Abstract
The authors are developing an intake tool based on the Brief International Classification of Functioning Disability and Health Core Set for Hearing Loss, by operationalizing its categories into a Patient Reported Outcome Measure. This study was aimed at identifying enablers and barriers to using this tool as perceived by hearing health professionals (HHPs) and patients. Focus groups and interviews were held with HHPs (ENT surgeons, N = 14; audiologists, N = 8) and patients (N = 18). Interview questions were based on the Capability-Opportunity-Motivation-Behavior (COM-B) model. Using the COM-B model and the Theoretical Domains Framework (TDF), transcript fragments were divided into meaning units, which were then categorized into capability-, opportunity- and motivation-related barriers and enablers. These were further specified into TDF domains. HHP barriers included: lack of time to use the tool (O); and fear of being made responsible for addressing any emerging problems, which may be outside the expertise of the HHP (M). Enablers included integration of the tool in the electronic patient record (O); opportunity for the patient to be better prepared for the intake visit (M); and provision of a complete picture of the patient’s functioning via the tool (M). Patient’ barriers included fear of losing personal contact with the HHP (M); and fear that use of the tool might negatively affect conversations with the HHP (M). Enablers included knowledge on the aim and relevance of the tool (C); expected better self-preparation (M); and a more focused intake (M). These findings suggest that an intervention is needed to enhance HHPs’ knowledge, skills and motivation regarding the relevance and the clinical usefulness of the tool. Providing clear and specific information on the purpose of the tool can also enhance patient motivation. For both HHPs and patients, opportunities relating to the (digital) administration and the design of the tool provide additional targets for successful implementation.
Highlights
Adults with ear and hearing problems may experience both physical impairments and psychosocial consequences that can significantly impact their functioning in daily life [1]
Note that the Core Sets for Hearing Loss (CSHL) was developed for adults with hearing loss, which explains why we created an ICF-based intake tool for patients who come to an Audiology Center and/or an ENT practice for hearing loss-related complaints
This was identified as a psychosocial capability (COM-B) by health professionals (HHPs) that can be further linked to the Theoretical Domains Framework (TDF) category knowledge
Summary
Adults with ear and hearing problems may experience both physical impairments and psychosocial consequences that can significantly impact their functioning in daily life [1]. Ear and hearing problems are often understood in the context of the specific disease (medical perspective) with a focus on relieving the impairments that exist on the level of body functions and body structures. Such an approach does not include the level of participation (restrictions) and the individual’s personal and environmental context, and only partially describes and addresses the consequences of ear and hearing problems [4, 6]. Any inclusion of these aspects in current clinical practice is unlikely to be standardized
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