (diet and physical activity) intervention had a 71% reduction in incident diabetes over the 3-year trial. However, few of the 26.4 million American adults age ≥65 years with prediabetes are participating in the National DPP. The BRInging the Diabetes prevention program to GEriatric Populations (BRIDGE) randomized trial compares an in-person DPP program Tailored for Older AdulTs (DPP-TOAT) to a DPP-TOAT delivered via group virtual sessions (V-DPP-TOAT) in a randomized, controlled trial design (N = 230). Eligible patients are recruited through electronic health records (EHRs) and randomized to the DPP-TOAT or V-DPP-TOAT arm. The primary effectiveness outcome is 6-month weight loss and the primary implementation outcome is intervention session attendance with a non-inferiority design. Findings will inform best practices in the delivery of an evidence-based intervention.
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Affiliation(s)
- Jeannette M Beasley
- Department of Nutrition and Food Studies, New York University, New York, NY, United States
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
| | - Emily A Johnston
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
| | - Mary Ann Sevick
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
- Department of Population Health, Institute for Excellence in Health Equity, New York University, New York, NY, United States
| | - Melanie Jay
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
- Department of Population Health, Institute for Excellence in Health Equity, New York University, New York, NY, United States
- VA New York Harbor Healthcare System, Medicine Service, New York, NY, United States
| | - Erin S Rogers
- Department of Population Health, Institute for Excellence in Health Equity, New York University, New York, NY, United States
| | - Hua Zhong
- Department of Population Health, Institute for Excellence in Health Equity, New York University, New York, NY, United States
| | - Sondra Zabar
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
| | - Eric Goldberg
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
| | - Joshua Chodosh
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
- Department of Population Health, Institute for Excellence in Health Equity, New York University, New York, NY, United States
- VA New York Harbor Healthcare System, Medicine Service, New York, NY, United States
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5
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Stuck AK, Born S, Stuck AE, Kompis M. Potentially Inadequate Real-Life Speech Levels by Healthcare Professionals during Communication with Older Inpatients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4543. [PMID: 36901552 PMCID: PMC10001886 DOI: 10.3390/ijerph20054543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The aim of this study was to investigate real-life speech levels of health professionals during communication with older inpatients in small group settings. METHODS This is a prospective observational study assessing group interactions between geriatric inpatients and health professionals in a geriatric rehabilitation unit of a tertiary university hospital (Bern, Switzerland). We measured speech levels of health professionals during three typical group interactions (discharge planning meeting (n = 21), chair exercise group (n = 5), and memory training group (n = 5)) with older inpatients. Speech levels were measured using the CESVA LF010 (CESVA instruments s.l.u., Barcelona, Spain). A threshold of <60 dBA was defined as a potentially inadequate speech level. RESULTS Overall, mean talk time of recorded sessions was 23.2 (standard deviation 8.3) minutes. The mean proportion of talk time with potentially inadequate speech levels was 61.6% (sd 32.0%). The mean proportion of talk time with potentially inadequate speech levels was significantly higher in chair exercise groups (95.1% (sd 4.6%)) compared to discharge planning meetings (54.8% (sd 32.5%), p = 0.01) and memory training groups (56.3% (sd 25.4%), p = 0.01). CONCLUSIONS Our data show that real-life speech level differs between various types of group settings and suggest potentially inadequate speech levels by healthcare professionals requiring further study.
