| 1. |
- Convery, Elizabeth, et al.
(författare)
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Factors Associated With Successful Setup of a Self-Fitting Hearing Aid and the Need for Personalized Support
- 2018
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Ingår i: Ear & Hearing. - : Ovid Technologies (Wolters Kluwer Health). - 0196-0202. ; 40:4, s. 794-804
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Self-fitting hearing aids have the potential to increase the accessibility of hearing health care. The aims of this study were to (1) identify factors that are associated with the ability to successfully set up a pair of commercially available self-fitting hearing aids; 2) identify factors that are associated with the need for knowledgeable, personalized support in performing the self-fitting procedure; and (3) evaluate performance of the individual steps in the self-fitting procedure.Design: Sixty adults with hearing loss between the ages of 51 and 85 took part in the study. Half of the participants were current users of bilateral hearing aids; the other half had no previous hearing aid experience. At the first appointment, participants underwent assessments of health locus of control, hearing aid self-efficacy, cognitive status, problem-solving skills, demographic characteristics, and hearing thresholds. At the second appointment, participants followed a set of computer-based instructions accompanied by video clips to self-fit the hearing aids. The self-fitting procedure required participants to customize the physical fit of the hearing aids, insert the hearing aids into the ear, perform self-directed in situ audiometry, and adjust the resultant settings according to their preference. Participants had access to support with the self-fitting procedure from a trained clinical assistant (CA) at all times.Results: Forty-one (68%) of the participants achieved a successful self-fitting. Participants who self-fit successfully were significantly more likely than those who were unsuccessful to have had previous experience with hearing aids and to own a mobile device (when controlling for four potential covariates). Of the 41 successful self-fitters, 15 (37%) performed the procedure independently and 26 (63%) sought support from the CA. The successful self-fitters who sought CA support were more likely than those who self-fit independently to have a health locus of control that is externally oriented toward powerful others. Success rates on the individual steps in the self-fitting procedure were relatively high. No one step was more problematic than any other, nor was there a systematic tendency for particular participants to make more errors than others. Steps that required use of the hearing aids in conjunction with the self-fitting app on the participant’s mobile device had the highest rates of support use.Conclusions: The findings of this study suggest that nonaudiologic factors should be considered when selecting suitable candidates for the self-fitting hearing aids evaluated in this study. Although computer-based instructions and video clips were shown to improve self-fitting skill acquisition relative to past studies in which printed instruction booklets were used, the majority of people are still likely to require access to support from trained personnel while carrying out the self-fitting procedure, especially when this requires the use of an app.
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| 2. |
- Convery, Elizabeth, et al.
(författare)
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Predictors of hearing loss self-management in older adults
- 2018
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 41:17, s. 2026-2035
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To determine the factor structure of a clinical tool for the assessment of hearing loss self-management, and to identify predictors of the total score on the assessment and the extracted factor scores.Materials and methods: Hearing loss self-management assessments were conducted with 62 older adults. The factor structure of the assessment was determined by exploratory factor analysis. Multiple linear regression analyses identified significant contributors to the total score and to each of the extracted factors.Results: Three factors were identified, each representing a distinct domain of hearing loss self-management: Actions, Psychosocial Behaviours, and Knowledge. The most common significant predictor was hearing health care experience, which predicted self-management overall and in the Actions and Knowledge domains. Health literacy predicted hearing loss self-management overall and in the Psychosocial Behaviours domain. Actions were additionally predicted by hearing aid self-efficacy and gender, Psychosocial Behaviours by health locus of control, and Knowledge by age.Conclusions: The results of the factor analysis suggested that hearing loss self-management is a multidimensional construct. Each domain of hearing loss self-management was influenced by different contextual factors. Subsequent interventions to improve hearing loss self-management should therefore be domain-specific and tailored to relevant contextual factors.
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| 3. |
- Convery, Elizabeth, et al.
(författare)
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The Relationship Between Hearing Loss Self-Management and Hearing Aid Benefit and Satisfaction
- 2019
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Ingår i: American Journal of Audiology. - : American Speech Language Hearing Association. - 1059-0889 .- 1558-9137. ; 28:2, s. 274-284
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Hearing loss self-management refers to the knowledge and skills people use to manage the effects of hearing loss on all aspects of their daily lives. The purpose of this study was to investigate the relationship between self-reported hearing loss self-management and hearing aid benefit and satisfaction.Method: Thirty-seven adults with hearing loss, all of whom were current users of bilateral hearing aids, participated in this observational study. The participants completed self-report inventories probing their hearing loss self-management and hearing aid benefit and satisfaction. Correlation analysis was used to investigate the relationship between individual domains of hearing loss self-management and hearing aid benefit and satisfaction.Results: Participants who reported better self-management of the effects of their hearing loss on their emotional well-being and social participation were more likely to report less aided listening difficulty in noisy and reverberant environments and greater satisfaction with the effect of their hearing aids on their self-image. Participants who reported better self-management in the areas of adhering to treatment, participating in shared decision making, accessing services and resources, attending appointments, and monitoring for changes in their hearing and functional status were more likely to report greater satisfaction with the sound quality and performance of their hearing aids.Conclusion: Study findings highlight the potential for using information about a patient's hearing loss self-management in different domains as part of clinical decision making and management planning.
