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  • 1.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Clinician-Supported Internet-Delivered Psychological Treatment of Tinnitus2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, p. 299-301Article in journal (Refereed)
    Abstract [en]

    Purpose: Internet-delivered psychological treatments for tinnitus distress have existed for more than 15 years, and there are a slowly growing number of studies. The aim of this brief report is to review the evidence and to comment on the future potentials of Internet treatments for tinnitus. Method: Studies were retrieved, and in total 6 controlled studies were included in the review with 9 different comparisons (6 in which the treatment was compared against a control group and 3 in which Internet treatment was compared against group treatment). Moreover, 2 open studies based on clinical samples in regular care were also included in the review. The outcomes for the 2 controlled sets of studies were analyzed using meta-analytic methods. Results: For the 6 studies comparing Internet treatment against a no-treatment control condition, a moderate effect size was found (Hedgess g = 0.58). The 3 studies comparing Internet treatment against face-to-face group treatments showed a small difference of Hedgess g = 0.13. Conclusions: Internet-delivered psychological treatment holds promise as a treatment alternative to other standard forms of treatment delivery, including group treatment. Larger studies are needed as well as ways to blend information technology with regular services.

  • 2.
    Andersson, Gerhard
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark; Karolinska Institute, Sweden.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Oticon AS, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Preminger, Jill E.
    University of Louisville, KY 40292 USA.
    Internet and Audiology: A Review of the First International Meeting2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, p. 269-270Article, review/survey (Refereed)
    Abstract [en]

    Purpose: The purpose of this research forum article is to describe the impetus for holding the First International Meeting on Internet and Audiology (October 2014) and to introduce the special research forum that arose from the meeting. Method: The rationale for the First International Meeting on Internet and Audiology is described. This is followed by a short description of the research sections and articles appearing in the special issue. Six articles consider the process of health care delivery over the Internet; this includes health care specific to hearing, tinnitus, and balance. Four articles discuss the development of effective Internet-based treatment programs. Six articles describe and evaluate Internet-based interventions specific to adult hearing aid users. Conclusion: The fledgling field of Internet and audiology is remarkably broad. The Second International Meeting on Internet and Audiology ocurred in September 2015.

  • 3.
    Arlinger, Stig
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences.
    Nordqvist, Peter
    Royal Institute Technology, Sweden.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    International Outcome Inventory for Hearing Aids: Data From a Large Swedish Quality Register Database2017In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 26, no 3, p. 443-450Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this study was to analyze a database of completed International Outcome Inventory for Hearing Aids (IOI-HA) questionnaires obtained from over 100,000 clients fitted with new hearing aids in Sweden during the period of 2012-2016. Mean IOI-HA total scores were correlated with degree of hearing loss, unilateral versus bilateral fitting, first-time versus return clients, gender, and variation among dispensing clinics. The correlations with expectations, service quality, and technical functioning of the hearing aids were also analyzed. Method: Questionnaires containing the 7 IOI-HA items as well as questions concerning some additional issues were mailed to clients 3-6 months after fitting of new hearing aids. The questionnaires were returned to and analyzed by an independent research institute. Results: More than 100 dispensing clinics nationwide take part in this project. A response rate of 52.6% resulted in 106,631 data sets after excluding incomplete questionnaires. Forty-six percent of the responders were women, and 54% were men. The largest difference in mean score (0.66) was found for the IOI-HA item "use" between return clients and first-time users. Women reported significantly higher (better) scores for the item "impact on others" compared with men. The bilaterally fitted subgroup reported significantly higher scores for all 7 items compared with the unilaterally fitted subgroup. Experienced users produced higher scores on benefit and satisfaction items, whereas first-time users gave higher scores for residual problems. No correlation was found between mean IOI-HA total score and average hearing threshold level (pure-tone average [ PTA]). Mean IOI-HA total scores were found to correlate significantly with perceived service quality of the dispensing center and with the technical functionality of the hearing aids. Conclusions: When comparing mean IOI-HA total scores from different studies or between groups, differences with regard to hearing aid experience, gender, and unilateral versus bilateral fitting have to be considered. No correlation was found between mean IOI-HA total score and degree of hearing loss in terms of PTA. Thus, PTA is not a reliable predictor of benefit and satisfaction of hearing aid provision as represented by the IOI-HA items. Identification of a specific lower fence in PTA for hearing aid candidacy is therefore to be avoided. Large differences were found in mean IOI-HA total scores related to different dispensing centers.

