Addressing Patients' Psychosocial Concerns Regarding Hearing Aids Within Audiology Appointments for Older Adults

Ekberg, Katie; Grenness, Caitlin; Hickson, Louise

doi:10.1044/2014_aja-14-0011

Cited by 120 publications

(114 citation statements)

References 31 publications

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“…Effectively, all appointments were dominated by audiologist talk that focused predominately on hearing aid discussion, leaving psychosocial concerns largely unaddressed. This finding confirms that of Ekberg, Grenness, and Hickson [23] who used conversation analysis to explore how the audiologists involved in the present study addressed the psychosocial concerns of their patients. Ekberg et al [23] reported that when patients raised psychosocial concerns, audiologists did not typically engage with these and redirected the conversation back to hearing aids.…”

Section: Discussionsupporting

confidence: 89%

“…This finding confirms that of Ekberg, Grenness, and Hickson [23] who used conversation analysis to explore how the audiologists involved in the present study addressed the psychosocial concerns of their patients. Ekberg et al [23] reported that when patients raised psychosocial concerns, audiologists did not typically engage with these and redirected the conversation back to hearing aids. Collectively, this body of research suggests that audiologists are not currently taking a patient-centred approach when discussing recommendations for rehabilitation.…”

Section: Discussionsupporting

confidence: 89%

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Audiologist-patient communication profiles in hearing rehabilitation appointments

Meyer

Barr

Khan

et al. 2017

Patient Education and Counseling

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Highlights Audiology consultations remain clinician-centred.  Three-quarters of appointments began with a biopsychosocial interaction.  All appointments ended with a biomedical interaction dominated by hearing aid talk.  Audiologist-patient communication was not associated with decision to trial HAs. Audiologist-patient communication in hearing rehabilitation 2 AbstractObjective. To profile the communication between audiologists and patients in initial appointments on a biomedical-psychosocial continuum; and explore the associations between these profiles and 1) characteristics of the appointment and 2) patients' decisions to pursue hearing aids.Methods. Sixty-three initial hearing assessment appointments were filmed and audiologistpatient communication was coded using the Roter Interaction Analysis System. A hierarchical cluster analysis was conducted to profile audiologist-patient communication, after which regression modelling and Chi-squared analyses were conducted.Results. Two distinct audiologist-patient communication profiles were identified during both the history taking phase (46 = biopsychosocial profile, 15 = psychosocial profile) and diagnosis and management planning phase (45 = expanded biomedical profile, 11 = narrowly biomedical profile). Shorter appointments were significantly more likely to be associated with a narrowly biomedical interaction during the diagnosis and management planning phase. No significant associations were found between audiologist-patient communication profile and patients' decisions to pursue hearing aids. Conclusion.Initial audiology consultations appear to remain clinician-centred. Three quarters of appointments began with a biopsychosocial interaction; however, 80% ended with an expanded biomedical interaction.Practice Implications. Findings suggest that audiologists could consider modifying their communication in initial appointments to more holistically address the needs of patients.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 89%

Audiologist-patient communication profiles in hearing rehabilitation appointments

Meyer

Barr

Khan

et al. 2017

Patient Education and Counseling

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“…In relation to the ICF framework, this indicates that little attention is given to activity, participation and contextual factors that influence patients' experiences of their hearing impairment and are essential to the development of appropriate rehabilitation plans. The current findings are similar to the results reported in several studies conducted in Australia, where the audiologists seldom addressed patients' psychosocial concerns and rarely offered rehabilitation options other than hearing aids (Ekberg, Grenness & Hickson, 2014;.…”

Section: Discussionsupporting

confidence: 81%

Evaluation of audiological rehabilitation services for adults with hearing impairment in Malaysia