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| 4. |
- Danermark, Berth, et al.
(författare)
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International classification of functioning, disability, and health core sets for hearing loss : A discussion paper and invitation
- 2010
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Ingår i: International Journal of Audiology. - Oxon, United Kingdom : Taylor & Francis. - 1499-2027 .- 1708-8186. ; 49:4, s. 256-262
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Tidskriftsartikel (refereegranskat)abstract
- The World Health Organization’s International Classification of Functioning, Disability and Health (ICF) has adopted a multifactorial understanding of functioning and disability, merging a biomedical paradigm with a social paradigm into a wider understanding of human functioning. Altogether there are more than 1400 ICF-categories describing different aspects of human functioning and there is a need to developing short lists of ICF categories to facilitate use of the classification scheme in clinical practice. To our knowledge, there is currently no such standard measuring instrument to facilitate a common validated way of assessing the effects of hearing loss on the lives of adults. The aim of the project is the development of an internationally accepted, evidence-based, reliable, comprehensive and valid ICF Core Sets for Hearing Loss. The processes involved in this project are described in detail and the authors invite stakeholders, clinical experts and persons with hearing loss to actively participate in the development process.
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| 5. |
- Grenness, Caitlin, et al.
(författare)
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Communication Patterns in Audiologic Rehabilitation History-Taking: Audiologists, Patients, and Their Companions
- 2015
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Ingår i: Ear and Hearing. - : LIPPINCOTT WILLIAMS and WILKINS. - 0196-0202 .- 1538-4667. ; 36:2, s. 191-204
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The nature of communication between patient and practitioner influences patient outcomes. Specifically, the history-taking phase of a consultation plays a role in the development of a relationship and in the success of subsequent shared decision making. There is limited research investigating patient-centered communication in audiology, and this study may be the first to investigate verbal communication in an adult audiologic rehabilitation context. This research aimed, first, to describe the nature of verbal communication involving audiologists, patients, and companions in the history-taking phase of initial audiology consultations and, second, to determine factors associated with communication dynamics. Design: Sixty-three initial audiology consultations involving patients over the age of 55, their companions when present, and audiologists were audio-video recorded. Consultations were coded using the Roter Interaction Analysis System and divided into three consultation phases: history, examination, and counseling. This study analyzed only the history-taking phase in terms of opening structure, communication profiles of each speaker, and communication dynamics. Associations between communication dynamics (verbal dominance, content balance, and communication control) and 11 variables were evaluated using Linear Mixed Model methods. Results: The mean length of the history-taking phase was 8.8 min (range 1.7 to 22.6). A companion was present in 27% of consultations. Results were grouped into three areas of communication: opening structure, information exchange, and relationship building. Examination of the history opening structure revealed audiologists tendency to control the agenda by initiating consultations with a closed-ended question 62% of the time, followed by interruption of patient talk after 21.3 sec, on average. The aforementioned behaviors were associated with increased verbal dominance throughout the history and increased control over the content of questions. For the remainder of the history, audiologists asked 97% of the questions and did so primarily in closed-ended form. This resulted in the audiologist talking as much as the patient and much more than the companions when they were present. Questions asked by the audiologist were balanced in topic: biomedical and psychosocial/lifestyle; however, few emotionally focused utterances were observed from any speaker (less than 5% of utter ances). Conclusions: Analysis of verbal communication involving audiologists, patients, and companions in the history-taking phase in 63 initial audiology consultations revealed a communicative exchange that was audiologist-controlled and structured, but covered both medical and lifestyle content. Audiologists often attempted to create a relationship with their patients; however, little emotional relationship building occurred, which may have implications later in the consultation when management decisions are being made. These results are not in line with patient-centered communication principles. Further research and changes to clinical practice are warranted to transform patient-centered communication from an ideal to a reality.
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| 6. |
- Grenness, Caitlin, et al.
(författare)
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Patient-centred audiological rehabilitation : Perspectives of older adults who own hearing aids
- 2014
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Ingår i: International Journal of Audiology. - : Informa Healthcare. - 1499-2027 .- 1708-8186. ; 53:S1, s. S68-S75
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Patient-centred care is a term frequently associated with quality health care. Despite extensive literature from a range of health-care professions that provide description and measurement of patient-centred care, a definition of patient-centredness in audiological rehabilitation is lacking. The current study aimed to define patient-centred care specific to audiological rehabilitation from the perspective of older adults who have owned hearing aids for at least one year. Design: Research interviews were conducted with a purposive sample of older adults concerning their perceptions of patient-centredness in audiological rehabilitation, and qualitative content analysis was undertaken. Study sample: The participant sample included ten adults over the age of 60 years who had owned hearing aids for at least one year. Results: Data analysis revealed three dimensions to patient-centred audiological rehabilitation: the therapeutic relationship, the players (audiologist and patient), and clinical processes. Individualised care was seen as an overarching theme linking each of these dimensions. Conclusions: This study reported two models: the first model describes what older adults with hearing aids believe constitutes patient-centred audiological rehabilitation. The second provides a guide to operationalised patient-centred care. Further research is required to address questions pertaining to the presence, nature, and impact of patient-centred audiological rehabilitation.