  • 4.
    Beukes, Eldre W.
    et al.
    Anglia Ruskin Univ, England; Lamar Univ, TX 77710 USA.
    Allen, Peter M.
    Anglia Ruskin Univ, England; Anglia Ruskin Univ, England; Lamar Univ, TX 77710 USA.
    Baguley, David M.
    Anglia Ruskin Univ, England; Nottingham Biomed Res Ctr, England; Univ Nottingham, England; Lamar Univ, TX 77710 USA.
    Manchaiah, Vinaya
    Lamar Univ, TX 77710 USA; Audiol India, India; Manipal Univ, India.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Inst, Sweden.
    Long-Term Efficacy of Audiologist-Guided Internet-Based Cognitive Behavior Therapy for Tinnitus2018In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 27, no 3, p. 431-447Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this study was to investigate the long-term outcomes 1 year after undertaking an audiologist-guided Internet-based cognitive behavioral therapy (iCBT) intervention for tinnitus. Secondary aims were to identify any predictors of outcome and whether there were any unwanted events related to undertaking iCBT for tinnitus. Method: Participants who had previously undertaken a randomized iCBT efficacy trial for tinnitus were invited to participate. Of the 146 who were initially randomized for the efficacy trial, 104 participants completed the 1-year post-intervention assessment measures. The primary outcome was a change in tinnitus distress as assessed by the Tinnitus Functional Index. Secondary assessment measures were included for insomnia, anxiety, depression, hearing handicap, hyperacusis, cognitive failures, and satisfaction with life. An intention-to-treat analysis using repeated-measures analysis of variance and hierarchical multiple regression was used for statistical analysis. Unwanted effects were categorized according to the unwanted events checklist. Results: Undertaking iCBT for tinnitus led to significant improvements 1 year post-intervention for tinnitus and related difficulties, for example, insomnia, anxiety, depression, hearing handicap, hyperacusis, and life satisfaction. The best predictors of improving tinnitus severity at 1-year post-intervention were greater baseline tinnitus severity scores, reading more of the modules, and higher satisfaction with the intervention. Unwanted events were reported by 11% of the participants and were more likely to be reported by women than men. These events were related to worsening of symptoms, the emergence of new symptoms, negative well-being, and prolongation of treatment. Conclusions: The clinical benefits of audiologist-guided iCBT for tinnitus and tinnitus-related difficulties were sustained 1 year post-intervention. Predictors of outcome indicated that the intervention is applicable to a wide range of participants regardless of their demographic backgrounds. Attempts should be made to minimize unwanted events in subsequent trials.

  • 5.
    Brännström, Jonas K
    et al.
    Linköping University, Faculty of Arts and Sciences. Dept of clinical science, Section of Logopedics, Phoiatrics and audiology, Lund University, Sweden.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Ingo, Elisabeth
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Månsson, Kristoffer N. T.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon A/S, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Centre, Oticon A/S, Denmark.
    The Process of Developing an Internet-Based Support System for Audiologists and First-Time Hearing Aid Clients2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, p. 320-324Article in journal (Refereed)
    Abstract [en]

    Background: In audiologic practice, complementary information sources and access to the clinician between appointments improve information retention and facilitate adjustment behaviors. An Internet-based support system is a novel way to support information sharing and clinician access. Purpose: This research forum article describes the process of developing an Internet-based support system for audiologists and their first-time hearing aid clients. Method: The iterative development process, including revisions by 4 research audiologists and 4 clinical audiologists, is described. The final system is exemplified. Conclusion: An Internet-based support system was successfully developed for audiologic practice.

