Self-reported Communication Strategies Used by Individuals with Hearing Loss and its Influence on the Hearing Loss Related Quality of Life of their Communication Partners

Group Audiologic Rehabilitation for Adults and Their Communication Partners

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 (<em>n</em>=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.

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.

The Communication Strategies scale of the Communication Profile for the Hearing Impaired (CPHI) was translated into Swedish and used in several studies of people with hearing impairment (Hallberg & Carlsson, in press; Hallberg, Erlandsson, & Carlsson, 1991). In this study the scale was evaluated in terms of descriptive statistics, corrected item-total correlations, principal component analysis, and internal consistency reliability. Agreement with results from American studies is surprisingly good. Normative data based on three samples are presented: a general Swedish hearing-impaired sample with predominantly sensorineural hearing loss (N = 199), a subgroup of 105 younger subjects with noise-induced hearing loss, and a subgroup of 39 older subjects with sensorineural hearing loss due to heredity and/or old age. A significantly more frequent use of maladaptive behaviors (p less than .001) and verbal communication strategies (p less than .01) was reported by older subjects with age-related and/or hereditary hearing loss than by younger subjects with noise-induced hearing loss. The Communication Strategies scale seems to be an adequately reliable and clinically useful instrument for assessing adaptive and maladaptive strategies in hearing-impaired subjects.

SIG 7 Perspectives Vol. 18, No. 1, October 2011

Third-party hearing loss-related quality of life (HLQoL) reports measure the third-party disability as a result of communicating regularly with someone with hearing loss. Scales with known psychometric characteristics validated on a diverse subject population are needed in order to describe the activity limitations and participation restrictions experienced by spouses as a result of living with an individual with hearing loss. The purpose of the present study was to develop a scale to measure third-party HLQoL in spouses of people with hearing loss with acceptable psychometric characteristics. This scale is known as the Hearing Impairment Impact-Significant Other Profile (HII-SOP). In Study 1, the initial test items were developed and evaluated with a factor analysis for adequate construct validity. In Study 2, the internal consistency reliability, the validity, and the test-retest reliability of the revised test were evaluated. In Study 1, 120 people between 34 and 87 yr of age participated and in Study 2, 164 people between 23 and 88 yr of age participated. In Study 1, a 41-item questionnaire was developed based on five content areas: physical adjustment, social activities, emotional reaction, intimate relationship, and change in roles. The scale was submitted to a factor analysis to analyze interrelationships among items, determine the underlying dimensions, and select items for the final scale. In Study 2, the internal consistency reliability, construct validity, and test-retest reliability were evaluated in the revised 20-item questionnaire. The internal-consistency reliability was measured using Cronbach's alpha. Validity was assessed by observing the correlations of the new scale with well-established scales measuring related constructs: overall health-related quality of life, marital communication, HLQoL, and negative affect, in both the person with hearing loss and the spouse. Test-retest reliability was measured in a subset of the spouses who completed the HII-SOP between 2 and 4 wk after the initial scale was completed. The HII-SOP is a 20-item scale with three subscales which measure: (1) the emotions that arise when having a spouse with hearing loss as well as the impact of the hearing loss on the marital relationship, (2) the impact of the hearing loss on the social life of the spouse, and (3) the communication strategies used by the spouse. The scale and its subscales have adequate internal-consistency reliability suggesting that the 20 items do measure a single construct and the subscales do measure distinct subconstructs. The HII-SOP scale was significantly correlated with measures expected to relate to the construct of third-party disability associated with hearing loss. Finally, the HII-SOP scale has adequate test-retest reliability (r = 0.90) and the 95% critical differences is 19.7 points. The HII-SOP is a scale to measure third-party HLQoL in spouses of individuals with hearing loss. Scores of 20-39 reflect mild third-party disability, scores of 40-59 reflect moderate third-party disability, and scores >60 reflect severe third-party disability associated with hearing loss.

Purpose. The aims were to (i) translate the Amsterdam Inventory for Auditory Disability and Handicap (AIADH) into Swedish and evalute its usefulness, (ii) describe hearing difficulties and psychological well-being (quality of life) and (iii) explore variables related to psychological well-being in a Swedish population.Method. Seventy-nine consecutive patients, referred to the hearing clinic for hearing examination and audiological rehabilitation, formed the study sample. Along with pure-tone audiometry, the AIADH, the Psychological General Well-being index and the Communication Strategies Scale were used.Results. Men had significantly worse hearing on the high frequencies (2, 3, 4 and 6 kHz) than women but their quality of life was significantly higher than for women. Men scored significantly lower on ‘auditory localization’ and adopted non-verbal communication strategies less often than women. A stepwise regression analysis showed that ‘maladaptive behaviours’ and ‘intelligibility in quiet’ explained 48% of the variance in quality of life.Conclusion. Psychosocial consequences of hearing loss, such as lowered quality of life, cannot be predicted from audiometric data alone. The adverse relationship between maladaptive behaviour and quality of life emphasizes the relevance of developing training programs aiming to improve coping with the consequences of a hearing impairment.The AIADH may be useful in assessing self-reported difficulties among patients with hearing problems, but needs to be further developed in terms of psychometric evaluations and reliability testings based on a larger representative sample.