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Affiliation(s)
- Anna K. Stuck
- Department of Geriatrics, University of Bern, University Hospital Inselspital Bern, 3010 Bern, Switzerland
| | - Stephan Born
- Department of Geriatrics, University of Bern, University Hospital Inselspital Bern, 3010 Bern, Switzerland
| | - Andreas E. Stuck
- Department of Geriatrics, University of Bern, University Hospital Inselspital Bern, 3010 Bern, Switzerland
| | - Martin Kompis
- Department of ENT, Head and Neck Surgery, University of Bern, University Hospital Inselspital Bern, 3010 Bern, Switzerland
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6
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Koerber RM, Vaccarello L, Ho A. The Intelligibility of the Reversed-Stethoscope Technique in Age-Related Hearing Loss. Can Geriatr J 2022; 25:127-133. [PMID: 35747410 PMCID: PMC9156421 DOI: 10.5770/cgj.25.527] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background This study evaluated the effectiveness of the reverse stethoscope technique in improving speech intelligibility. In this technique, a clinician places the earpieces of their stethoscope into the ears of a hearing-impaired patient and speaks into the chest piece. Methods The International Speech Test Signal was presented to four Littman® stethoscope models and a Pocketalker® personal voice amplifier using an Audioscan® hearing instrument test box. The acoustic outputs of the stethoscopes and voice amplifier were measured across the frequency spectrum of speech. The Speech Intelligibility Index of the resulting speech was calculated for natural speech and for each device in relation to 10 standardized hearing losses representing the population of older adults. Results For each of the 10 hearing losses, the speech signal emitted by the stethoscopes was quieter and yielded lower speech intelligibility scores than regular speech. In contrast, the voice amplifier provided mid- and high-frequency amplification and improved speech intelligibility scores for all but the mildest hearing losses. Conclusions The reverse stethoscope technique worsens the clarity of speech and should not be used with older, hearing-impaired patients. Instead, clinicians should use regular speech or, preferably, personal voice amplifiers.
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Affiliation(s)
- Raphaelle M Koerber
- Michael G. DeGroote School of Medicine, McMaster University, Waterloo Regional Campus, Kitchener, ON
| | | | - Allan Ho
- Division of Otolaryngology Head and Neck Surgery, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB
- Edmonton Ear Clinic, Edmonton, AB
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Impact of hearing loss on clinical interactions between older adults and health professionals: a systematic review. Eur Geriatr Med 2020; 11:919-928. [DOI: 10.1007/s41999-020-00358-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
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Lichen IM, Berning MJ, Bower SM, Stanich JA, Jeffery MM, Campbell RL, Walker LE, Bellolio F. Non-pharmacologic interventions improve comfort and experience among older adults in the Emergency Department. Am J Emerg Med 2020; 39:15-20. [PMID: 32507574 DOI: 10.1016/j.ajem.2020.04.089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/19/2020] [Accepted: 04/28/2020] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE Determine if a comfort cart would improve older adults' comfort and facilitate communication during Emergency Department (ED) visits. METHODS A comfort cart containing low-cost, non-pharmacological interventions to improve patient comfort and ability to communicate (e.g., hearing amplifiers, reading glasses) were made available to patients aged ≥65 years. Patients and clinicians were surveyed to assess effectiveness. We followed the Standards for Quality Improvement Reporting Excellence: SQUIRE 2.0 guidelines. RESULTS Three hundred patients and 100 providers were surveyed. Among patients, 98.0%, 95.1%, and 67.5% somewhat or strongly agreed that the comfort cart improved comfort, overall experience, and independence, respectively. Among providers, 97.0%, 95.0%, 87.0%, and 83% somewhat or strongly agreed that the comfort cart provided comfort, improved patient satisfaction, increased ability to give compassionate care, and increased patient orientation. CONCLUSION The comfort cart was an affordable and effective intervention that improved patients' comfort by facilitating communication, wellbeing, and compassionate care delivery.
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Affiliation(s)
| | | | - Susan M Bower
- Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA; Department of Nursing, Mayo Clinic, Rochester, MN, USA.
| | | | - Molly M Jeffery
- Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA; Department Health Science Research, Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA.
| | - Ronna L Campbell
- Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA.
| | - Laura E Walker
- Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA.
| | - Fernanda Bellolio
- Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA; Department Health Science Research, Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA.