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| 7. |
- Grenness, Caitlin, et al.
(författare)
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Patient-centred care : A review for rehabilitative audiologists
- 2014
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Ingår i: International Journal of Audiology. - : Informa Healthcare. - 1499-2027 .- 1708-8186. ; 53:S1, s. S60-S67
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This discussion paper aims to synthesise the literature on patient-centred care from a range of health professions and to relate this to the field of rehabilitative audiology. Through review of the literature, this paper addresses five questions: What is patient-centred care? How is patient-centred care measured? What are the outcomes of patient-centred care? What are the factors contributing to patient-centred care? What are the implications for audiological rehabilitation? Design: Literature review and synthesis. Study sample: Publications were identified by structured searches in PubMed, Cinahl, Web of Knowledge, and PsychInfo, and by inspecting the reference lists of relevant articles. Results: Few publications from within the audiology profession address this topic and consequently a review and synthesis of literature from other areas of health were used to answer the proposed questions. Conclusion: This paper concludes that patient-centred care is in line with the aims and scope of practice for audiological rehabilitation. However, there is emerging evidence that we still need to inform the conceptualisation of patient-centred audiological rehabilitation. A definition of patient-centred audiological rehabilitation is needed to facilitate studies into the nature and outcomes of it in audiological rehabilitation practice.
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| 8. |
- Grenness, Caitlin, et al.
(författare)
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The Nature of Communication throughout Diagnosis and Management Planning in Initial Audiologic Rehabilitation Consultations
- 2015
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Ingår i: JOURNAL OF THE AMERICAN ACADEMY OF AUDIOLOGY. - : American Academy of Audiology. - 1050-0545 .- 2157-3107. ; 26:1, s. 36-50
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Tidskriftsartikel (refereegranskat)abstract
- Background: Effective practitioner-patient communication throughout diagnosis and management planning positively influences patient outcomes. A patient-centered approach whereby patient involvement in decision making is facilitated, a therapeutic relationship is developed, and information is bilaterally exchanged in an appropriate manner, leads to improved patient satisfaction, adherence to treatment, and self-management. Despite this knowledge, little is known about the nature of audiologist-patient communication throughout diagnosis and management planning. Purpose: This research aimed to explore verbal communication between audiologists and patients/ companions throughout diagnosis and management planning in initial audiology consultations. Specifically, this study aimed to describe the nature and dynamics of communication by examining the number, proportion, and type of verbal utterances by all speakers (audiologist, patient, and companion when present). In addition, this study aimed to investigate the influence of audiologist, patient, and consultation factors, such as verbal dominance, content balance, and communication control, on the dynamics of communication. Study Sample: A total of 62 initial audiological rehabilitation consultations (involving 26 different audiologists) were filmed and analyzed using the Roter Interaction Analysis System. All patients were older than 55 yr, and a companion was present in 17 consultations. Data Collection and Analysis: This study focused solely on the communication relating to diagnosis and management planning (referred to as the "counseling phase"). Diagnosis, recommendations, rehabilitation options, and patient decisions were recorded along with the communication profiles and communication dynamics measured using the Rotor Interaction Analysis System. Associations between communication dynamics (content balance, communication control, and verbal dominance) and eight variables were evaluated with Linear Mixed Model methods. Results: The mean length of time for diagnosis and management planning was 29.0 min (range, 2.2- 78.5 min). Communication profiles revealed that patient-centered communication was infrequently observed. First, opportunities to build a relationship were missed, such that patients psychosocial concerns were rarely addressed and patients/companions showed little involvement in management planning. Second, the amount of talk was asymmetrical and the majority of audiologists education and counseling utterances related to hearing aids; yet, only 56% of patients decided to obtain hearing aids at the conclusion of the consultation. Hearing aids were recommended in 83% of consultations where a hearing loss was diagnosed and alternative options were rarely provided. Thus, shared decision making rarely occurred, and audiologists often diagnosed a hearing loss and recommended hearing aids without patient involvement. In addition, when a greater proportion of time was dedicated to diagnosis and management planning, patients had greater input and control by asking more questions and requesting further information. Conclusions: Patient-centered communication was rarely observed in the 62 consultations. Thus, although not measured in this study, patient outcomes are likely to be affected. Future research should examine the influence of audiologist communication on outcomes and encourage a shift toward patient-centered audiological rehabilitation.
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| 9. |
- Hickson, Louise, et al.
(författare)
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Evidence-based practice in audiology : rehabilitation options for adults with hearing impairment
- 2013
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Ingår i: American Journal of Audiology. - : American Speech-Language-Hearing Association. - 1059-0889 .- 1558-9137. ; 22, s. 329-331
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE:Three questions are addressed: 1) What is Evidence-Based Practice (EBP) and why is it important for adults with hearing impairment? 2) What is the evidence about intervention options for adults who fail a hearing screening and are identified with hearing impairment? 3) What intervention options do adults choose when identified with hearing impairment for the first time?METHODS:The five steps of the EBP process are discussed in relation to a clinical question about whether hearing aids and communication programs reduce activity limitations and participation restrictions compared to no treatment for adults who fail a hearing screening and are identified with hearing impairment.RESULTS:Systematic reviews of the evidence indicate that both hearing aids and communication programs reduce activity limitations and participation restrictions for this population and are therefore appropriate options. A study is then described in which these options were presented to 153 clients identified with hearing impairment for the first time: 43% chose hearing aids, 18% chose communication programs and the remaining 39% chose not to take any action.CONCLUSIONS:EBP supports the offer of intervention options to adults who fail a hearing screening and are identified with hearing impairment.
