Hearing Healthcare Professionals Research Articles

Parent experiences with genetic testing for pediatric hearing loss.

The purpose of the current study was to assess parent perceptions and experiences of genetic testing, as well as barriers for not undergoing testing in a sample of families of children with hearing loss. A 44-item questionnaire, The Parent Perception of Genetic Testing Questionnaire developed by the research study team was administered. Participants were recruited from a pediatric otolaryngology/audiology practice and social media. A total of 146 parents of children with hearing loss participated. Approximately 47.6% of the children in our sample underwent genetic testing, 44.8% did not, and 7.6% of parents were unsure. For those that did not undergo testing, reasons included: unaware (6.2%), not interested (8.9%), cost (8.9%), time (3.4%), fearful of results (2.7%), and never offered (15.1%). For those that did undergo testing, over half of the parents reported that they did not receive counseling before (55.1%) and 41.7% reported they received counseling after the testing. Furthermore, parents were confused about the results with 18.3% reporting they were Very Confused, 28.3% Somewhat Confused, 20% A Little Confused, and 33.3% Not Confused at All about the variant of uncertain or unknown significance. Notably, less than half of parents (43.4%) remembered what they were told about the mode of inheritance. Overall, our study highlighted the low adoption rate of genetic testing and lack of integration into standard of care for otology/audiology practices. Collaboration between hearing healthcare professionals and geneticists is warranted to determine how to reduce barriers to access while improving pre- and post-counseling.

Kaupapa Māori development of te reo Māori assessments and culturally responsive hearing healthcare in Te Waipounamu: findings from wānanga

ABSTRACT The development of valid and robust te reo Māori (te reo) hearing assessments in Aotearoa New Zealand (Aotearoa) is an area of research that requires further attention from a Kaupapa Māori stance. In support of te reo revitalisation, this article shares findings from two wānanga in Te Waipounamu (the South Island of Aotearoa) with research partners (hearing healthcare professionals and Māori health and education professionals). Research partners’ perspectives and experiences of barriers and facilitators to ear and hearing healthcare in Te Waipounamu, development of te reo assessments, and their application in clinical and community settings are explored. Embedded within Kaupapa Māori theory and methodology, data was analysed using reflexive thematic analysis to identify commonalities and patterns in ‘Hauora Māori Community’ and ‘Hearing Healthcare Community’. This paper presents seven whakaaro themes and first steps from provider perspectives towards the development of culturally appropriate and responsive hearing healthcare tools and services.

Validation of the Pediatric Spatial Hearing Questionnaire.

Spatial hearing is necessary for adequate sound awareness and speech perception abilities; however, research indicates that children have difficulties on these spatial hearing tasks that affect functioning in their daily environment. The purpose of this study was to validate a pediatric version of the Spatial Hearing Questionnaire (P-SHQ) for determining binaural hearing benefits and spatial hearing ability in children. We recruited parents and guardians of 68 children ages kindergarten through eighth grade to participate. Parents completed the P-SHQ, the Speech, Spatial and Qualities of Hearing Scale-Parent version, and a demographic questionnaire. To determine the factor structure of the P-SHQ, we conducted an exploratory factor analysis and reliability was assessed by calculating correlation coefficients. Three factors emerged during factor analysis: Factor 1 = sound localization, Factor 2 = speech-in-noise perception, and Factor 3 = speech perception in quiet. The P-SHQ has good internal consistency reliability (α = .97), and high item-total correlations were found. The correlation between scores from the P-SHQ questionnaire and the SSQ-Spatial subscale questionnaire provides evidence for the construct validity of the P-SHQ. The P-SHQ is a reliable and valid questionnaire to assess spatial hearing ability in children. This quick-to-administer tool can be incorporated into audiological care to determine the spatial hearing skills of a child and assist in counseling, making it a valuable assessment for hearing health care professionals.

Hearing loss and psychosocial outcomes: Influences of social emotional aspects and personality.

