Family member involvement in audiology appointments with older people with hearing impairment

Ekberg, Katie; Meyer, Carly; Scarinci, Nerina; Grenness, Caitlin; Hickson, Louise

doi:10.3109/14992027.2014.948218

Cited by 76 publications

(76 citation statements)

References 44 publications

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“…Data from the interviews suggest that families were not encouraged to take an active role in rehabilitation and their involvement was restricted to being an 'assistant' to the audiologist. The results of the current study are supported by an investigation that found audiologists in Australia did not encourage families to actively participate in patients' rehabilitation, despite the families' desire to contribute (Ekberg, Meyer, Scarinci, Grenness, & Hickson, 2015). These findings suggested gaps in audiological management of adults with hearing impairment where audiologists do not address the contextual factors outlined in the ICF.…”

Section: Discussionsupporting

confidence: 74%

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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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Section: Discussionsupporting

confidence: 74%

“…Research by Ekberg et al (2015) in Australia indicates that merely including a family member in an appointment session does not ensure his/her involvement in the rehabilitation process.…”

Section: Discussionmentioning

confidence: 99%

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

Ali¹

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“…Having a family member in attendance may help audiologists to explicate communication problems within the family. Previous research has found that family members who attend appointments display a desire to have an active involvement in the interaction (Ekberg et al, 2014b(Ekberg et al, , 2015Meyer et al, 2015;Preminger, 2003).…”

Section: Clinical Implications For Optimizing Clients' Hearing Rehabimentioning

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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“…The conceptual map developed as part of this work presents several other promising targets for intervention development in this context, notably for the ongoing work on the involvement of the family and friends of the person with the hearing loss [21,44,[65][66][67].…”

Section: Implications For Future Researchmentioning

confidence: 99%

Improving Collaborative Behaviour Planning in Adult Auditory Rehabilitation: Development of the I-PLAN Intervention Using the Behaviour Change Wheel

Barker

Lusignan

Cooke

2017

Annals of Behavioral Medicine

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Background The consequences of poorly managed hearing loss can be ameliorated with hearing aid use but rates of use are sub-optimal. The impact of audiologist behaviour on subsequent use, particularly over the long term, is unknown. Purpose This study aimed to describe the role of the behaviour change wheel in developing an intervention to introduce and embed particular clinical behaviours into adult hearing aid fitting consultations, within the framework of the Medical Research Council guidance on complex interventions. Methods Following the steps of the behaviour change wheel, audiologist behaviours that might influence hearing aid use were identified based on a systematic review and qualitative work with audiologists. An analysis, using the COM-B model, identified potential drivers of the target behaviours. This was used to select intervention functions and behaviour change techniques likely to influence behaviour in this context. Results The target behaviours were as follows: giving information about the benefits of hearing aid use and the negative consequences of non-use, providing prompts for use and engaging in collaborative behavioural planning for use. The behavioural analysis suggested that psychological capability, opportunity and motivation were potential drivers of these behaviours. The intervention functions of education, coercion, training, environmental restructuring, modelling and enablement were selected and combined to develop a single complex intervention that seeks to address the target behaviours. Conclusions This is the first study to use the behaviour change wheel to develop a complex intervention in the context of audiology. The theory-based development of the intervention will facilitate evaluation of its feasibility and effectiveness.

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Family member involvement in audiology appointments with older people with hearing impairment

Cited by 76 publications

References 44 publications

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

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

Improving Collaborative Behaviour Planning in Adult Auditory Rehabilitation: Development of the I-PLAN Intervention Using the Behaviour Change Wheel

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