How do patients decide on interventions for single sided deafness? A qualitative investigation of patient views

Abstract

Background: Single-sided deafness presents communication challenges for adults. There are a range of care options, including CROS hearing aids, available but little is known about patient preferences for these interventions. Objective: The objective of this study was to understand the viewpoints of patients making decisions about audiological interventions they use. Methods: A constructivist worldview using thematic analysis to undertake a constant comparative analysis of 8 semi-structured interviews. Sampling: Participants were recruited from Portsmouth Hospitals University NHS Trust audiology service in England. Findings: The results of the study describe ongoing iterative judgements being made by participants, informed by their access to information, effectiveness of audiological interventions, stigma, barriers to accessing care, and constant cost-benefit analyses being made. The key factors involved in decision-making by individuals with Single-sided deafness (SSD) are discussed. Conclusions: This study represents the first in-depth exploration of the individual's lifeworld related to which factors influence use of different audiological interventions by individuals with SSD. It highlights the complex and ongoing nature of how decisions are made by these individuals and identifies the need for greater information provision by clinicians, such as through use of a decision aid tool.

Choice of treatment evaluated after trial periods with bone conduction devices and contralateral routing of sound systems in patients with single‐sided deafness

“…However, in line with previous literature, 17 , 19 we could not identify any patient or disease‐specific characteristics related to the choice of treatment after the trial periods. Similar to other studies, 18 , 19 , 26 the choice of treatment was mainly driven by subjective factors. The described subjective BCD and CROS advantages and disadvantages in our study were comparable to previous literature reporting on reasons for treatment acceptance or rejection.…”

“…In literature, reported reasons for treatment acceptance or rejection are diverse and cover objective as well as subjective reasons. The most important reasons for rejection include limited benefit in hearing abilities, physical discomfort, the need for surgery, cosmetic reasons or a better experience with another device 17–19,26 . Currently, there are no clear patient‐ or disease‐specific characteristics identified to be related to the choice of treatment 17,19 …”

The Core Rehabilitation Outcome Set for Single-Sided Deafness (CROSSSD) study: International consensus on outcome measures for trials of interventions for adults with single-sided deafness

“…10 Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Oxford Road, Manchester M13 9WL, UK. 11 Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health University of Manchester, Oxford Road, Manchester M13 9PL, UK. 12 National Acoustic Laboratories, Australian Hearing Hub, Macquarie University, Sydney, NSW 2109, Australia.…”

“…However, the difficulties that SSD imposes can also affect the individual's psychological and social well-being [8,9], and therefore, outcomes that assess the impact on an individual's overall health and well-being are also relevant and potentially as important [10]. Healthcare users express uncertainty about choice of treatment options for SSD often due to a lack of clarity about their benefit [11]. A subsequent systematic review identified a total of 520 outcome domains from 96 studies that evaluated SSD interventions [12].…”

The Core Rehabilitation Outcome Set for Single-Sided Deafness (CROSSSD) study: International consensus on outcome measures for trials of interventions for adults with single-sided deafness

“…However, the di culties that SSD imposes can also affect the individual's psychological and social well-being [8,9], and therefore outcomes that assess the impact on an individual's overall health and well-being are also relevant and potentially as important [10]. Healthcare users express uncertainty about choice of treatment options for SSD often due to a lack of clarity about their bene t [11]. A subsequent systematic review identi ed a total of 520 outcome domains from 96 studies that evaluated SSD interventions [12].…”