Hearing Healthcare Professionals Research Articles

Impact of Tumarkin attacks on complaints and work ability in Ménière's disease.

The purpose of the present study was to characterize the occurrence of Tumarkin attacks in patients with Ménière'sdisease (MD), and to study its association with reported complaints, severity of consequences, and also self-reported work ability. The study used a cross-sectional design. Data obtained from the Finnish Ménière Federation using an electronic survey was analyzed. 602 people with MD responded to the survey (62% response rate) with a mean age of 56.7 years and a mean duration of the disease 12.4 years. 49% of the respondents experienced Tumarkin attacks, which lasted for a few seconds to a few minutes. There were significant differences in complaints reported by MD patients with and without Tumarkin attacks. Respondents with Tumarkin attacks experienced various consequences, including tripping, falls, fear, anxiety, problems in dyadic life, and even transient loss of consciousness. Respondents with Tumarkin attacks had more frequently applied for pension than those not having Tumarkin attacks. On an average, respondents with Tumarkin attacks had less self-reported working ability when compared to those without Tumarkin attacks. The current study results suggest various differences in terms of complaints reported, severity of consequences, and the self-reported working ability in MD patients with and without Tumarkin attacks. Hearing healthcare professionals must examine Tumarkin attacks and their consequences in patients with MD during clinical examinations. In addition, the therapy should focus on alleviating the consequences and improving work ability.

Today's Hearing Technologies: Definitions, Regulations, Overlaps

Today's Hearing Technologies: Definitions, Regulations, Overlaps

Parent-directed commentaries during children's hearing habilitation appointments: a practice in family-centred care.

Family-centred care (FCC) is recognized as best practice in the delivery of early intervention services for children with hearing loss (HL) and their families. However, there has been little research involving direct observation of family-centred communication practices in paediatric hearing habilitation appointments, which means little is currently known about how family members are involved within appointments, and how FCC is accomplished by health professionals through their interactions with families. To examine the interaction between hearing healthcare professionals, children with HL, and their parents within video-recorded paediatric hearing habilitation appointments (including both audiology and speech and language therapy appointments), with a particular focus on how parents were involved in the interaction. The data for this study involved a corpus of 48 video-recorded paediatric hearing habilitation appointments from three clinical sites (including 33 audiology appointments and 15 speech pathology appointments). Participants included 14 audiologists, 8 speech and language therapists, 41 children with HL (aged 18 months and over) and 48 of their attending family members (e.g., parents/carers). The data were analyzed using conversation analysis. Analysis revealed one specific practice that health professionals used to engage parents in the interaction during child-directed assessment and therapy tasks: that of 'parent-directed commentaries', where health professionals shifted their attention to the parent(s) to describe or evaluate what they were observing during appointment tasks. Health professionals were observed to produce two types of parent-directed commentaries: (1) a positive evaluation of the child's just-prior response; and (2) an account for the child's prior behaviour (sometimes also accompanied by a positive evaluation). These commentaries appeared at systematic points in the interaction when the child had been displaying difficulty with their response to the health professional. The parent-directed commentaries accomplished several important functions: they engaged the parent's attention in the interaction; focused the parent's attention on positive responses from the child (while shrouding less positive responses); played down potential negative perceptions of the child's previous missed/incorrect responses; and provided parents with reassurance of their child's progress during the ongoing task. The parent-directed commentaries identified in this study provide an example of the practical, interactional resources that health professionals can draw on within paediatric appointments to facilitate FCC with parents.

Development of a multimedia educational programme for first-time hearing aid users: a participatory design

Objective: To develop content for a series of interactive video tutorials (or reusable learning objects, RLOs) for first-time adult hearing aid users, to enhance knowledge of hearing aids and communication.Design: RLO content was based on an electronically-delivered Delphi review, workshops, and iterative peer-review and feedback using a mixed-methods participatory approach.Study sample: An expert panel of 33 hearing healthcare professionals, and workshops involving 32 hearing aid users and 11 audiologists. This ensured that social, emotional and practical experiences of the end-user alongside clinical validity were captured.Results: Content for evidence-based, self-contained RLOs based on pedagogical principles was developed for delivery via DVD for television, PC or internet. Content was developed based on Delphi review statements about essential information that reached consensus (≥90%), visual representations of relevant concepts relating to hearing aids and communication, and iterative peer-review and feedback of content.Conclusions: This participatory approach recognises and involves key stakeholders in the design process to create content for a user-friendly multimedia educational intervention, to supplement the clinical management of first-time hearing aid users. We propose participatory methodologies are used in the development of content for e-learning interventions in hearing-related research and clinical practice.

