| 1. |
- Helvik, Anne-Sofie, et al.
(författare)
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Activity limitation and participation restriction in adults seeking hearing aid fitting and rehabilitation
- 2006
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Ingår i: Disability and Rehabilitation. - London : Informa Healthcare. - 0963-8288 .- 1464-5165. ; 28:5, s. 281-288
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Tidskriftsartikel (refereegranskat)abstract
- Purposes: We first aimed to describe demographic and audiological characteristics of adults referred to a university hospital for hearing aid (HA) fitting and rehabilitation. Our second aim was to employ an inventory that assesses life consequences of hearing impairment (HI) in terms of perceived activity limitation and participation restriction for the first time in a Norwegian adult outpatient population. A third aim was to study life consequences by audiological and demographic characteristics.Subjects and methods: During one year consecutive patients (n?=?343) were requested to answer the Hearing Disability and Handicap Scale (HDHS) assessing activity limitation and participation restriction in relation to an audiological examination and medical consultation. The mean threshold of hearing (MTH) was ascertained by pure tone thresholds at 0.5?–?1?–?2?–?4 kHz in the better ear.Results: Activity limitation and participation restriction were both higher for HA experienced than HA naïve subjects ( p < 0.01). In a multivariable model, the explained adjusted variance of activity limitation (R2) was 43.4% with MTH, perceived duration, and severity of hearing problems as predictor variables. Correspondingly, the explained adjusted variance of participation restriction was 28.4% for a model with MTH, age, gender and perceived severity of hearing problems as predictors.Conclusions: As a standard supplement to audiometric tests, HDHS may be successfully applied as a clinical tool among similar hearing impaired outpatients in order to assess activity limitation and participation restriction as part of audiological rehabilitation.
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| 2. |
- Helvik, Anne-Sofie, et al.
(författare)
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Coping ability and everyday life situations in relation to audiological rehabilitation
- 2007
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Ingår i: Audiological Medicine. - London : Informa Healthcare. - 1651-386X .- 1651-3835. ; 5:2, s. 112-118
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Tidskriftsartikel (refereegranskat)abstract
- The relationship between the reported use of coping strategies and experience of everyday life prior to audiological rehabilitation and the number of rehabilitation consultations needed, were studied in a group of adults. The study took place at St. Olav's University Hospital, Norway and included 132 adult patients (77 men and 55 women) with no previous audiological rehabilitation or experience with hearing aid (HA) use. Hearing impairment was assessed by pure tone audiometry, while use of communication specific coping strategies and daily life situations were obtained using self-report inventories. The latter concerned activity limitation, participation restriction, and psychological well-being. The patients' hospital records were reviewed approximately 18 months after their first consultation. In total, 41 patients (31%) needed no more than the required minimum number of three consultations to complete rehabilitation including HA fitting, while 91 patients needed more than this. Logistic regression was used to study coping and everyday life in relation to the need for three versus more consultations. Little experienced participation restriction was related to the need for only three consultations. Use of communication specific coping strategies, activity limitation, or psychological well-being was not associated with the number of consultations needed. © 2007 Taylor & Francis.
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| 3. |
- Helvik, Anne-Sofie, et al.
(författare)
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Effects of Impaired Hearing on Perceived Health and Life Situation
- 2006
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Ingår i: Scandinavian Journal of Disability Research. - Oslo, Norway : Taylor & Francis. - 1501-7419 .- 1745-3011. ; 8:4, s. 263-277
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to determine the association between level of hearing loss (HL) and perceived health and life situation. A population sample of 343 outpatient adults who consulted a university hospital in Norway for hearing aids and rehabilitation was studied. Health and life situation was assessed by self-reported measures of general health, anxiety, participation in social activities, and life satisfaction. Level of HL was estimated by mean hearing threshold in the better ear, and categorized according to international standards. Subjects with normal hearing in the better ear were used as reference. Explanatory health and life situation variables were dichotomized and analysed using logistic regression models. The results showed that perception of good health was negatively affected by increasing HL before and after adjustment for potential confounders (p for trend <0.05). Compared with non-impaired individuals, the odds of perceiving their health as “not good”, were four times higher for the most severely affected subjects (p < 0.05). The odds for reporting anxiety, of abstaining from participation in social activities, and of being generally dissatisfied increased for patients with moderate and higher levels of HL. In conclusion, perception of health was negatively associated with increasing HL, while anxiety, participation in social activities, and perceived life satisfaction did not significantly correlate with the level of loss. Thus, degree of HL seems to be of quite limited importance when consequences of HL are judged.