The aim of this study was to examine the effects of social isolation, loneliness, anxiety, depression, higher stress, and memory complaints interacting with personality traits as a function of hearing loss. Personality traits have previously been shown to correlate with anxiety and depression, as well as hearing loss, suggesting an effect of personality on the relationship between social emotional outcomes and hearing loss. A cross-sectional survey including validated screening measures was anonymously administered. Measures included personality (Big Five Index-2 Extra-Short Form), stress (Perceived Stress Scale), anxiety and depression (Patient Health Questionnaire for Depression and Anxiety), loneliness (Three-Item Loneliness Scale), social engagement (Lubben Social Network Scale-6), and self-perceived memory complaints (Subjective Cognitive Function). Eight hundred and ninety-one responses were obtained from adults between the ages of 18 and 90 years old (M = 50 years old). Hearing loss was positively correlated with subjective memory complaints only when not accounting for demographic variables, personality traits, psychosocial outcomes, and social emotional outcomes. There were additive effects of hearing loss and negative emotionality on increases in memory complaints in those who self-identified as maybe having hearing loss. Higher degrees of hearing loss also increased loneliness, with greater hearing loss negating the positive correlation between extraversion and social engagement. Overall, our results suggest that hearing loss significantly interacts with personality traits and other social emotional measures. Our results suggest that the impact of hearing loss on memory complaints, social isolation, and loneliness may differ across patients with hearing loss in comparison with those who think they maybe have hearing loss. Information from this study may provide insights for hearing healthcare and mental healthcare professionals to better serve persons with hearing loss who may require additional support or interventions.

Consumer Perspectives on Improving Hearing Aids: A Qualitative Study.

Hearing aids play a pivotal role in mitigating the impact of hearing loss, yet their adoption and consistent usage remains suboptimal. Understanding the hearing aid needs of individuals with hearing loss is important to support uptake, use, and outcomes. The current study describes users' perspectives on how hearing aids can be improved. A cross-sectional, qualitative, content analysis design was used for an open-ended question from an online survey, exploring user perspectives on hearing aid improvements. Participants were adult hearing aid users in the United States, surveyed from the HearingTracker and Lexie Hearing user database. A total of 628 participants (Mage = 66 years) were surveyed. The majority of participants used bilateral, behind-the-ear hearing aids that were obtained either through a hearing health care professional or online. Three domains, highlighting areas for hearing aid improvement, were identified. (a) The hearing aid features domain described user issues surrounding physical appearance and fit, general features, streaming, battery functionality, adjustments, smartphone applications, and hearing aid-related accessories. There was dissatisfaction with aesthetics and functionality, with a notable desire for improvements in physical appearance and fit (n = 161), and features to improve self-efficacy. (b) The sound quality domain described user issues surrounding sound perception and difficult situations. Participants highlighted unmet needs for clarity, especially in noisy environments (n = 143). (c) The service-delivery domain described user issues surrounding audiology services and general satisfaction, with criticisms centered on the high cost of hearing aids (n = 193) and the credibility of hearing health care professionals. Hearing aid users appreciated current technological advances but expressed a need for improvements, to better align devices with their requirements. Key areas included physical aesthetics, user control over device adjustments, sound clarity, cost accessibility, and trust between the user and hearing health care professional. Future designs should focus on features enhancing user autonomy and self-efficacy.

Auditory processing disorder: an online survey of hearing healthcare professionals’ knowledge and practices

Objective To investigate (1) the current level of awareness and knowledge on Auditory Processing Disorder (APD) among Audiologists and other hearing healthcare professionals; (2) current practices in screening, diagnosis, and management of APD in children and adults across the UK; (3) professional’s acceptance of APD assessment and diagnosis. Design An online survey was disseminated through the British Academy of Audiology and ENT UK. Study sample A total of 191 hearing healthcare professionals responded to the survey. Results Overall, while 63% of the respondents considered themselves to be adequately informed about APD, only 4% viewed themselves as very informed on the topic. Fewer than half of the respondents report screening (31%), diagnosing (14%), or managing (36%) cases of APD. For screening APD, professionals most commonly use auditory processing tests in adults and take case histories in children, whereas routine audiological procedures are the primary method for diagnosing APD in both adults and children. Although modifying the listening environment is a widely recommended management strategy for APD, half of the respondents indicated that a diagnosis of APD has no implications for patient management. Conclusions There is a critical need to promote APD-related training to ensure they can provide appropriate referrals and management.

Exploration and Analysis of Cochlear Implant Content on Social Media.