  • 6.
    Essery, Rosie
    et al.
    University of Southampton, England.
    Kirby, Sarah
    University of Southampton, England.
    Geraghty, Adam W. A.
    University of Southampton, England.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Carlbring, Per
    University of Stockholm, Sweden.
    Bronstein, Adolfo
    University of London Imperial Coll Science Technology and Med, England.
    Little, Paul
    University of Southampton, England.
    Yardley, Lucy
    University of Southampton, England.
    The Development of Balance Retraining: An Online Intervention for Dizziness in Adults Aged 50 Years and Older2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, p. 276-279Article in journal (Refereed)
    Abstract [en]

    Purpose: This article outlines the rationale and development process for an online intervention based on vestibular rehabilitation therapy (VRT). The intervention aims to assist adults aged 50 years and older to self-manage and reduce dizziness symptoms. Method: The intervention was developed according to the person-based approach to digital intervention design focused on accommodating perspectives of target users. A prototype version of the intervention was provided to 18 adults (11 women, 7 men) aged 50 years and older with dizziness. These adults were invited to use the intervention over a 6-week period and, during this time, took part in a think-aloud session. This session sought to understand users perceptions of how acceptable, engaging, and easy to use they found the online intervention. Results: Users were extremely positive regarding how easy to navigate, visually appealing, and informative they found the intervention. Think-aloud sessions provided valuable data for informing small amendments to further enhance acceptability of the intervention for target users. Conclusions: Informed by these development-phase data, a finalized version of the intervention is now being investigated in a primary care-based randomized controlled trial. Results should provide an understanding of whether VRT can be effectively-especially, cost-effectively-delivered via an online intervention to adults aged 50 years and older.

  • 7.
    Gutenberg, Johanna
    et al.
    Oticon AS, Denmark.
    Katrakazas, Panagiotis
    Natl Tech Univ Athens, Greece.
    Trenkova, Lyubov
    Pazardzhik Reg Adm, Bulgaria.
    Murdin, Louisa
    Guys and St Thomas NHS Fdn Trust, England.
    Brdaric, Dario
    Inst Publ Hlth Osijek Baranya Cty, Croatia.
    Koloutsou, Nina
    Univ London, England.
    Ploumidou, Katherine
    Athens Med Grp, Greece.
    Pontoppidan, Niels Henrik
    Oticon AS, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon Med, Denmark.
    Big Data for Sound Policies: Toward Evidence-Informed Hearing Health Policies2018In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 27, no 3, p. 493-502Article in journal (Refereed)
    Abstract [en]

    Purpose: The scarcity of health care resources calls for their rational allocation, including within hearing health care. Policies define the course of action to reach specific goals such as optimal hearing health. The process of policy making can be divided into 4 steps: (a) problem identification and issue recognition, (b) policy formulation, (c) policy implementation, and (d) policy evaluation. Data and evidence, especially Big Data, can inform each of the steps of this process. Big Data can inform the macrolevel (policies that determine the general goals and actions), mesolevel (specific services and guidelines in organizations), and microlevel (clinical care) of hearing health care services. The research project EVOTION applies Big Data collection and analysis to form an evidence base for future hearing health care policies. Method: The EVOTION research project collects heterogeneous data both from retrospective and prospective cohorts (clinical validation) of people with hearing impairment. Retrospective data from clinical repositories in the United Kingdom and Denmark will be combined. As part of a clinical validation, over 1,000 people with hearing impairment will receive smart EVOTION hearing aids and a mobile phone application from clinics located in the United Kingdom and Greece. These clients will also complete a battery of assessments, and a subsample will also receive a smartwatch including biosensors. Big Data analytics will identify associations between client characteristics, context, and hearing aid outcomes. Results: The evidence EVOTION will generate is relevant especially for the first 2 steps of the policy-making process, namely, problem identification and issue recognition, as well as policy formulation. EVOTION will inform microlevel, mesolevel, and macrolevel of hearing health care services through evidence-informed policies, clinical guidelines, and clinical care. Conclusion: In the future, Big Data can inform all steps of the hearing health policy-making process and all levels of hearing health care services.