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| 4. |
- Helvik, Anne-Sofie, et al.
(författare)
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Hearing Impairment, Sense of Humour and Communication Strategies
- 2007
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Ingår i: Scandinavian Journal of Disability Research. - Philadelphia : Routledge. - 1501-7419 .- 1745-3011. ; 9:1, s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- One purpose of this study was to describe sense of humour and communication strategies in a general population of adults who needed hearing aid (HA) fitting or refitting. Another purpose was to explore the correlation between characteristics of hearing impairment (HI), sense of humour, and other participant characteristics and the communication strategies as outcome. Consecutive patients (n=343) at the Department of Audiology during 1 year completed the Sense of Humour Questionnaire-6 (SHQ-6) and the Communication Strategies Scale (CSS with maladaptive behaviour, verbal and non-verbal strategies). It was found that a high sense of humour was related to female gender and younger age. In multiple regression analyses, use of non-verbal communication strategies was more prevalent among females and increased with younger age, longer duration of HI, and previous HA experience. Use of verbal communication strategies and maladaptive communication behaviour increased with increasing HI. Use of verbal strategies was further associated with younger age and previous HA experience. Frequent use of maladaptive behaviour was related to younger age, longer duration of HI and less sense of humour. Maladaptive behaviour, alternatively expressed as negative reactions to stressful events in communication, was negatively associated with sense of humour. This study may indicate a role for sense of humour in prevention of maladaptive behaviour. It may also improve our understanding of what factors influence the use of communication strategies.
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| 5. |
- Helvik, Anne-Sofie, et al.
(författare)
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Life Consequences of Hearing Loss in Terms of Activity Limitation and Participation Restriction
- 2006
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Ingår i: Scandinavian Journal of Disability Research. - Oslo, Norway : Taylor & Francis. - 1501-7419 .- 1745-3011. ; 8:1, s. 53-66
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Tidskriftsartikel (refereegranskat)abstract
- The consequences of hearing loss in terms of perceived activity limitation and participation restriction were studied in a general population of 343 adults with hearing impairment using the Hearing Disability and Handicap Scale. Coping was measured by the Sense of Humour Questionnaire and the Communication Strategies Scale and combined with objective and subjective audiological variables and demographic factors (age, gender and education). In stepwise linear modelling, several variables contributed significantly to the outcome (adjusted R2=53.3% for activity limitation and 47.2% for participation restriction). Audiological factors explained most of the variance in activity limitation (R2=37.1%), while coping factors were the main predictors for participation restriction (R2=35.2%). Maladaptive behaviour in the Communication Strategies Scale was the strongest predictor and explained 13.7% and 32.4% of the variance in activity limitation and participation restriction, respectively. More frequent use of maladaptive behaviour was related to larger limitation and restriction. This study adds to the understanding of factors that negatively influence daily life in terms of activity limitation and participation restriction. This may in turn have consequences for aural rehabilitation efforts.
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| 6. |
- Helvik, Anne-Sofie, et al.