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| 10. |
- Hickson, Louise, et al.
(författare)
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Individualised active communication education (I-ACE): another clinical option for adults with hearing impairment with a focus on problem solving and self-management
- 2019
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Ingår i: International Journal of Audiology. - : TAYLOR & FRANCIS LTD. - 1499-2027 .- 1708-8186. ; 58:8, s. 504-509
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This clinical note describes the Individualised - Active Communication Education (I-ACE) programme designed to improve problem solving and self-management in adults with hearing impairment. Design: The I-ACE was offered to adult clients seeking help for the first time and effects were measured for participants using self-report questionnaires: the Client Oriented Scale of Improvement (goal attainment), the Hearing Handicap Questionnaire (hearing disability), and the International Outcome Inventory - Alternative Interventions (outcomes) immediately after programme completion and 3 months later. Participants also provided qualitative feedback about I-ACE. Study sample: Twenty-three participants completed I-ACE, with 22 completing all self-report questionnaires and 23 participants providing qualitative feedback. Results: The participants reported positive outcomes and goal attainment, but no change in hearing disability post-programme. The effects were maintained 3 months later. Qualitative feedback indicated that I-ACE supported participants in recognising and increasing awareness of their hearing difficulties and in developing potential solutions to these difficulties. Participants also enjoyed the opportunity to involve communication partners. Conclusion: I-ACE is an appropriate option for adults with hearing impairment who wish to become more aware of their hearing difficulties and how to solve them.
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| 11. |
- Hickson, Louise, et al.
(författare)
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The Chronic Care Model and Chronic Condition Self-Management: An Introduction for Audiologists
- 2019
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Ingår i: Seminars in Hearing. - : Georg Thieme Verlag KG. - 0734-0451 .- 1098-8955. ; 40:01, s. 007-025
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Tidskriftsartikel (refereegranskat)abstract
- Hearing health care is biomedically focused, device-centered, and clinician-led. There is emerging evidence that these characteristics—all of which are hallmarks of a health care system designed to address acute, rather than chronic, conditions—may contribute to low rates of help-seeking and hearing rehabilitation uptake among adults with hearing loss. In this review, we introduce audiologists to the Chronic Care Model, an organizational framework that describes best-practice clinical care for chronic conditions, and suggest that it may be a viable model for hearing health care to adopt. We further introduce the concept of chronic condition self-management, a key component of chronic care that refers to the knowledge and skills patients use to manage the effects of a chronic condition on all aspects of daily life. Drawing on the chronic condition evidence base, we demonstrate a link between the provision of effective self-management support and improved clinical outcomes and discuss validated methods with which clinicians can support the acquisition and application of self-management skills in their patients. We examine the extent to which elements of chronic condition self-management have been integrated into clinical practice in audiology and suggest directions for further research in this area.
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| 12. |
- Knudsen, Line V, et al.
(författare)
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Conducting qualitative research in audiology : A tutorial
- 2012
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Ingår i: International Journal of Audiology. - : Informa Healthcare. - 1499-2027 .- 1708-8186. ; 51:2, s. 83-92
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:Qualitative research methodologies are being used more frequently in audiology as it allows for a better understanding of the perspectives of people with hearing impairment. This article describes why and how international interdisciplinary qualitative research can be conducted.DESIGN:This paper is based on a literature review and our recent experience with the conduction of an international interdisciplinary qualitative study in audiology.RESULTS:We describe some available qualitative methods for sampling, data collection, and analysis and we discuss the rationale for choosing particular methods. The focus is on four approaches which have all previously been applied to audiologic research: grounded theory, interpretative phenomenological analysis, conversational analysis, and qualitative content analysis.CONCLUSIONS:This article provides a review of methodological issues useful for those designing qualitative research projects in audiology or needing assistance in the interpretation of qualitative literature.
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| 13. |
- Laplante-Lévesque, Ariane, et al.
(författare)
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A qualitative study of shared decision making in rehabilitation audiology
- 2010
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Ingår i: Journal of the Academy of Rehabilitative Audiology. - : Academy of Rehabilitative Audiology. - 0149-8886. ; 43, s. 27-43
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Tidskriftsartikel (refereegranskat)abstract
- This study examined rehabilitative audiology clients’ experiences with shared decision making. Adults with acquired hearing impairment and with no previous experience of rehabilitative audiology were recruited for a shared decision making clinical trial. A sample of 22 participants completed an in-depth interview which was transcribed and analyzed using content analysis. The results were organized into an evidence-based model of rehabilitative audiology shared decision making. Participants described decision making by its actors, processes, and dimensions. Two themes, “my story” and “trust,” highlight the importance of a client-centered and ethical approach to shared decision making in rehabilitative audiology.
