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From Detection to Intervention Psychological Aspects of Online Hearing Rehabilitation
Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Hearing problems are among the most common causes of disability worldwide for adults. It is currently classified as one of the top five causes of years lived with disability. Between the years 2005 and 2015 the global prevalence of hearing loss increased with about 26 %. The negative impact of hearing loss on those affected is not limited to communication problems, as a range of other negative effects can be present, such as increased levels of social isolation, problems in the work-place and psychological distress.

The different studies of the thesis can be summarized in three overall research questions. The first question was if hearing loss can be detected through automated online screening procedures, and what are the characteristics of those who participate in online screening (Study I and II)? The second question focused on development and testing of a measure dealing with psychological acceptance of hearing loss (Study III). Finally, the third research question concerned if online administered guided self-help based on Acceptance and Commitment Therapy could help persons with hearing loss and psychological distress (Study IV)?

In the screening studies (Study I and II) an online speech-in-noise hearing test was initially developed and later updated. Screening for hearing problems with this test was found to be feasible, and 16.7 (Study I) and 19% (Study II) of the participants were recommended to seek professional care for their potential hearing loss. These participants had more cognitive problems, were more likely to be of male gender, and had lower levels of education than those without measured hearing problems. Study III showed that it was possible to measure hearing-related acceptance with a new questionnaire and that this measure was a better predictor of disability than instruments measuring anxiety, depression, or measured hearing performance. In Study IV, people with hearing loss and comorbid psychological distress were offered an eight-week long internet-based therapist-guided self-help treatment inspired by ACT. After treatment ended, the intervention group had lower levels of perceived hearing disability, increased ratings of quality of life and reduced depressive symptoms in relation to the wait-list control group. This thesis suggests that the internet can be used to assist early detection, measuring acceptance of hearing loss and finally as a treatment modality for persons who experience distress in relation to their hearing loss.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2018. , p. 82
Series
Linköping Studies in Arts and Sciences, ISSN 0282-9800 ; 751Studies from the Swedish Institute for Disability Research, ISSN 1650-1128 ; 92
Keywords [en]
Hearing, Screening, Cognition, Acceptance and Commitment Therapy
National Category
Public Health, Global Health, Social Medicine and Epidemiology Otorhinolaryngology Psychology
Identifiers
URN: urn:nbn:se:liu:diva-152429DOI: 10.3384/diss.diva-152429ISBN: 9789176852262 (print)OAI: oai:DiVA.org:liu-152429DiVA, id: diva2:1259674
Public defence
2018-09-26, VAL, Hus Vallfarten, Campus Valla, Linköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2018-10-30 Created: 2018-10-30 Last updated: 2019-09-26Bibliographically approved
List of papers
1. Internet-based hearing screening using speech-in-noise: validation and comparisons of self-reported hearing problems, quality of life and phonological representation
Open this publication in new window or tab >>Internet-based hearing screening using speech-in-noise: validation and comparisons of self-reported hearing problems, quality of life and phonological representation
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2013 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 3, no 9, p. 3223-Article in journal (Refereed) Published
Abstract [en]

Objectives For the last decade a host of different projects have been launched to allow persons who are concerned about their hearing status to quickly and at a low cost test their hearing ability. Most often, this is carried out without collecting complementary information that could be correlated with hearing impairment. In this two-part study we first, present the development and validation of a novel Internet-based hearing test, and second, report on the associations between this test and phonological representation, quality of life and self-reported hearing difficulties.

Design Cross-sectional study.

Setting An opportunity sample of participants was recruited at the Stockholm central station for the first study. All parts of the second study were conducted via the Internet, with testing and self-report forms adapted for online use.

Participants The first part of the study was carried out in direct contact with the participants, and participants from the second study were recruited by means of advertisements in newspapers and on webpages. The only exclusion criterion was that participants had to be over 18 years old. Most participants were between 60 and 69 years old. There were almost an equal number of men and women (total n=316).

Outcome measures 48 participants failed the Internet-based hearing screening test. The group failing the test reported more problems on the Amsterdam Inventory of Auditory Disability. In addition, they were found to have diminished phonological representational skills. However, no difference in quality of life was found.

Conclusions Almost one in five participants was in need of contacting their local hearing clinic. This group had more complaints regarding tinnitus and hyperacusis, rated their own hearing as worse than those who passed, and had a poorer capability of generating accurate phonological representations. This study suggests that it is feasible to screen for hearing status online, and obtain valid data.

Place, publisher, year, edition, pages
BMJ Open, 2013
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-100529 (URN)10.1136/bmjopen-2013-003223 (DOI)000330541900030 ()24041846 (PubMedID)
Available from: 2013-11-08 Created: 2013-11-08 Last updated: 2019-01-15Bibliographically approved
2. Internet-based acceptance and commitment therapy for psychological distress experienced by people with hearing problems: a pilot randomized controlled trial
Open this publication in new window or tab >>Internet-based acceptance and commitment therapy for psychological distress experienced by people with hearing problems: a pilot randomized controlled trial
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2018 (English)In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 47, no 2, p. 169-184Article in journal (Refereed) Published
Abstract [en]

Psychological distress is common among people with hearing problems, but treatments that specifically target this aspect have been almost non-existent. In this pilot randomized controlled trial, an eight-week long Internet-based treatment, informed by Acceptance and Commitment Therapy, was administered to explore the feasibility and efficacy of such a treatment. Included participants were randomized to either treatment (n=31) or wait-list control (n=30) condition. All participants were measured prior to randomization and immediately after treatment ended using standardized self-report instruments measuring hearing-related emotional and social adjustment (Hearing Handicap Inventory for the Elderly - S, HHIE-S), quality of life (Quality of Life Inventory, QOLI), and symptoms of depression and anxiety (Patient health Questionnaire, PHQ-9 and Generalized Anxiety Disorder scale, GAD-7). Linear mixed effects regression analysis using the full intention-to-treat sample demonstrated that the treatment had superior outcomes on the main outcome measure as compared with the control group, Cohens d=0.93, 95% CI [0.24, 1.63]. The benefits of treatment over control were also evident in scores of depression, Cohens d=0.61, 95% CI [0.04, 1.19], and quality of life, Cohens d=0.88, 95% CI [0.14, 1.61]. The results provide preliminary support for Internet-delivered acceptance and commitment therapy as a potentially effective treatment of psychological symptoms associated with hearing problems.

Place, publisher, year, edition, pages
ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2018
Keywords
Hearing; distress; acceptance and commitment therapy; acceptance; randomized controlled trial
National Category
Applied Psychology
Identifiers
urn:nbn:se:liu:diva-145251 (URN)10.1080/16506073.2017.1365929 (DOI)000424157000006 ()28895787 (PubMedID)
Note

Funding Agencies|Swedish council for Working Life and Social Research [2009-0055]

Available from: 2018-02-21 Created: 2018-02-21 Last updated: 2018-12-12

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