(författare)
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Psychological well-being of adults with acquired hearing impairment
- 2006
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Ingår i: Disability and Rehabilitation. - London : Informa Healthcare. - 0963-8288 .- 1464-5165. ; 28:9, s. 535-545
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To study psychological well-being (health-related quality of life) in a population of adults 20 years and over with hearing impairment (HI) and its relation to audiological factors, consequences of the HI, sense of humour, and use of communication strategies.Subjects and methods: Consecutive adults (n = 343) at the outpatient Unit of Audiology of a Norwegian university hospital answered the Psychological General Well-being inventory (PGWB), Hearing Disability and Handicap Scale (HDHS), Sense of Humour Questionnaire-6 (SHQ-6), and Communication Strategies Scale (CSS) in relation to an audiological examination and medical consultation.Results: Mean PGWB index for the whole sample was 81.4 (SD 14.3) and females reported a significantly lower psychological well-being. In multiple linear regression analyses well-being was negatively associated with high levels of activity limitation and participation restriction. PGWB index was positively associated with high sense of humour, but was neither explained by audiological factors nor use of communication strategies.Conclusions: Psychological well-being was associated with the outcome of a standard HI assessment of activity limitation and participation restriction, but not with degree of HI and use of communication strategies.
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| 7. |
- Helvik, Anne-Sofie, et al.
(författare)
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Psychometric evaluation of a Norwegian version of the Communication Strategies Scale of the Communication Profile for the Hearing Impaired
- 2007
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Ingår i: Disability and Rehabilitation. - London : Informa Healthcare. - 0963-8288 .- 1464-5165. ; 29:6, s. 513-520
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Tidskriftsartikel (refereegranskat)abstract
- Aim.To evaluate the Communication Strategies Scale (CSS) in an adult Norwegian sample with hearing loss.Subjects and methods.Of 474 invited patients, a total of 337 consecutive adults admitted to the outpatient Unit of Audiology, ENT Department of a university hospital answered the CSS of the Communication Profile for the Hearing Impaired. The inventory assesses the use of three specific coping strategies; Maladaptive Behaviour, Verbal and Nonverbal Communication Strategies. The psychometric evaluation included construct validity by corrected item-total correlation, the internal consistency reliability by coefficient alpha (Cronbach's) and standard error of the measurement (SEM). Internal structure was evaluated by factor analyses using principal factors followed by a varimax rotation.Results.CSS showed good psychometric properties with acceptable and good internal consistency reliability for the subscales. The internal structure of the entire scale gave main loadings at 24 of 25 items at the same factor as the original one.Conclusion.CSS may well be used as a clinical tool in the routine assessment of maladaptive and adaptive communication strategies in an unselected adult population of hearing impaired outpatients.
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| 8. |
- Helvik, Anne-Sofie, et al.
(författare)
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Psychometric evaluation of a Norwegian version of the Hearing Disability and Handicap Scale
- 2007
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Ingår i: Scandinavian Journal of Disability Research. - Philadelphia : Routledge. - 1501-7419 .- 1745-3011. ; 9:2, s. 112-124
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate the Hearing Disability and Handicap Scale (HDHS) in an unselected population of adults with hearing impairment.Subjects and methods:A total of 342 consecutive adults who consulted the outpatient unit of audiology in the ENT department of a Norwegian university hospital answered HDHS, which intends to assess the negative consequences of hearing loss. The psychometric evaluation included internal structure analyses and made use of principal factors followed by varimax rotation, construct validity by corrected item-total correlation, and internal consistency reliability by Cronbach's alpha coefficient. Results: HDHS showed good psychometric properties with three factors, i.e. speech perception (five items), non-speech sound (five items) and participation restriction (10 items). All had good internal consistency reliability. The inventory distinguished between activity limitations and other problems related to social life participation.Conclusion:HDHS was found to be adequate for research and clinical purposes in an unselected adult population with a quite different cultural background and language than the original one.
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| 9. |
- Helvik, Anne-Sofie, et al.
(författare)
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Why do some individuals with objectively verified hearing loss reject hearing aids?