Social media has an ever-growing presence in patients' lives, particularly with the dissemination of both useful and misleading information. We performed an exploration and analysis of content pertaining to cochlear implantation on a popular social media platform. "Cochlear implant" (CI) was queried on TikTok in early October 2022 in a cross-sectional analysis. The 100 top videos were collected. Non-English and duplicate videos were excluded. Two independent researchers used the Global Quality Scale (GQS) and modified DISCERN tool to score videos; higher ratings indicate increased quality and reliability. Demographic data were also recorded. Of the 100 videos assessed, 95 met the inclusion criteria. The average video had 2.36 million views, 328 thousand likes, and a duration of 36.1 seconds. The mean GQS was 1.91 (standard deviation (SD) 0.85), and the modified DISCERN score was 1.48 (SD 1.20). Posters were predominantly laypersons (93.7%), including CI users or parents of pediatric CI users. No videos featured audiologists or otolaryngologists. Nearly half of the videos (48.4%) discussed the experience of a patientor parent of a pediatric patientwith CIs, and 24.2% were aimed at directly educating the viewers about CIs or the deaf community. Most videos featured CI users or families of pediatric CI users and detailed specific patient experiences. The deaf and CI communities have strong social media presences. Most videos had limited quality and reliability, measured via the GQS and modified DISCERN tool, and no videos featured hearing healthcare professionals, highlighting opportunities for clinicians to use the platform as a patient resource.

The portrayal of hearing loss information in online Mandarin videos

Background/purposeWith increasing accessibility to the Internet, patients frequently use the Internet for hearing healthcare information. No study has examined the information about hearing loss available in the Mandarin language on online video-sharing platforms. The study's primary purpose is to investigate the content, source, understandability, and actionability of hearing loss information in the Mandarin language's one hundred most popular online videos. MethodIn this project, publicly accessible online videos were analyzed. One hundred of the most popular Mandarin-language videos about hearing loss were identified (51 videos on YouTube and 49 on the Bilibili video-sharing platform). They were manually coded for different popularity metrics, sources, and content. Each video was also rated using the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-AV) to measure the understandability and actionability scores. ResultsThe video sources were classified as either media (n = 36), professional (n = 39), or consumer (n = 25). The videos covered various topics, including symptoms, consequences, and treatment of hearing loss. Overall, videos attained adequate understandability scores (mean = 73.6%) but low (mean = 43.4%) actionability scores. ConclusionsWhile existing online content related to hearing loss is quite diverse and largely understandable, those videos provide limited actionable information. Hearing healthcare professionals, media, and content creators can help patients better understand their conditions and make educated hearing healthcare decisions by focusing on the actionability information in their online videos.

A Closer Look at Hearing Loss, Dementia, and Stigma

A Closer Look at Hearing Loss, Dementia, and Stigma

Impacts and Identification of Hearing Aid Refurbishing Programs for People with Hearing Loss: A Scoping Review.

This article consists of a scoping review completed to describe the impacts of refurbished hearing aids (HAs) for people with hearing loss, and to identify existing HA refurbishing programs around the world. In this review, JBI methodological guidance for scoping reviews was followed. All types of sources of evidence were considered. Thirty-six sources of evidence were included, 11 articles and 25 web pages. Results suggest that refurbished HAs may improve communication and social participation for individuals with hearing loss and provide monetary savings to them and to governmental agencies. Twenty-five HA refurbishing programs were identified, all based in developed countries and distributing refurbished HAs mostly locally, but also in developing countries. Issues related to refurbished HAs were highlighted, such as potential cross-contamination, quick obsolescence, and repairing problems. Some facilitators for the success of this intervention are to offer accessible and affordable follow-up services, repairs, and batteries, and to ensure awareness and participation of hearing healthcare professionals and citizens with hearing loss. In conclusion, the use of refurbished HAs appears to be a valuable option for low-income people with hearing loss, but it should be included in a more global intervention program to ensure its sustainability.

Hearing Healthcare Professionals' Views about Over-The-Counter (OTC) Hearing Aids: Analysis of Retrospective Survey Data.