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| 14. |
- Laplante-Lévesque, Ariane, et al.
(författare)
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An Australian survey of audiologists’ preferences for patient-centredness
- 2014
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Ingår i: International Journal of Audiology. - : Informa Healthcare. - 1499-2027 .- 1708-8186. ; 53:S1, s. S76-S82
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Patient-centredness is becoming a core value of health services worldwide, however it remains largely unexplored in audiology. This study investigated audiologists’ preferences for patient-centredness and identified factors that explain audiologists’ preferences for patient-centredness. Design: All members of the Audiological Society of Australia received two questionnaires: (1) a descriptive questionnaire (e.g. age, gender, place of residence, years in practice, employment characteristics), and (2) a modified patient-practitioner orientation scale (PPOS; Krupat et al, 2000) which measures preferences for two aspects of patient-centredness, sharing and caring. Study sample: In total 663 (46%) audiologists returned both questionnaires fully completed. Results: Mean PPOS scores indicated that audiologists prefer patient-centredness. Linear regression modelling identified that older audiologists, that had practiced longer, and who worked in community education, industrial audiology, or teaching had a signifi cantly greater preference for patient-centredness than their peers. In contrast, audiologists who practiced in a private environment and who worked in the area of assessment of adults had a significantly lesser preference for patient-centredness than their peers. Conclusions: Audiologists prefer client-centredness and age, years of experience, and employment characteristics can partly explain preferences for patient-centredness. Future research should explore the relationships between patient-centredness and intervention outcomes in audiology.
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| 15. |
- Laplante-Lévesque, Ariane, et al.
(författare)
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Comparing response options for the International Outcome Inventory for Hearing Aids (IOI-HA) and for Alternative Interventions (IOI-AI) daily-use items
- 2012
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Ingår i: International Journal of Audiology. - : Informa Healthcare. - 1499-2027 .- 1708-8186. ; 51:10, s. 788-791
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:This study investigated how clients quantify use of hearing rehabilitation. Comparisons focused on the daily-use item of the International Outcome Inventory for Hearing Aids (IOI-HA), and for Alternative Interventions (IOI-AI).DESIGN:Adults with hearing impairment completed the original versions of the IOI-HA and the IOI-AI daily-use item which has five numerical response options (e.g. 1-4 hours/day) and a modified version with five word response options (e.g. 'Sometimes'). Respondents completed both IOI versions immediately after intervention completion and three months later.STUDY SAMPLE:In total, 64 people who had obtained hearing aids completed both IOI-HA versions and 27 people who had participated in communication programs completed both IOI-AI versions.RESULTS:Participants reported higher scores on the modified (word) daily-use item than on the original (number) daily-use item. Participants who completed the IOI-AI did so significantly more than participants who completed the IOI-HA. This was true both after intervention completion and three months later.CONCLUSION:This study showed that comparisons between IOI-HA and IOI-AI daily-use item scores should be made with caution. Word daily-use response options are recommended for the IOI-AI (i.e. Never; Rarely; Sometimes; Often; and Almost always).
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| 16. |
- Laplante-Lévesque, Ariane, et al.
(författare)
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Factors influencing rehabilitation decisions of adults with acquired hearing impairment
- 2010
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Ingår i: International Journal of Audiology. - : Informa Healthcare. - 1499-2027 .- 1708-8186. ; 49:7, s. 497-507
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Tidskriftsartikel (refereegranskat)abstract
- Several rehabilitation interventions yielding comparable outcomes are available to adults with acquired hearing impairment. However, the reasons why people choose particular interventions and not others have not been systematically investigated. This study explored the factors influencing the rehabilitation decisions of adults with acquired hearing impairment. Four options (hearing aids, group communication program, individual communication program, and no intervention) were discussed using shared decision making with 153 adults with acquired hearing impairment who had not previously received hearing rehabilitation. A selected sub-sample of 22 participants described the factors that influenced their decision during a semi-structured interview. Using qualitative content analysis, seven categories of factors influencing rehabilitation decisions were identified: (1) convenience; (2) expected adherence and outcomes; (3) financial costs; (4) hearing disability; (5) nature of intervention; (6) other people’s experiences, recommendations, and support; and (7) preventive and interim solution. All categories of factors were a positive influence for a particular intervention for some participants and a negative influence for the same intervention for other participants. The results support a client-centred approach to decision making.
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| 17. |
- Laplante-Levesque, Ariane, et al.