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Mormer E, Bubb KJ, Alrawashdeh M, Cipkala-Gaffin JA. Hearing Loss and Communication Among Hospitalized Older Adults: Prevalence and Recognition. J Gerontol Nurs 2020; 46:34-42. [DOI: 10.3928/00989134-20200316-03] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 01/03/2020] [Indexed: 11/20/2022]
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10
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Lee W, Chang Y, Shin H, Ryu S. Hearing Loss and Risk of Overall, Injury-Related, and Cardiovascular Mortality: The Kangbuk Samsung Health Study. J Clin Med 2020; 9:jcm9051415. [PMID: 32397655 PMCID: PMC7290521 DOI: 10.3390/jcm9051415] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 05/06/2020] [Accepted: 05/07/2020] [Indexed: 12/16/2022] Open
Abstract
Hearing loss (HL) has been related to cardiovascular risk factors as well as prevalence of cardiovascular disease itself. We evaluated the association of HL with overall, injury-related, and cardiovascular mortality. A cohort study included 580,798 Korean adults (mean age: 39.7) who attended a screening exam between 2002 and 2016 with a follow-up of up to 17 years. HL was defined as a pure-tone average of thresholds at 0.5, 1.0, and 2.0 kHz ≥25 dB (decibels) in the better ear and further categorized into mild (25–<40 dB) and moderate-to-severe (≥40 dB). Overall and cause-specific mortality was ascertained through linkage to national death records. During median follow-up of 8.4 years, 6581 overall deaths, 977 cardiovascular deaths, and 1161 injury-related deaths were identified. Compared to participants with normal hearing, multivariable-adjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs) for overall mortality among participants with mild and moderate-to-severe HL were 1.13 (1.05–1.21) and 1.30 (1.16–1.46), respectively. Corresponding HRs (95% CIs) for cardiovascular mortality were 1.32 (1.10–1.58) and 1.53 (1.16–2.01), respectively, and corresponding HRs (95% CIs) for injury-related mortality were 1.03 (0.81–1.31) and 1.64 (1.13–2.36), respectively. In this large cohort, HL was positively and independently associated with overall, cardiovascular, and injury-related mortality. A significantly elevated risk of cardiovascular mortality started from mild HL.
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Affiliation(s)
- Woncheol Lee
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea;
| | - Yoosoo Chang
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea;
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Korea;
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul 06351, Korea
- Correspondence: (Y.C.); (S.R.)
| | - Hocheol Shin
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Korea;
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea
| | - Seungho Ryu
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea;
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Korea;
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul 06351, Korea
- Correspondence: (Y.C.); (S.R.)
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11
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Miyawaki A, Kobayashi Y, Kawachi I. Self-Reported Hearing/Visual Loss and Mortality in Middle-Aged and Older Adults: Findings From the Komo-Ise Cohort, Japan. J Epidemiol 2019; 30:67-73. [PMID: 30662042 PMCID: PMC6949181 DOI: 10.2188/jea.je20180198] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background The association of sensory loss with mortality remains unclear. We aimed to explore the associations of hearing loss (HL), visual loss (VL), and dual sensory loss (DSL) with survival. Methods Data came from the Komo-Ise study cohort in Gunma Prefecture, Japan, where the community-dwelling residents aged 40–69 years were followed up from 1993 to 2010. We analyzed 9,522 individuals who answered the follow-up questionnaires in 2000 (average age 64 [range, 47 to 77] years in 2000). The primary exposures were “HL only,” “VL only,” or “DSL”, with “no HL/VL” as the reference. These sensory loss statuses were assessed by asking the difficulty in hearing conversation or reading newspaper even with aids in the follow-up questionnaires in 2000. All-cause and cause-specific mortality were ascertained from linkage to death certificate data. Cox proportional hazards models adjusting for confounders, including demographic factors, socioeconomic status, and health status, were used. Potential mediators (depression, walking disability, and social participation) were additionally adjusted for. Results There were 1,105 deaths over the 10-year follow-up. After adjustment for the potential confounders, HL and DSL were associated with increased all-cause mortality (hazard ratios of 1.74 [95% CI, 1.18–2.57] and 1.63 [95% CI, 1.09–2.42], respectively). Potential mediators explained a modest portion of the association. As for cause-specific mortality, HL was associated with increased cancer mortality, while VL and DSL were associated with increased cardiovascular disease mortality. Conclusions Self-reported HL and DSL may be risk factors of mortality among middle-aged or elderly Japanese populations.