Over-the-counter hearing aids have been available to consumers in the US since 17 October 2022 following a ruling by the Food and Drug Administration. However, their reception by hearing healthcare professionals (HHP) has been mixed, and concerns have been expressed by many HHPs. The aim of this study was to examine the concerns that HHPs have towards over-the-counter (OTC) hearing aids. The study used a retrospective survey design. The survey data of HHPs (n = 730) was obtained from Hearing Tracker. A 22-item structured questionnaire was administered using a Question Scout platform. Descriptive analyses examined reported areas of concern and a Fisher's exact test examined the relationship between demographics and responses. A cluster analysis with partitioning around medoids (PAM) was used to identify a sub-group of participants based on responses. Nearly half of HHPs who participated reported that they will support patients with OTC hearing aids purchased elsewhere, whereas a quarter reported that they will sell OTC hearing aids in their clinic or website. HHPs expressed over 70% agreement in 'concern' statements in 14 of the 17 items. Issues about safety, counseling, and audiological care were the key concerns expressed by HHPs about OTC hearing aids. Some demographics (i.e., profession, primary position) were associated with responses to some statements. Two groups were identified based on the responses to concern statements. The HHPs in the first cluster 'OTC averse' (51%) agreed on all the 17 concern statements, whereas the second cluster 'OTC apprehensive' (49%) had some items rated as disagree (i.e., consumers will give up on amplification) and neither agree nor disagree (i.e., do not provide good value, warranties and return periods will be worse), and remaining items were rated as agree. OTC hearing aids were initiated to improve affordability, accessibility, and hearing aid uptake and are currently a rapidly emerging category of hearing devices. Overall, the results of the current study indicate that HHPs have serious concerns about OTC hearing aids. HHP concerns cited in this study provide useful feedback to stakeholders (e.g., HHP professional agencies, FDA, industry, and insurance payers) involved in improving OTC hearing aid implementation.

New horizons in holistic, person-centred health promotion for hearing healthcare

Over the course of a lifetime, the risk of experiencing multiple chronic conditions (multimorbidity) increases, necessitating complex healthcare regimens. Healthcare that manages these requirements in an integrated way has been shown to be more effective than services that address specific diseases individually. One such chronic condition that often accompanies ageing is hearing loss and related symptoms, such as tinnitus. Hearing loss is not only highly prevalent in older adults but is also a leading cause of disability. Accumulating evidence demonstrates an interplay between auditory function and other aspects of health. For example, poorer cardiometabolic health profiles have been shown to increase the risk of hearing loss, which has been attributed to microvascular disruptions and neural degeneration. Additionally, hearing loss itself is associated with significantly increased odds of falling and is a potentially modifiable risk factor for cognitive decline and dementia. Such evidence warrants consideration of new possibilities-a new horizon-for hearing care to develop a holistic, person-centred approach that promotes the overall health and wellbeing of the individual, as well as for audiology to be part of an interdisciplinary healthcare service. To achieve this holistic goal, audiologists and other hearing healthcare professionals should be aware of the range of conditions associated with hearing loss and be ready to make health promoting recommendations and referrals to the appropriate health practitioners. Likewise, healthcare professionals not trained in audiology should be mindful of their patients' hearing status, screening for hearing loss or referring them to a hearing specialist as required.

PP71 Lessons Learned During Analyses Of Appropriate Hearing Care: Building Bridges Between Patient Organizations, Health Professionals And Insurance Companies

IntroductionAs part of the cyclic Appropriate Care programme of the National Health Care Institute in the Netherlands, a systematic analysis of hearing health care is taking place. Parties in hearing health care are actively involved throughout the entire process. This abstract focuses on lessons learned from the cooperation as a HTA body with a diverse group of stakeholders.MethodsWe carried out an in-depth analysis for the patient journey of both children and adults with ear complaints or hearing impairment. Different kinds of information were included in the analyses, including claims data, quantitative and qualitative research, analyses of (international) guidelines and patient information. A range of strategies were used to co-operate and interact with patient organizations, hearing health care professionals, institutes/hospitals and insurance companies.ResultsClose collaboration between the project team and patient organizations turned out to be effective to comprehend patient’ perspectives. Data analyses were often found to be challenging in hearing health care, as the reimbursement data lacked sufficient information. In several cases, building bridges between parties, but also in relation to our HTA body was needed. Conclusions from the analyses were being shared and discussed with a panel of involved stakeholders, leading to support, but not always consensus on potential room for improvement. An internal review process turned out to be helpful in sharing experiences on effective multi-stakeholder management.ConclusionsWe believe that the process did influence the way stakeholders think about the appropriate use of the different available treatment options. Building bridges, and combining different perspectives from patient organizations, health-care professionals and insurance companies is necessary in a cyclic approach. The cyclic appropriate Care programme proved to be a constructive approach for collaboration with stakeholders.