Developing Foundational Counseling Skills for Addressing Adherence Issues in Auditory Rehabilitation.

Successfully getting patients with confirmed hearing loss to use hearing aids is a major challenge for hearing health care professionals. Treatment adherence has been defined as the active involvement of patients in collaborating with health care providers to plan and manage treatment regimens. Counseling patients with hearing loss on adherence to recommendations of hearing aid uptake and utilization is dependent upon building a patient-centered therapeutic relationship during the initial diagnostic evaluation. The purpose of this article is to provide resources, tools, and engaging learning activities for training students on the development of a hierarchy of counseling skills: informational counseling (e.g., checking comprehension and problem clarification), communication skills (e.g., promotion of shared-communication space, congruence, listening with the third ear, unconditional positive regard, and empathy), and health behavior change (e.g., Motivational Interviewing and the Teach-Back Method) that are prerequisites for addressing treatment adherence.

The ALFA4Hearing Model (At-a-Glance Labeling for Features of Apps for Hearing Health Care) to Characterize Mobile Apps for Hearing Health Care

The aim of the study was to analyze, by using the ALFA4Hearing model (At-a-Glance Labeling for Features of Apps for Hearing Health Care), a sample of apps over a wide range of services in the hearing health care (HHC) domain in order to take a first picture of the current scenario of apps for HHC. We tested 120 apps, and we characterized them by using the ALFA4Hearing model, which includes 29 features in 5 components (Promoters, Services, Implementation, Users, and Descriptive Information). We analyzed (a) the distribution of the 29 features in the sample, (b) the relationship between the Implementation features and the Services provided by the apps, and (c) the distribution of the 29 features in apps for professional use. The analysis of our sample of apps by means of the ALFA4Hearing model highlighted interesting trends and emerging challenges. Also, results suggested many potential opportunities for research and clinical practice, such as greater involvement of stakeholders, improved evidence base, higher technical quality, and usability. The ALFA4Hearing model is able to represent, at a glance, a large amount of information about apps for HHC, highlighting trends and challenges. It might be useful to HHC professionals as a basis for app characterization and informed decision making.

Hearing health access in developing countries.

The developing world carries a disproportionate burden of hearing loss. Individuals with hearing loss in austere settings worldwide are also potentially impacted by their impairment to a greater extent owing to underdeveloped or nonexistent hearing health infrastructure. The purpose of this review is to examine the state of the literature on hearing health access in developing countries and identify areas for improvement. Over the last 10 years progress has been made in some areas, whereas other aspects of hearing health in developing countries have changed very little. There has been expansion of efforts to train primary care and local hearing healthcare providers to recognize and appropriately treat preventable causes of hearing loss in the developing world. Applications of telehealth to connect providers and patients in rural locales have grown. Adaptions of newborn hearing screening programs that better fit local resources and customs have been reported. There has been a considerable increase in interest, including cost-benefit analyses, with regard to the use of cochlear implants in the developing world. In spite of progress, the developing world still shoulders a disproportionate amount of the world's hearing loss, in particular chronic ear disease, and there is a paucity of well trained local hearing healthcare professionals to deal with the challenge. The role of international humanitarian efforts, telemedicine, and education is highlighted.

Applications of direct-to-consumer hearing devices for adults with hearing loss: a review.