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Affiliation(s)
- Atsushi Miyawaki
- Department of Public Health, Graduate School of Medicine, The University of Tokyo.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health
| | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine, The University of Tokyo
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health
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Shukla A, Nieman CL, Price C, Harper M, Lin FR, Reed NS. Impact of Hearing Loss on Patient–Provider Communication Among Hospitalized Patients: A Systematic Review. Am J Med Qual 2018; 34:284-292. [DOI: 10.1177/1062860618798926] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Age-related hearing loss is a highly prevalent chronic condition in older adults, but hearing loss is rarely accounted for in patient–provider communication studies. This systematic review synthesizes current evidence on the impact of age-related hearing loss on patient–provider communication in hospitalized older adults. Five databases were queried to identify original research that examined patient–provider communication in older adults with hearing loss in an inpatient setting. Of 1053 studies, 13 were included in the final review. All studies reported an adverse effect of hearing loss on patient–provider communication. Among studies that evaluated an intervention to improve communication in older adults with hearing loss, simple interventions such as low-cost voice amplifiers were found to improve communication. An understanding of the effect of hearing loss on patient–provider communication and strategies to mitigate the impact are needed in order to provide safe, quality, patient-centered care to older adults with hearing loss.
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13
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Hearing Loss: Why Does It Matter for Nursing Homes? J Am Med Dir Assoc 2018; 19:323-327. [PMID: 29396185 DOI: 10.1016/j.jamda.2017.12.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 12/08/2017] [Accepted: 12/13/2017] [Indexed: 01/17/2023]
Abstract
Over the past decade, hearing loss has emerged as a key issue for aging and health. We describe why hearing loss may be especially disabling in nursing home settings and provide an estimate of prevalence using the Minimum Data Set (MDS v.3.0). We outline steps to mitigate hearing loss. Many solutions are inexpensive and low-tech, but require significant awareness and institutional commitment.
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Mormer E, Cipkala-Gaffin J, Bubb K, Neal K. Hearing and Health Outcomes: Recognizing and Addressing Hearing Loss in Hospitalized Older Adults. Semin Hear 2017; 38:153-159. [PMID: 28522889 DOI: 10.1055/s-0037-1601570] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
As age increases, the prevalence of hearing loss significantly increases, reaching up to 89% of those 80 years and older. Hearing loss in older patients is often unrecognized and its consequences are often underappreciated. Hearing loss can interfere with the ability to exchange important health information and to participate in health care decision-making. Hearing loss during hospitalization increases the risk of misdiagnosis. There is a lack of empirical data regarding prevalence and recognition of hearing loss in hospitalized older adults. In this article, we describe a variety of negative outcomes that may result when older inpatients are functioning with unrecognized hearing loss.