- 2008
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Ingår i: Audiological Medicine. - London : Informa Healthcare. - 1651-386X .- 1651-3835. ; 6:2, s. 141-148
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Tidskriftsartikel (refereegranskat)abstract
- We investigated, in new hearing aid candidates, whether or not the use of coping strategies and the life situation, in terms of activity limitation, participation restriction and psychological well-being, were associated with the outcome of audiological counselling, i.e. the patients’ acceptance or rejection of a hearing aid (HA). The study included 173 consecutive adult patients (104 men and 69 women) with a need for audiological rehabilitation including HA-fitting. Use of communication strategies (Communication Strategies Scale, CSS), experience of activity limitation and participation restriction (Hearing Disability and Handicap Scale, HDHS), and general psychological well-being (Psychological General Well-being scale, PGWB) were assessed by self-report inventories. The hospital records, reviewed 1.5years after the first consultation, showed that 39 patients (25 men and 14 women, 23%) had not accepted a hearing aid. In crude and adjusted logistic regression analyses a low report (high scores) of maladaptive behaviour in communication was associated with a three-times higher odds for rejecting a hearing aid, while a highly perceived activity limitation and participation restriction were related to lower odds for rejection. Patients who felt they had few problems with their hearing or overlooked or repressed their shortcomings, rejected HAs more often.
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| 10. |
- Kidanto, Hussein L, 1964-
(författare)
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Improving quality of perinatal care through clinical audit : a study from a tertiary hospital in Dar es Salaam, Tanzania
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Perinatal audit has been tested and proved an important tool for reduction of perinatal mortality and assessment of quality of perinatal care. At Muhimbili National Hospital (MNH), a tertiary hospital in Dar es salaam, Tanzania we performed a retrospective cross-sectional study using data from an obstetrics database to classify all perinatal deaths during 1999-2003. We also determined the prevalence of anaemia in pregnancy and its impact on perinatal outcome. Furthermore, we conducted a perinatal audit to study potential determinants and causes of perinatal and neonatal deaths and their avoidability. We also assessed the quality of care of patients admitted with eclampsia using a criteria based audit. Stillbirth, early neonatal and perinatal mortality rates (PMR) were 96, 27 and 124 respectively. A large proportion of foetuses (38%) had no audible foetal heart beat on admission at MNH labour ward and the majority of the neonatal deaths were asphyxiated at delivery. The PMR for multiples and singletons were 269 and 118 respectively resulting in a rate ratio of 2.4 (95%CI: 2.1-2.4). The prevalence of anaemia and severe anaemia was 68% and 5.8%, respectively. Severity of anaemia increased the risk of preterm delivery with ORs of 1.4, 1.4 and 4.1 for women with mild, moderate and severe anaemia as compared to women with normal haemoglobin levels. The corresponding risks for LBW and VLBW were 1.2, 1.7 and 3.8, and 1.5, 1.9 and 4.2 respectively. The prevalence of preterm delivery and LBW was 17% and 14% respectively. The hospital-based incidence of eclampsia was 504 per 10,000 women or 5.1 % of all mothers admitted. Suboptimal care were identified on criteria regarding management plan by senior staff, review of the plans by specialist obstetrician, delay on caesarean section, monitoring patients on magnesium sulphate and inadequate use of the laboratory. Two out of three patients requiring operation were not operated within set standards. Birth asphyxia was the main cause of intrapartum fresh stillbirth (47%) and early neonatal deaths (51%), whereas eclampsia (25%) and preeclampsia (8.3%) were main maternal medical conditions. The majority of stillbirths were fresh, indicating foetal demise during labour or just before delivery. The audit study identified suboptimal care in about 80% of audited cases out of which about 50% were found to be the likely cause of the adverse perinatal outcome. Inadequate maternal and foetal monitoring during labour were the main suboptimal factors, though delay in referral and operative interventions were also prominent. Based on these studies, we conclude that: The perinatal mortality (PMR) in this study was higher than the national average. About one in four perinatal deaths at MNH can be attributed to avoidable factors linked to obstetric care Main causes of perinatal and neonatal deaths were intrapartum birth asphyxia, immaturity related and infections Management of patients in labour needs to be improved Suboptimal care that is essentially avoidable included: inadequate monitoring of patients during labour, delay of care, e.g. long decision to surgery interval, and delayed referral of patients fromprimary hospitals The prevalence of anaemia in pregnancy was very high; and low birth weight and preterm delivery was independently associated with severity of anaemia The prevalence of eclampsia at MNH was high and the case management needs to be improved
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