Middle Ear Pathologies Persist in Adults Living With HIV Despite the Use of Antiretroviral Therapy

Middle Ear Pathologies Persist in Adults Living With HIV Despite the Use of Antiretroviral Therapy

Considerations for the Over-the-Counter Hearing Aid Delivery Model

Purpose: The U.S. Food and Drug Administration (FDA) introduced the Reauthorization Act that included provisions for self-fitting hearing aids to be sold over the counter in 2017, and in August 2022, the FDA published the final regulatory guidelines for the safety and efficacy of the devices. The American Speech-Language-Hearing Association and other professional organizations provided feedback to proposed regulations before they were finalized. This article updates hearing health care and related professionals on the history and state of hearing aid delivery models and addresses considerations for clinicians, physicians, and consumers. Conclusions: Direct-to-consumer (DTC) hearing devices can vary largely in quality and performance capability. Some might meet the finalized FDA safety and performance criteria for over-the-counter hearing aids and be able to provide accurate amplification for mild-to-moderate hearing loss but most likely cannot meet the needs of more severe hearing losses, for which they are not approved. Other DTC devices may not meet the FDA criteria and may not provide accurate amplification for many degrees of hearing loss. It is important that these devices are correctly advertised and marketed to those with hearing loss no worse than mild to moderate. Consumers and health care providers also need to know how to identify quality devices that can meet patients' hearing needs. The DTC hearing devices may be difficult to program; thus, manufacturers should provide support for consumers to properly fit these devices. Lastly, hearing health care professionals should take the time to verify that any current and soon-to-come DTC hearing devices can be useful for a given patient population.

Viewpoints on the Implications of Over-The-Counter Hearing Aids

Purpose: The purpose of this article is to offer diverse viewpoints on the potential impact of over-the-counter (OTC) hearing aids on patients and hearing health care professionals. OTC hearing aids are discussed from the perspective of an editor of a hearing industry trade publication, an audiologist and business owner, a hearing aid user and consumer advocate, and a researcher and professor. Conclusions: Given the increasing attention surrounding OTCs, there is a need to understand diverse perspectives. The editor provides a historical context and overview of the Food and Drug Administration's OTC regulations and reflects on implications based on nearly 3 decades of experience reporting on the hearing industry. An audiologist provides her perspective on what she has observed among clinicians who appear to either resist or embrace the OTC hearing aid concept and offers recommendations for how to engage with OTCs for the benefit of patients. A hearing aid user and consumer advocate shares how OTCs might impact her own hearing care and comments on how audiologists can support consumers who choose OTCs. Lastly, a researcher offers her response to common concerns based in the literature and comments on the perceived value of OTC hearing aids. This article is concluded with a discussion on future areas of need and recommendations.

KNOWLEDGE AND ATTITUDE ABOUT MANAGEMENT OF HYPERACUSIS AMONG SPEECH AND HEARING PG STUDENTS

Hyperacusis is dened as a reduced tolerance to sounds of average intensity, sometimes accompanied by painful sensitivity to ordinary environmental sounds, with perceptual, psychological, and social dimensions (Stadio et. al, 2018). Common etiologies of Hyperacusis can be associated with various pathologic conditions related to peripheral auditory system as well as central nervous system diseases. Patients with hyperacusis are misdiagnosed to have tinnitus and because of not getting proper assessment the patient having no benet from the intervention. In the present study, an attempt has made to adapt, modify & validate the Questionnaire developed by Mr. Suman Kumar et. al.,(2014) on Awareness of hyperacusis management among hearing health care professionals - a nationwide telephonic survey in to Knowledge and Attitude about management of Hyperacusis among Speech and Hearing PG students in Bengaluru, Karnataka by sending a questionnaire which consist of 15 questions to Speech and Hearing PG students through various online mode. It was found that 84.89% participants were aware about hyperacusis. 86.04 % of participants had correct knowledge about assessment of hyperacusis. 78.48% participants reported correct responses about management of Hyperacusis. Assessment and management of Hyperacusis needs to be done carefully because quality of life is the primary importance in treatment for individual with hyperacusis.