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Affiliation(s)
- Elaine Mormer
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Janet Cipkala-Gaffin
- University of Pittsburgh Medical Center (UPMC), Shadyside, Pittsburgh Pennsylvania
| | - Kelsi Bubb
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania.,University of Pittsburgh Medical Center (UPMC), Shadyside, Pittsburgh Pennsylvania
| | - Kelly Neal
- University of Pittsburgh Medical Center (UPMC), Shadyside, Pittsburgh Pennsylvania
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15
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Cohen JM, Blustein J, Weinstein BE, Dischinger H, Sherman S, Grudzen C, Chodosh J. Studies of Physician-Patient Communication with Older Patients: How Often is Hearing Loss Considered? A Systematic Literature Review. J Am Geriatr Soc 2017; 65:1642-1649. [DOI: 10.1111/jgs.14860] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Jamie M. Cohen
- State University of New York Upstate Medical University; Syracuse New York
| | - Jan Blustein
- Wagner Graduate School of Public Service, New York University; New York New York
- Department of Population Health; New York University School of Medicine; New York New York
| | - Barbara E. Weinstein
- Doctor of Audiology Program; The Graduate Center, City University of New York; New York New York
| | - Hannah Dischinger
- Oregon Health & Science University School of Medicine; Portland Oregon
| | - Scott Sherman
- Department of Population Health; New York University School of Medicine; New York New York
- Division of Geriatric Medicine and Palliative Care, Department of Medicine; New York University School of Medicine; New York New York
| | - Corita Grudzen
- Department of Emergency Medicine; New York University School of Medicine; New York New York
| | - Joshua Chodosh
- Department of Population Health; New York University School of Medicine; New York New York
- Division of Geriatric Medicine and Palliative Care, Department of Medicine; New York University School of Medicine; New York New York
- VA New York Harbor Heathcare System; New York New York
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Zhang S, Moyes S, McLean C, Searchfield G, Welch D, Jacobs R, Kerse N. Self-reported hearing, vision and quality of life: Older people in New Zealand. Australas J Ageing 2012; 35:98-105. [DOI: 10.1111/j.1741-6612.2012.00627.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Shiran Zhang
- Department of General Practice and Primary Health Care; School of Population Health; Faculty of Medical and Health Sciences; University of Auckland; Auckland New Zealand
| | - Simon Moyes
- Department of General Practice and Primary Health Care; School of Population Health; Faculty of Medical and Health Sciences; University of Auckland; Auckland New Zealand
| | - Chris McLean
- Department of General Practice and Primary Health Care; School of Population Health; Faculty of Medical and Health Sciences; University of Auckland; Auckland New Zealand
| | - Grant Searchfield
- Audiology Section; School of Population Health; Faculty of Medical and Health Sciences; University of Auckland; Auckland New Zealand
| | - David Welch
- Audiology Section; School of Population Health; Faculty of Medical and Health Sciences; University of Auckland; Auckland New Zealand
| | - Robert Jacobs
- Department of Optometry and Vision Science; Faculty of Science; University of Auckland; Auckland New Zealand
| | - Ngaire Kerse
- Department of General Practice and Primary Health Care; School of Population Health; Faculty of Medical and Health Sciences; University of Auckland; Auckland New Zealand
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Associations between hearing impairment and mortality risk in older persons: the Blue Mountains Hearing Study. Ann Epidemiol 2010; 20:452-9. [PMID: 20470972 DOI: 10.1016/j.annepidem.2010.03.011] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2009] [Revised: 01/27/2010] [Accepted: 03/07/2010] [Indexed: 11/21/2022]
Abstract
PURPOSE To assess whether hearing loss predicts an increased risk of mortality. METHODS The Blue Mountains Hearing Study examined 2956 persons (49+ years) during 1997 to 2000. The Australian National Death Index was used to identify deaths until 2005. Hearing loss was defined as the pure-tone average (0.5-4 kHz) of air-conduction hearing thresholds greater than 25 dB HL. Associations between hearing loss and mortality risk were estimated using Cox regression and structural equation modeling (SEM). RESULTS When we used Cox regression, we discovered that hearing loss was associated with increased risk of cardiovascular (hazard ratio [HR] 1.36, 95% confidence interval [CI] 1.08-1.84) and all-cause (AC) mortality (HR 1.39, 95% CI 1.11-1.79) after adjustment for age and sex but not after multivariable adjustment. SEM pathway analysis, however, revealed a greater AC mortality risk (HR 2.58, 95% CI 1.64-4.05) in persons with hearing loss, which was mediated: cognitive impairment (HR 1.45, 95% CI 1.08-1.94) and walking disability (HR 1.63, 95% CI 1.24-2.15). These variables increased mortality both directly and indirectly through effects on self-rated health. CONCLUSIONS Hearing loss was associated with increased AC mortality via three mediating variables: disability in walking, cognitive impairment, and self-rated health. It is important to recognize that persons with combined disabilities are at increased risk of cardiovascular and AC mortality.