BackgroundThis systematic literature review is aimed at investigating applications of direct-to-consumer hearing devices for adults with hearing loss. This review discusses three categories of direct-to-consumer hearing devices: 1) personal sound amplification products (PSAPs), 2) direct-mail hearing aids, and 3) over-the-counter (OTC) hearing aids.MethodA literature review was conducted using EBSCOhost and included the databases CINAHL, MEDLINE, and PsycINFO. After applying prior agreed inclusion and exclusion criteria, 13 reports were included in the review.ResultsIncluded studies fell into three domains: 1) electroacoustic characteristics, 2) consumer surveys, and 3) outcome evaluations. Electroacoustic characteristics of these devices vary significantly with some meeting the stringent acoustic criteria used for hearing aids, while others producing dangerous output levels (ie, over 120-dB sound pressure level). Low-end (or low-cost) devices were typically poor in acoustic quality and did not meet gain levels necessary for most adult and elderly hearing loss patterns (eg, presbycusis), especially in high frequencies. Despite direct-mail hearing aids and PSAPs being associated with lower satisfaction when compared to hearing aids purchased through hearing health care professionals, consumer surveys suggest that 5%–19% of people with hearing loss purchase hearing aids through direct-mail or online. Studies on outcome evaluation suggest positive outcomes of OTC devices in the elderly population. Of note, OTC outcomes appear better when a hearing health care professional supports these users.ConclusionWhile some direct-to-consumer hearing devices have the capability to produce adverse effects due to production of dangerously high sound levels and internal noise, the existing literature suggests that there are potential benefits of these devices. Research of direct-to-consumer hearing devices is limited, and current published studies are of weak quality. Much effort is needed to understand the benefits and limitations of such devices on people with hearing loss.

Stages of change in audiology: comparison of three self-assessment measures

Objective: In a clinical setting, theories of health behaviour change could help audiologists and other hearing health care professionals understand the barriers that prevent people with hearing problems to seek audiological help. The transtheoretical (stages of change) model of health behaviour change is one of these theories. It describes a person’s journey towards health behaviour change (e.g. seeking help or taking up rehabilitation) in separate stages: precontemplation, contemplation, preparation, action, and, finally, maintenance. A short self-assessment measure of stages of change may guide the clinician and facilitate first appointments. This article describes correlations between three stages of change measures of different lengths, one 24-item and two one-item. Design: Participants were recruited through an online hearing screening study. Adults who failed the speech-in-noise recognition screening test and who had never undergone a hearing aid fitting were invited to complete further questionnaires online, including the three stages of change measures. Study sample: In total, 224 adults completed the three measures. Results: A majority of the participants were categorised as being in one of the information- and help-seeking stage of change (contemplation or preparation). The three stages of change measures were significantly correlated. Conclusions Our results support further investigating the use of a one-item measure to determine stages of change in people with hearing impairment.

Benefits of Extended High-Frequency Audiometry for Everyone

Benefits of Extended High-Frequency Audiometry for Everyone

Audism and Its Implications for Audiology

Purpose Two healthcare providers with hearing loss, one neuropsychologist, and one audiologist, explore the concept of audism and its implications within the field of audiology. Method Literature review and frank contemplation. Results The present investigation found no peer-reviewed literature on the topic of audism within the audiology discipline. Awareness of audism and its manifestations have implications for helping audiologists and other hearing healthcare professionals to improve patient satisfaction and treatment compliance. Conclusions Audism is the notion that one is superior based on one's ability to hear or to behave in the manner of one who hears. Strong consideration should be given to including language and cultural studies of the Deaf community within audiology graduate training curriculums. Suggestions for overcoming audism—whether intentional or unintentional—are provided along with research recommendations.

Validated Smartphone-Based Apps for Ear and Hearing Assessments: A Review.

BackgroundAn estimated 360 million people have a disabling hearing impairment globally, the vast majority of whom live in low- and middle-income countries (LMICs). Early identification through screening is important to negate the negative effects of untreated hearing impairment. Substantial barriers exist in screening for hearing impairment in LMICs, such as the requirement for skilled hearing health care professionals and prohibitively expensive specialist equipment to measure hearing. These challenges may be overcome through utilization of increasingly available smartphone app technologies for ear and hearing assessments that are easy to use by unskilled professionals.ObjectiveOur objective was to identify and compare available apps for ear and hearing assessments and consider the incorporation of such apps into hearing screening programsMethodsIn July 2015, the commercial app stores Google Play and Apple App Store were searched to identify apps for ear and hearing assessments. Thereafter, six databases (EMBASE, MEDLINE, Global Health, Web of Science, CINAHL, and mHealth Evidence) were searched to assess which of the apps identified in the commercial review had been validated against gold standard measures. A comparison was made between validated apps.ResultsApp store search queries returned 30 apps that could be used for ear and hearing assessments, the majority of which are for performing audiometry. The literature search identified 11 eligible validity studies that examined 6 different apps. uHear, an app for self-administered audiometry, was validated in the highest number of peer reviewed studies against gold standard pure tone audiometry (n=5). However, the accuracy of uHear varied across these studies.ConclusionsVery few of the available apps have been validated in peer-reviewed studies. Of the apps that have been validated, further independent research is required to fully understand their accuracy at detecting ear and hearing conditions.