(författare)
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Hearing help-seeking and rehabilitation : Perspectives of adults with hearing impairment
- 2012
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Ingår i: International Journal of Audiology. - : Informa Healthcare. - 1499-2027 .- 1708-8186. ; 51:2, s. 93-102
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:This study investigated the perspectives of adults with hearing impairment on hearing help-seeking and rehabilitation.DESIGN:Individual semi-structured interviews were completed.STUDY SAMPLE:In total, 34 adults with hearing impairment in four countries (Australia, Denmark, UK, and USA) participated. Participants had a range of experience with hearing help-seeking and rehabilitation, from never having sought help to being satisfied hearing-aid users.RESULTS:Qualitative content analysis identified four main categories ('perceiving my hearing impairment', 'seeking hearing help', 'using my hearing aids', and 'perspectives and knowledge') and, at the next level, 25 categories. This article reports on the densest categories: they are described, exemplified with interview quotes, and discussed.CONCLUSIONS:People largely described hearing help-seeking and rehabilitation in the context of their daily lives. Adults with hearing impairment rarely described clinical encounters towards hearing help-seeking and rehabilitation as a connected process. They portrayed interactions with clinicians as isolated events rather than chronologically-ordered steps relating to a common goal. Clinical implications of the findings are discussed.
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| 18. |
- Laplante-Lévesque, Ariane, et al.
(författare)
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Matching evidence with client preferences
- 2012
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Ingår i: Evidence-based practice in audiology. - San Diego, CA : Plural Publishing, Inc.. - 9781597564199 ; , s. 41-58
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 19. |
- Laplante-Lévesque, Ariane, et al.
(författare)
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Predictors of Rehabilitation Intervention Decisions in Adults With Acquired Hearing Impairment
- 2011
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Ingår i: Journal of Speech, Language and Hearing Research. - : American Speech-Language-Hearing Association. - 1092-4388 .- 1558-9102. ; 54, s. 1385-1399
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This study investigated the predictors of rehabilitation intervention decisions in middle-age and older adults with acquired hearing impairment seeking help for the first time.Method: Using shared decision making, 139 participants were offered intervention options: hearing aids, communication programs (group or individual), and no intervention. Multivariate analysis (logistic regression) provided odds ratios and 95% confidence intervals for intervention decision predictors when all other variables were held constant.Results: Seven intervention decision predictors were identified: (a) application for subsidized hearing services (participants more likely to choose hearing aids and less likely to choose communication programs), (b) hearing impairment (hearing aids more likely and no intervention less likely), (c) communication self-efficacy (hearing aids less likely), (d) powerful others as locus of control (hearing aids less likely), (e) hearing disability perceived by others and self (hearing aids more likely), (f ) perceived communication program effectiveness (communication programs more likely), and (g) perceived suitability of individual communication program (hearing aids less likely and communication programs more likely).Conclusion: Findings suggest the need for clinicians to explicitly elicit the predictors identified by this study when involving adults with acquired hearing impairment in intervention decisions.
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| 20. |
- Laplante-Lévesque, Ariane, et al.
(författare)
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Promoting the Participation of Adults With Acquired Hearing Impairment in Their Rehabilitation
- 2010
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Ingår i: Journal of the Academy of Rehabilitative Audiology. - : Academy of Rehabilitative Audiology. - 0149-8886. ; 43, s. 11-26
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this tutorial is to review approaches that promote client participation in health care. More specifically, client-centeredness, joint goal setting, and shared decision making are defined; their applications to the management of people with chronic health conditions, and more specifically acquired hearing impairment, are outlined; and the evidence for their effectiveness is described. Future directions in audiology clinical practice and research are proposed to resolve whether such approaches can improve outcomes for people with acquired hearing impairment.
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| 21. |
- Laplante-Lévesque, Ariane, et al.
(författare)
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Rehabilitation of older adults with hearing impairment : A critical review
- 2010
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Ingår i: Journal of Aging and Health. - : Sage Publications. - 0898-2643 .- 1552-6887. ; 22:2, s. 143-153
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Hearing impairment, which affects both peripheral and central structures of the auditory system, is highly prevalent among older adults and has serious consequences both for the people with hearing impairment and for those around them. This article provides an updated overview of the rehabilitation of this population.Methods: This article critically reviews the rehabilitation interventions available to older adults with hearing impairment: hearing aids, hearing assistance technology, and communication programs.Results: Current evidence suggests positive outcomes of similar magnitude for the three rehabilitation interventions, however their availability/uptake and adherence are suboptimal.Discussion: To improve the current situation, two changes to practice are warranted. First, availability of the range of rehabilitation interventions should be improved. Second, in accordance with the self-management of other chronic health conditions, older adults with hearing impairment should be invited to be actively involved in their rehabilitation.
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| 22. |
- Laplante-Lévesque, Ariane, et al.