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Fitzgerald JT, Stansfield RB, Tang T, Oh M, Frohna A, Armbruster B, Gruppen L, Anderson R. Patient and provider perceptions of diabetes: measuring and evaluating differences. PATIENT EDUCATION AND COUNSELING 2008; 70:118-125. [PMID: 17997265 PMCID: PMC2223066 DOI: 10.1016/j.pec.2007.09.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2007] [Revised: 08/22/2007] [Accepted: 09/16/2007] [Indexed: 05/25/2023]
Abstract
OBJECTIVE This study measures diabetes care perceptions of patients and their providers, and examines perceptions differences of patient-provider pairs. METHODS Patient and provider perceptions were assessed using the Diabetes Semantic Differential Scales (DSDS) which ask respondents to rate diabetes care concepts using contrasting adjective pairs. The DSDS was scored by two methods: using means and using factor analysis. Persons with diabetes 40-years-old or older were recruited. Using a "snowball" sampling strategy, potential provider participants were identified by their patients; 71 providers agreed. These providers represented 51% of the patient participants and created 138 patient-provider pairs. RESULTS For the mean scores, there were significant differences between patients and providers for 5 of the 18 semantic differentials (28%). Similarly, the factor scores indicated significant differences for 14 of 54 factors (26%). The effect sizes indicated practical differences. CONCLUSION Significant differences exist between patient and provider perceptions. Generally, patients have the more positive diabetes perceptions. PRACTICE IMPLICATIONS During patient and provider discussions, participants can perceive diabetes concepts differently. The DSDS can determine perception differences. While it is best to use factor analyses to score the DSDS, mean scores are more easily calculated and indicate the broad conceptual areas where patient and provider differ.
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Chia EM, Wang JJ, Rochtchina E, Cumming RR, Newall P, Mitchell P. Hearing Impairment and Health-Related Quality of Life: The Blue Mountains Hearing Study. Ear Hear 2007; 28:187-95. [PMID: 17496670 DOI: 10.1097/aud.0b013e31803126b6] [Citation(s) in RCA: 314] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To assess the association between hearing impairment and health-related quality of life (HRQOL) in an older population, using the self-administered 36-item Short-Form Health Survey (SF-36). DESIGN Participants of the Blue Mountains Hearing Study (BMHS, N = 2956) attended a comprehensive interview and hearing examination in which both self-reported and measured hearing impairments were assessed. Hearing impairment was defined as the pure-tone average of air-conduction hearing thresholds >25 decibels hearing level (dB HL) for the four frequencies (0.5 to 4.0 kHz) in the better ear. RESULTS Of the 2431 participants with complete data (mean age, 67.0 yr), 1347 (55.4%) did not have measured hearing loss, whereas 324 (13.3%) had unilateral (285 mild, 22 moderate, 17 severe) and 760 (31.3%) had bilateral hearing impairment (478 mild, 207 moderate, 75 severe). After adjusting for demographic and medical confounders, bilateral hearing impairment was associated with poorer SF-36 scores in both physical and mental domains (fall in physical component score, PCS of 1.4 points, p = 0.025; fall in mental component score, MCS of 1.0 point, p = 0.13), with poorer scores associated with more severe levels of impairment (PCS p(trend) = 0.04, MCS p(trend) = 0.003). Participants with bilateral hearing impairment who habitually used hearing aids had a slightly better PCS (mean, 43.1; standard error [SE], 0.9) than those with the same impairment who did not have hearing aids or who only used them occasionally (mean, 41.2; SE 0.5), although this finding was not statistically significant (p = 0.055). Persons with self-reported hearing loss had significantly poorer HRQOL than corresponding persons without, but persons with unilateral or high-frequency hearing loss did not have significantly different HRQOL scores than their corresponding counterparts. CONCLUSIONS This study quantifies the associated disease burden of age-related hearing impairment on health-related quality of life in a population-based cohort of older persons.