The Adverse Effects of Heavy Metals with and without Noise Exposure on the Human Peripheral and Central Auditory System: A Literature Review.

Exposure to some chemicals in the workplace can lead to occupational chemical-induced hearing loss. Attention has mainly focused on the adverse auditory effects of solvents. However, other chemicals such as heavy metals have been also identified as ototoxic agents. The aim of this work was to review the current scientific knowledge about the adverse auditory effects of heavy metal exposure with and without co-exposure to noise in humans. PubMed and Medline were accessed to find suitable articles. A total of 49 articles met the inclusion criteria. Results from the review showed that no evidence about the ototoxic effects in humans of manganese is available. Contradictory results have been found for arsenic, lead and mercury as well as for the possible interaction between heavy metals and noise. All studies found in this review have found that exposure to cadmium and mixtures of heavy metals induce auditory dysfunction. Most of the studies investigating the adverse auditory effects of heavy metals in humans have investigated human populations exposed to lead. Some of these studies suggest peripheral and central auditory dysfunction induced by lead exposure. It is concluded that further evidence from human studies about the adverse auditory effects of heavy metal exposure is still required. Despite this issue, audiologists and other hearing health care professionals should be aware of the possible auditory effects of heavy metals.

Auditory Brain Development in Children with Hearing Loss – Part Two

Auditory Brain Development in Children with Hearing Loss – Part Two

Auditory Brain Development in Children With Hearing Loss – Part One

Auditory Brain Development in Children With Hearing Loss – Part One

Lessons from LOCHI.

Lessons from LOCHI.

Should All Deaf Children Learn Sign Language?

Should All Deaf Children Learn Sign Language?

The Benefits of Social Support for Listeners with Impaired Hearing

The Benefits of Social Support for Listeners with Impaired Hearing

Measuring Success: Cost-Effectiveness and Expanding Access to Cochlear Implantation.

Only a small fraction of patients with profound sensorineural hearing loss have access to cochlear implantation with the majority of these affected people living in developing countries. Cost effectiveness analysis (CEA) is an important tool to demonstrate the value of this technology to healthcare policy makers. This approach requires that hearing healthcare professionals incorporate methods of assessing long-term benefits of cochlear implantation that include psychosocial, quality of life, and disability outcomes. This review explores different aspects of CEA methodology relevant to cochlear implants and discusses ways that we can improve global access by addressing factors that influence cost-effectiveness.

Understanding the psychosocial experiences of adults with mild-moderate hearing loss: An application of Leventhal’s self-regulatory model

Objective: This study explored the psychosocial experiences of adults with hearing loss using the self-regulatory model as a theoretical framework. The primary components of the model, namely cognitive representations, emotional representations, and coping responses, were examined. Design: Individual semi-structured interviews were conducted. The data were analysed using an established thematic analysis procedure. Study sample: Twenty-five adults with mild-moderate hearing loss from the UK and nine hearing healthcare professionals from the UK, USA, and Canada were recruited via maximum variation sampling. Results: Cognitive representations: Most participants described their hearing loss as having negative connotations and consequences, although they were not particularly concerned about the progression or controllability/curability of the condition. Opinions differed regarding the benefits of understanding the causes of one’s hearing loss in detail. Emotional representations: negative emotions dominated, although some experienced positive emotions or muted emotions. Coping responses: engaged coping (e.g. hearing aids, communication tactics) and disengaged coping (e.g. withdrawal from situations, withdrawal within situations): both had perceived advantages and disadvantages. Conclusions: This novel application of the self-regulatory model demonstrates that it can be used to capture the key psychosocial experiences (i.e. perceptions, emotions, and coping responses) of adults with mild-moderate hearing loss within a single, unifying framework.