<span>One purpose of this study was to describe coping, disability and handicap, and psychological general wellbeing (quality of life) among women with noise‐induced hearing loss. An additional purpose was to explore psychological and audiological factors affecting quality of life in this female group. Three standardised questionnaires were used: the Communication Strategies Scale (CSS), the Hearing Disabilities and Handicap Scale (HDHS) and the Psychological General Well‐being Scale (PGWB). Data was consecutively assessed during one year at the hearing clinics on two hospitals in the western part of Sweden. Sixty‐five females with hearing loss of sensori‐neural type and a history of noise‐exposure were included in the study. In a stepwise regression analysis, “interpersonal distress” and “speech perception” (subscales of the HDHS) and “verbal communication strategies” explained 45 percent of the variance (multiple R = 0.67). Interestingly, pure‐tone audiometry and difficulties to hear sounds other than speech did not affect quality of life in this female group.</span>

Objectives To examine the effects of web-based SUpport PRogram (SUPR) for communication partners (CPs) of persons with hearing loss (PHLs) in a HA dispensing setting. Design Cluster randomised controlled trial (cRCT) with two arms (SUPR: Booklet, online videos; care as usual: no support) plus process evaluation. Measurements: baseline, and immediately-, six, and 12 months post-intervention. Outcomes: Significant Other Scale for Hearing Disability (SOS-HEAR), International Outcome Inventory for HAs/Alternative Interventions for Significant Others (IOI-HA/AI-SO). Process evaluation: dose-received, satisfaction, and benefit. Study sample The cRCT included 73 (SUPR) and 57 (care as usual) CPs. In the process evaluation study, 41 CPs (SUPR) participated. Results There were no significant effects of SUPR for third-party disability (SOS-HEAR), the proxy report (IOI-HA-SO item “use”), and third-party disability (IOI-HA-SO items “satisfaction”, and “quality of life”). SUPR-videos were watched by 15-22% of the CPs. SUPR materials were rated as moderately beneficial and useful. Conclusions Low baseline disability (floor effect) and low intervention dose-received may explain the findings. Directly targeting CPs rather than via their PHLs and providing intervention materials specifically for CPs may improve their engagement and contribute to SUPR’s value supplementary to standard HA care.

Communication strategies are sometimes used in communicating. This descriptive-comparative research analyzes the verbal and non-verbal communication strategies in the candidates’ campaign speeches; groupings of utterances used; sentence types by gender; and determines any significant difference in communication strategies. During the 2010 barangay election candidates’ forums, all campaign speeches were recorded, transcribed into tapescript and analyzed by experts. Percentages, averages and chi-square were used. Repetition, code switching, pause, sigh, groan, body movement, facial expressions and mime were the mostly employed strategies. Complex sentence was mostly used. Significant difference exists between common sentence types used but none in the verbal communication strategies.

Communication with speech generating devices (SGDs) with children with severe physical, communicative and cognitive impairments, such as children with cerebral palsy (CP), can be difficult. Use of partner strategies facilitates the communication and instructional approaches such as feedback and role play facilitate communication partners’ learning in how to use partner strategies. To describe communication partners’ use and learning about partner strategies in SGD-mediated communication with children with severe CP. Questionnaires (n = 65) were sent to caregivers (n = 30), teachers (n = 17), and teaching or personal assistants (n = 18) of children with severe CP. Response rate was 80%. To ask open-ended questions was the most frequently used partner strategy and aided augmented input the least frequently used partner strategy. Most commonly, participants learned partner strategies from speech and language pathologists (SLPs) who used verbal instructions when teaching partner strategies but seldom or never feedback, role play or video examples. Communication partners’ learning about partner strategies in SGD-mediated communication is inadequate and needs to be improved. SLPs, who are the main prescribers of SGDs and responsible for training and support in using them, should consider using instructional approaches when teaching communication partners about partner strategies in communication with an SGD.