(författare)
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Stages of change in adults with acquired hearing impairment seeking help for the first time : application of the transtheoretical model in audiologic rehabilitation
- 2013
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Ingår i: Ear and Hearing. - : Lippincott Williams & Wilkins. - 0196-0202 .- 1538-4667. ; 34:4, s. 447-457
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES:This study investigated the application of the transtheoretical (stages-of-change) model in audiologic rehabilitation. More specifically, it described the University of Rhode Island Change Assessment (URICA) scores of adults with acquired hearing impairment. It reported the psychometric properties (construct, concurrent, and predictive validity) of the stages-of-change model in this population.DESIGN:At baseline, 153 adults with acquired hearing impairment seeking help for the first time completed the URICA as well as measures of degree of hearing impairment, self-reported hearing disability, and years since hearing impairment onset. Participants were subsequently offered intervention options: hearing aids, communication programs, and no intervention. Their intervention uptake and adherence were assessed 6 months later and their intervention outcomes were assessed 3 months after intervention completion. First, the stages-of-change construct validity was evaluated by investigating the URICA factor structure (principal component analysis), internal consistency, and correlations between stage scores. The URICA scores were reported in terms of the scores for each stage of change, composite scores, stages with highest scores, and stage clusters (cluster analysis). Second, the concurrent validity was assessed by examining associations between stages of change and degree of hearing impairment, self-reported hearing disability, and years since hearing impairment onset. Third, the predictive validity was evaluated by investigating associations between stages of change and intervention uptake, adherence, and outcomes.RESULTS:First, in terms of construct validity, the principal component analysis identified four instead of three stages (precontemplation, contemplation, preparation, and action) for which the internal consistency was good. Most of the sample was in the action stage. Correlations between stage scores supported the model. Cluster analysis identified four stages-of-change clusters, which the authors named active change, initiation, disengagement, and ambivalence. In terms of concurrent validity, participants who reported a more advanced stage of change had a more severe hearing impairment, reported greater hearing disability, and had a hearing impairment for a longer period of time. In terms of predictive validity, participants who reported a more advanced stage of change were more likely to take up an intervention and to report successful intervention outcomes. However, stages of change did not predict intervention adherence.CONCLUSIONS:The majority of the sample was in the action stage. The construct, concurrent, and predictive validity of the stages-of-change model were good. The stages-of-change model has some validity in the rehabilitation of adults with hearing impairment. The data support that change might be better represented on a continuum rather than by movement from one step to the next. Of all the measures, the precontemplation stage score had the best concurrent and predictive validity. Therefore, further research should focus on addressing the precontemplation stage with a measure suitable for clinical use.
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| 23. |
- Laplante-Lévesque, Ariane, et al.
(författare)
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What makes adults with hearing impairment take up hearing AIDS or communication programs and achieve successful outcomes?
- 2012
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Ingår i: Ear and Hearing. - : Lippincott Williams & Wilkins. - 0196-0202 .- 1538-4667. ; 33:1, s. 79-93
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES:Client involvement in health decision making, or shared decision making, is increasingly being advocated. For example, rehabilitation interventions such as hearing aids and communication programs can be presented as options to adults with hearing impairment seeking help for the first time. Our previous research focused on the predictors of intervention decisions when options were presented with a decision aid. However, not all participants took up the intervention they initially decided upon. Although it is interesting to understand what informs adults with hearing impairment's intervention decisions, it is their intervention uptake and outcomes which best represent the ultimate end result of the rehabilitation process. This prospective study investigated the predictors of uptake and of successful outcomes of hearing aids and communication programs in middle-aged and older adults with hearing impairment seeking help for the first time.DESIGN:Using shared decision making, 153 participants with hearing impairment (average of air conduction thresholds at 0.5, 1, 2, and 4 kHz greater than 25 dB HL in at least one ear) aged 50 yr and older were presented with intervention options: hearing aids, communication programs (group or individual), and no intervention. Each participant received a decision aid and had at least 1 wk to consider intervention options before the intervention decision was made. Outcome measures for both hearing aids and communication programs at 3 mo after intervention completion were benefit (measured with the Client-Oriented Scale of Improvement), composite outcomes (measured with the International Outcome Inventory), and reduction in self-reported hearing disability (measured with the Hearing Handicap Questionnaire). Multivariate analysis (logistic and linear regression) identified predictors of intervention uptake and of successful outcomes when all other variables were held constant.RESULTS:Almost a quarter of the 153 participants (24%) did not take up the intervention they initially decided upon: 6 mo after making their intervention decision, 66 participants (43%) obtained hearing aids, 28 participants (18%) completed communication programs, and 59 participants (39%) did not complete an intervention. Seven intervention uptake predictors were identified: (1) application for subsidized hearing services (participants more likely to obtain hearing aids and less likely to complete no intervention); (2) higher socioeconomic status (no intervention less likely); (3) greater communication self-efficacy (hearing aids less likely); (4) greater contemplation stage of change (no intervention less likely); (5) greater hearing disability perceived by others and self (communication programs less likely); (6) greater perceived communication program effectiveness (communication programs more likely); and (7) greater perceived suitability of individual communication program (hearing aids less likely and communication programs more likely). Six predictors of successful intervention outcomes were identified: (1) higher socioeconomic status; (2) greater initial self-reported hearing disability; (3) lower precontemplation stage of change; (4) greater action stage of change; (5) lower chance locus of control; and (6) greater hearing disability perceived by others and self.CONCLUSIONS:Self-reported hearing disability and stages of change are the two most robust predictors of intervention uptake and successful outcomes. Clinicians should offer intervention options and should discuss these predictors when helping adults with hearing impairment make optimal decisions.
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| 24. |
- Thorslund, Birgitta, 1976-, et al.