Factors Affecting the Use of Speech Testing in Adult Audiology.

ObjectiveTo evaluate hearing healthcare professionals’ (HHPs) speech testing practices in routine adult audiology services, and better understand the facilitators and barriers to speech testing provision.DesignA cross-sectional questionnaire studyStudy SampleA sample (n=306) of HHPs from the public (64%) and private sector (36%), in the United Kingdom (UK), completed the surveyResultsIn the UK, speech testing practice varied significantly between health sectors. Speech testing was carried out during the audiology assessment by 73.4% of private sector HHPs and 20.4% of those from the public sector. During the hearing aid intervention stage speech testing was carried out by 56.5% and 26.5% of HHPs from the private and public sector, respectively. Recognised benefits of speech testing included: 1) providing patients with relatable assessment information, 2) guiding hearing aid fitting, 3) supporting a diagnostic test battery. A lack of clinical time was a key barrier to uptake.ConclusionUse of speech testing varies in adult audiology. Results from the present study found the percentage of UK HHPs making use of speech tests was low compared to other countries. HHPs recognised different benefits of speech testing in audiology practice but the barriers limiting uptake were often driven by factors derived from decision makers rather than clinical rationale. Privately funded HHPs used speech tests more frequently than those working in the public sector where time and resources are under greater pressure and governed by guidance that does not include a recommendation for speech testing. Therefore, the inclusion of speech testing in national clinical guidelines could increase the consistency of use and facilitate the comparison of practice trends across centres.

Exploring accommodations along the education to employment pathway for deaf and hard of hearing healthcare professionals.

BackgroundDeaf and hard of hearing (DHH) people are an underserved population and underrepresented among healthcare professionals. A major barrier to success for DHH healthcare professionals is obtaining effective accommodations during education and employment. Our objective: describe DHH individuals’ experiences with accommodations in healthcare education.MethodsWe used an online survey and multipronged snowball sampling to recruit participants who identify as DHH and who had applied to a U.S. health professional school (regardless of acceptance status). One hundred forty-eight individuals representing multiple professions responded; 51 had completed their training. Over 80% had been accepted to, were currently enrolled, or had completed health professions schools or residency programs, and/or were employed. The survey included questions addressing experiences applying to health professions programs and employment; satisfaction with accommodations in school and training; having worked with a disability resource professional (DRP); and depression screening.ResultsUse and type of accommodation varied widely. While in school, respondents reported spending a mean of 2.1 h weekly managing their accommodations. Only 50% were highly satisfied with the accommodations provided by their programs. Use of disability resource providers (DRPs) for accommodations was highest during school (56%) and less frequent during post-graduate training (20%) and employment (14%). Respondents who transitioned directly from school to employment (versus via additional training) were more satisfied with their accommodations during school and were more likely to find employment (p = 0.02). Seventeen respondents screened positive for risk of depression; a positive screen was statistically associated with lower school accommodation satisfaction.ConclusionsDHH people study and practice across many health professions. While respondents were mostly successful in entering health professions programs, accommodation experiences and satisfaction varied. Satisfaction with accommodations was related to successful employment and wellness. Low satisfaction was associated with higher likelihood of depression symptoms. To increase representation in the workforce, healthcare professional schools, training programs, and employers should enhance support for the learning and working climates for people with disabilities.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12909-022-03403-w.

Understanding State-Level Advocacy: A Guide for Hearing Healthcare Professionals.

Advocacy is a core component of moving the hearing healthcare environment forward to optimize patient care and allow providers to work to the full extent of their scope of practice. Despite its importance, advocacy, particularly at the level of state governments, can present to many as a daunting, sometimes futile, task. The purpose of this article is to describe advocating at the state level for hearing healthcare service providers. This article will discuss considerations for audiology practitioners interested in state-level advocacy, including variations in state government organization, benefits and barriers to state advocacy, and state-level issues that affect practitioners.