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Affiliation(s)
- Ee-Munn Chia
- Centre for Vision Research, Department of Ophthalmology, University of Sydney, Westmead, Australia
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Brandt JC, Grabill CM. Communicating with special populations: children and older adults. Vet Clin North Am Small Anim Pract 2007; 37:181-98; abstract x. [PMID: 17162120 DOI: 10.1016/j.cvsm.2006.09.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Veterinary professionals must meet the growing expectations of a diverse range of clients to sustain success in veterinary medicine. Few veterinarians, however, receive comprehensive skills training for communicating effectively with clients, particularly among special populations, such as children and older adults. An increasing number of veterinary professionals have recognized a need to master requisite skills for effectively interacting with pet-owning families. This article highlights the importance of the human-animal bond for children and older adults, addresses issues of pet loss, and provides suggestions for meeting the communication needs of both populations.
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Affiliation(s)
- Jennifer C Brandt
- The Ohio State University College of Veterinary Medicine, Columbus, OH 43210-1089, USA.
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Fitzgerald JT, Gruppen LD, Wray LA, Shay BR, Anderson RM. Measuring perceptions of diabetes-related concepts: a preliminary study. DIABETES EDUCATOR 2003; 29:480-7. [PMID: 12854338 DOI: 10.1177/014572170302900312] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE This pilot study explored health professionals' and patients' perceptions of diabetes through the development of the Diabetes Semantic Differential Scales (DSDS). These scales evaluate the meaning of diabetes-related concepts. METHODS Health professionals (n = 39) attending a CME course completed the health professional version of the DSDS. Patients (n = 70) completed the patient version of the DSDS. RESULTS The reliability of the DSDS was supported. The scale scores of health professionals, African American patients, and Caucasian patients, examined initially by one-way analyses of variance, showed significant differences among the groups for 4 of the 18 diabetes concepts. Effect sizes were also examined among these groups. For 7 concepts, there was a significant practical difference between the perceptions of the health professionals and the African American patients. For the Caucasian patients, differences were noted for 6 concepts. CONCLUSIONS There are 3 primary inferences from this pilot study. First, health professionals and patients are likely to hold different perceptions of key diabetes concepts. Second, the concepts on which professionals and patients differ are not always what one would expect. Third, health professionals should clarify patients' understanding of diabetes to minimize the potential for miscommunication.
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Affiliation(s)
- James T Fitzgerald
- The Department of Medical Education, University of Michigan Medical School, Ann Arbor (Drs Fitzgerald, Gruppen, and Anderson)
- The Geriatric Research, Education, & Clinical Center (GRECC), VA Ann Arbor Healthcare System, Michigan (Dr Fitzgerald)
| | - Larry D Gruppen
- The Department of Medical Education, University of Michigan Medical School, Ann Arbor (Drs Fitzgerald, Gruppen, and Anderson)
| | - Linda A Wray
- The Department of Behavioral Health, Pennsylvania State University, University Park (Dr Wray)
| | - Barbara R Shay
- The Geriatrics Center, University of Michigan Medical School, Ann Arbor (Ms Shay)
| | - Robert M Anderson
- The Department of Medical Education, University of Michigan Medical School, Ann Arbor (Drs Fitzgerald, Gruppen, and Anderson)
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Affiliation(s)
- L Fook
- Arrowe Park Hospital, Upton Road, Wirral, Merseyside L69 5PE, UK
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