Ali¹

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The effects of hearing impairment on adult patients and their families have been extensively reported (e.g. communication difficulties, emotional distress and social engagement restrictions, and decreased quality of life). Therefore, audiologists have a responsibility to help patients and their families manage activity limitations and participant restrictions that arise from hearing impairment in the context of the International Classification of Functioning, Disability and Health (ICF). This approach is very much in line with the principles of patient-centred care (PCC) that have been extensively promoted as best practice for the healthcare management of older adults. Despite reports of the benefits of PCC for adult patients in Western countries, including adherence to management plans and reduced recovery time, it is not known whether this approach is incorporated into audiological services for adult patients in Malaysia.The aims of this thesis were to investigate (i) the nature of audiological rehabilitation services for adults with hearing impairment in Malaysia, and (ii) the extent of patient-centredness exhibited by audiologists in Malaysia. To address these aims, a mixed methods approach was used. The quantitative measures were utilised to explore the current practice of audiologists in managing adult patients and to identify the preferences for PCC in audiological management from the perspectives of audiologists and adult patients, while the qualitative measures provided an in-depth view of the implementation of PCC in audiological management. The types of methods utilised were online and paper based surveys, individual semi-structured in-depth interviews, and video observation.Chapter 1 describes Malaysia briefly, with a focus on the field of audiology and the services offered. The ICF framework, which structures this thesis, and the PCC approach, which is the focus of this thesis, is presented in this chapter. Chapter 2 describes the audiological management for adults with hearing impairment and their significant others in the context of the ICF, as recommended by established audiology professional associations. Chapter 2 also includes background on PCC in more detail.Chapter 3 explored the nature of audiological services for adults with hearing impairment in Malaysia, with an emphasis on whether current services addressed patients' overall functioning described in the ICF. In general, the audiologists in Malaysia addressed the hearing impairment and its associated activity limitations and participation restrictions in their ii management of adult patients. However, gaps were identified with there being a strong emphasis on addressing impairment-level impacts. Inadequate infrastructure, resources and facilities in the workplace may have contributed to the gaps in service provision and influenced the current practice of audiological management for patients in Malaysia.Chapter 4 identified the preferences of adult patients for PCC and the level of PCC they received from audiologists. Although the...

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“…Studies of healthcare interaction have revealed the ways in which clinicians and clients accomplish interactional tasks such as diagnosing, recommending, and responding to treatment, and address various interactional issues and dilemmas that arise as they undertake these tasks (Pilnick et al, 2009). This method has also been used in previous research of communication in audiology appointments, including family involvement in appointments, and how audiologists address clients' concerns regarding hearing aids (Ekberg et al, 2014a(Ekberg et al, ,b, 2015. During the history-taking phase of the appointment, clients' responses to audiologists' questions were analysed for how they described their hearing difficulties.…”

Section: Discussionmentioning

confidence: 99%

Application of the transtheoretical model of behaviour change for identifying older clients’ readiness for hearing rehabilitation during history-taking in audiology appointments

Ekberg

Grenness²,

Hickson

2016

International Journal of Audiology

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Objectives: The transtheoretical model (TTM) of behaviour change focuses on clients' readiness for adopting new health behaviours. This study explores how clients' readiness for change can be identified through their interactions with audiologists during history-taking in initial appointments; and whether clients' readiness has consequences for the rehabilitation decisions they make within the initial appointment. Design: Conversation analysis (CA) was used to examine video-recorded initial audiology appointments with older adults with hearing impairment. Study sample: The data corpus involved 62 recorded appointments with 26 audiologists and their older adult clients (aged 55+ years). Companions were present in 17 appointments. Results: Clients' readiness for change could be observed through their interaction with the audiologist. Analysis demonstrated that the way clients described their hearing in the history-taking phase had systematic consequences for how they responded to rehabilitation recommendations (in particular, hearing aids) in the management phase of the appointment. In particular, clients identified as being in a pre-contemplation stage-of-change were more likely to display resistance to a recommendation of hearing aids (80% declined). Conclusions: The transtheoretical model of behaviour change can be useful for helping audiologists individualize management planning to be congruent with individual clients' needs, attitudes, desires, and psychological readiness for action in order to optimize clients' hearing outcomes.

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Addressing Patients' Psychosocial Concerns Regarding Hearing Aids Within Audiology Appointments for Older Adults

Abstract: Older adults' psychosocial concerns regarding hearing aids may not always be sufficiently addressed within audiology appointments. A greater emphasis on emotionally focused communication within audiology could result in improved outcomes from hearing health care services.

Cited by 120 publications

References 31 publications

Audiologist-patient communication profiles in hearing rehabilitation appointments

Audiologist-patient communication profiles in hearing rehabilitation appointments

Evaluation of audiological rehabilitation services for adults with hearing impairment in Malaysia

Application of the transtheoretical model of behaviour change for identifying older clients’ readiness for hearing rehabilitation during history-taking in audiology appointments

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