(författare)
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Exploring older adults hearing and vision and driving : the Swedish study
- 2018
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Konferensbidrag (refereegranskat)abstract
- The aims of this study were to evaluate self-reported driving abilities and self-reported use of visual and hearing aids for driving, among older adults with varying degrees of Hearing Impairment (HI), Vision Impairment (VIA measure of visual processing related to driving performance was also assessed. The following research questions were examined: How are self-reported and clinically measured declines in sensory and cognitive skills associated with: Each other, Level of comfort in various driving situations, and Use of hearing and vision aids when driving.Participants included 109 older adults (58 women, 51 men) aged over 60 years (Mage = 69.5 years (SD=5.25), age range: 60—87) holding a valid driver’s license. Tests of vision, hearing and visual processing were performed to collect objective data. All participants filled in a questionnaire covering subjective measures of vision, hearing, driving habits, and use of vision and hearing aids. Correlations were made to examine the relations between objective and subjective measures
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| 25. |
- Öberg, Marie, et al.
(författare)
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A Preliminary Evaluation of the Active Communication Education Program in a Sample of 87-Year-Old Hearing Impaired Individuals
- 2014
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Ingår i: Journal of the American Academy of Audiology. - : American Academy of Audiology. - 1050-0545 .- 2157-3107. ; 25:2, s. 219-228
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previous research suggests that audiological rehabilitation for older adults could include group communication programs in addition to hearing aid fitting or as an alternative to hearing aid fitting for those people who do not wish to proceed with hearing aids. This pilot study was a first attempt to evaluate a Swedish version of such a program, Active Communication Education (ACE), which had been developed and previously evaluated in Australia (Hickson et.al, 2007a). Purpose: The aim of the study was to explore the use of the ACE program in an older-old population of people aged 87 yr in Sweden. Research Design: A within-subject intervention study. Study Sample: The participants were recruited from the Elderly in Linkoping Screening Assessment (ELSA), a population-based study of the functional abilities of all inhabitants of the city of Linkoping aged 85 yr in 2007. Participants who responded to the hearing related items in the ELSA study were approached for this study; 29 people agreed to undertake ACE, and 23 (79%) completed three or more sessions. Intervention: The ACE program consists of five weekly 2 hr group sessions with six to ten participants per group. Data Collection and Analysis: Self-report measures of communication strategy use, activity and participation, health-related quality of life, and depression were obtained preprogram, 3 wk postprogram, and 6 mo postprogram. Within-group changes and effect sizes were calculated. In addition, outcomes were measured postprogram using the International Outcome Inventory Alternative Interventions (IOI-AI; Noble, 2002) and a modified version of the Client Oriented Scale of Improvement (COSI; Dillon et al, 1997; Hickson et al, 2007b), and qualitative feedback was obtained. Results: The effect size of ACE was small (0.03-0.27), and, in the sample of 23 included in this pilot study, differences in pre- and postprogram assessments were not statistically significant. Results from the IOI-Al and the modified COSI indicated that these elderly participants found the program to be beneficial, and 90% stated that the course had increased their ability to deal with hearing loss and the problems it creates. Conclusions: This preliminary investigation indicates the potential benefits of ACE for older adults, and further research is needed with larger numbers of participants in different age groups to draw conclusions about the effectiveness of the ACE program for a general Swedish population.
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| 26. |
- Öberg, Marie, 1962-
(författare)
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Approaches to Audiological Rehabilitation with Hearing Aids : studies on pre-fitting strategies and assessment of outcomes
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Fourteen percent of the Swedish population report subjective hearing loss. The number of persons suffering from hearing loss is expected to increase in accordance with the increased length of the average life span, causing an associated increase in the demand for hearing health care services as new patient groups who expect a higher quality of life begin to request hearing care. The main goal of this thesis was to develop new approaches in audiological rehabilitation to meet these demands and achieve user satisfaction.Two randomized controlled trials including 39 and 38 subjects, respectively were performed that evaluated two interventions, user-controlled adjustment and sound awareness training, which were performed prior to a hearing aid fitting. The new approaches focused on increasing user participation and activity. To evaluate the goals of audiological rehabilitation, e.g., reducing auditory impairment, optimizing auditory activities and minimizing participation restrictions, several standardized self-reporting instruments were used to assess activity limitations, participation restriction, satisfaction and psychosocial well-being. Several of the instruments were validated for a Swedish population in a postal survey including 162 subjects. Furthermore, an interview instrument that was appropriate for telephone interviews and a categorization rating scale were developed for assessing the global clinical impression of the audiological rehabilitation.Few significant differences in outcomes were found between the treatment and control groups in the short term, and the interventions did not achieve additional or more successful hearing aid users in the long term. Thus, it was concluded that the hearing aid rehabilitation was effective in and of itself, as both the treatment and control groups showed significant improvements in psychosocial well-being and reduced activity limitation and participation restriction. The self-report instruments were found to be valid, and a factor analysis indicated that the number of questionnaires could be reduced with a recommendation for further clinical use. The telephone interviews evaluating the clinical global impression of the audiological rehabilitation were found to be effective and showed success in a vast majority of the users. Advantages such as simpler administration and less time consumption warrant their continued use in additional audiological settings.The pre-interventions in these studies need to be further investigated before they could be recommended for clinical use also in a Swedish context. The international standardized self reports, however, can already be recommended for clinical use. A first attempt to evaluate global clinical impression by telephone interviews was found to be effective and further validations are suggested.
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| 27. |
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| 28. |
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