Purpose Limited clinical and research evidence is available to support healthcare practitioners in the communication assessment and intervention of persons who are minimally conscious. This study placed a specific focus on the multimodal communication strategies familiar caregivers of persons who are minimally conscious observed, as well as the verbal and the nonverbal communication strategies they employed to build communication capacity. This may inform clinical practice as it provides valuable autobiographical information as well as familiar stimuli that may elicit responses from persons in a minimally conscious state. Method A descriptive qualitative design employing in-depth semi-structured interviews with familiar caregivers was utilised to address the purpose of the study. Result Familiar caregivers reported that they used both nonverbal and verbal communication strategies to obtain a response from persons who are minimally conscious. These caregivers also reported that these persons appeared to rely on nonverbal communication strategies to express 36 different communication functions. Conclusion Based on the findings of this study, it is clear that caregivers can be beneficial to persons who are minimally conscious, if they are able to observe and capitalise on naturally occurring multimodal communication strategies and functions. This study emphasises that familiar caregivers respect and value the dignity of persons who are minimally conscious and want to improve their communication capacity, but often lack confidence in their own communication skills.

Effective communication is of paramount importance in all aspects of life. To achieve this, verbal and nonverbal techniques may be utilized. These techniques are called Communication Strategies (CSs). The primary objective of this study was to investigate the verbal and nonverbal communication strategies used by EFL (English Foreign Language) learners in the classroom to enhance their communication ability and to achieve strategic proficiency in their communication. It also explored which strategies are more effective or successful for accomplishing strategic proficiency in communication and for compensating the limited knowledge. Data came from two sources: questionnaires which were accomplished by the 20 student participants and 2 teacher participants and an observation administered by the researcher. The results showed that the most common communication strategies used are repetition and paraphrasing, while the less used strategies are literal translation and nonverbal strategies. The findings also confirmed that paraphrasing, repetition and replacing words are more effective than literal translation and nonverbal strategies. In addition, the correlation analysis revealed that the greater experience students have in learning English, the more strategies they use and the Pearson correlation approved that paraphrasing clearly correlated with years of learning English, r = .44, p = .05. Therefore, the communicative technique paraphrasing is used by the students who have greater experience in learning English confirming that using it is dependent on the years or the experience of learning the language.

BackgroundEffective communication is a cornerstone of quality healthcare. Communication helps providers bond with patients, forming therapeutic relationships that benefit patient-centred outcomes. The information exchanged between the provider and patient can help in medical decision-making, such as better self-management. This rapid review investigated the effects of quality and effective communication on patient-centred outcomes among older patients.MethodsGoogle Scholar, PubMed, Scopus, CINAHL, and PsycINFO were searched using keywords like “effective communication,“ “elderly,“ and “well-being.“ Studies published between 2000 and 2023 describing or investigating communication strategies between older patients (65 years and above) and providers in various healthcare settings were considered for selection. The quality of selected studies was assessed using the GRADE Tool.ResultsThe search strategy yielded seven studies. Five studies were qualitative (two phenomenological study, one ethnography, and two grounded theory studies), one was a cross-sectional observational study, and one was an experimental study. The studies investigated the effects of verbal and nonverbal communication strategies between patients and providers on various patient-centred outcomes, such as patient satisfaction, quality of care, quality of life, and physical and mental health. All the studies reported that various verbal and non-verbal communication strategies positively impacted all patient-centred outcomes.ConclusionAlthough the selected studies supported the positive impact of effective communication with older adults on patient-centred outcomes, they had various methodological setbacks that need to be bridged in the future. Future studies should utilize experimental approaches, generalizable samples, and specific effect size estimates.

Describe how the burden on the communication partner (CP) from the patient's hearing loss, as perceived by both the patient and their CP, influences a patient's pursuit of hearing evaluation. Cross-sectional design. Demographics, perception of patient's hearing loss, and associated burden on the CP were collected from both patient and CP via online questionnaires. Patients and their CPs from Duke University Medical Center Otolaryngology Clinic, 55 to 75 years of age, being seen for any reason, who indicated a CP has expressed concern about their hearing. Final sample was 245 matched pairs. Based on completed questionnaires, on average, patients perceived their own hearing loss as more burdensome to the CP than the CP did. However, CPs of patients who believed themselves to have no hearing handicap scored the patient's hearing loss 54.3% higher than the patient. The patient's perspective about the amount of burden their hearing loss placed on the CP predicted patients seeking a hearing evaluation. Recognition of early stage hearing loss and associated burden on CPs may be delayed in patients; CPs may help elucidate unrecognized concerns. Educational approaches that raise awareness of burden of hearing loss on CPs along with hearing loss indications could be a feasible, multidimensional strategy to promote help seeking behaviors.