  • 8.
    Hickson, Louise
    et al.
    University of Queensland, Brisbane, Australia.
    Laplante-Lévesque, Ariane
    University of Queensland, Brisbane, Australia.
    Wong, Lena
    University of Hong Kong, Pokfulam.
    Evidence-based practice in audiology: rehabilitation options for adults with hearing impairment2013In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 22, p. 329-331Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    Three questions are addressed: 1) What is Evidence-Based Practice (EBP) and why is it important for adults with hearing impairment? 2) What is the evidence about intervention options for adults who fail a hearing screening and are identified with hearing impairment? 3) What intervention options do adults choose when identified with hearing impairment for the first time?

    METHODS:

    The five steps of the EBP process are discussed in relation to a clinical question about whether hearing aids and communication programs reduce activity limitations and participation restrictions compared to no treatment for adults who fail a hearing screening and are identified with hearing impairment.

    RESULTS:

    Systematic reviews of the evidence indicate that both hearing aids and communication programs reduce activity limitations and participation restrictions for this population and are therefore appropriate options. A study is then described in which these options were presented to 153 clients identified with hearing impairment for the first time: 43% chose hearing aids, 18% chose communication programs and the remaining 39% chose not to take any action.

    CONCLUSIONS:

    EBP supports the offer of intervention options to adults who fail a hearing screening and are identified with hearing impairment.

  • 9.
    Laplante-Lévesque, Ariane
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Centre, Denmark.
    Sundewall Thoren, Elisabet
    Eriksholm Research Centre, Denmark.
    Readability of Internet Information on Hearing: Systematic Literature Review2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, p. 284-288Article, review/survey (Refereed)
    Abstract [en]

    Purpose: This systematic literature review asks the following question: "What is the readability of Internet information on hearing that people with hearing impairment and their significant others can access in the context of their hearing care?" Method: Searches were completed in three databases: CINAHL, PubMed, and Scopus. Seventy-eight records were identified and systematically screened for eligibility: 8 records were included that contained data on the readability of Internet information on hearing that people with hearing impairment and their significant others can access in the context of their hearing care. Results: Records reported mean readability levels from 9 to over 14. In other words, people with hearing impairment and their significant others need 9 to 14 years of education to read and understand Internet information on hearing that they access in the context of their hearing care. Conclusion: The poor readability of Internet information on hearing has been well documented; it is time to focus on valid and sustainable initiatives that address this problem.

  • 10.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Oticon AS, Denmark.
    About Cognitive Outcome Measures at Ecological Signal-to-Noise Ratios and Cognitive-Driven Hearing Aid Signal Processing2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 2, p. 121-123Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this article is to discuss 2 questions concerning how hearing aids interact with hearing and cognition: Can signal processing in hearing aids improve memory? Can attention be used for top-down control of hearing aids? Method: Memory recall of sentences, presented at 95% correct speech recognition, was assessed with and without binary mask noise reduction. A short literature review was performed on recent findings on new brain-imaging techniques showing potential for hearing aid control. Conclusions: Two experiments indicate that it is possible to show improved memory with an experimental noise reduction algorithm at ecological signal-to-noise ratios and that it is possible to replicate these findings in a new language. The literature indicates that attention-controlled hearing aids may be developed in the future.

  • 11.
    Malmberg, Milijana
    et al.
    Boras Hospital, Sweden; University of Gothenburg, Sweden.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Oticon AS, Denmark.
    Kahari, Kim
    University of Gothenburg, Sweden.
    Jansson, Gunilla
    Boras Hospital, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Implementing Internet-Based Aural Rehabilitation in a General Clinical Practice2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, p. 325-328Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this paper is to share the lessons that were learned about the process of implementing an Internet-based, randomized controlled trial (RCT) in general clinical practice (GCP) and to address some of the advantages of using the Internet as a tool to implement a RCT in GCP. The RCT implemented focused on investigating Internet-based aural rehabilitation (AR) in addition to hearing aid (HA)-fitting supplemented with telephone support, and it was applied in a clinical setting. The results of this RCT and the questionnaires chosen will be presented in an article elsewhere. Procedure: Here, the procedure of the implemented trial is presented, and the implementation challenges are presented and discussed. Specifically, we describe the trial research question, recruitment strategy, patient eligibility criteria, the questionnaires, clinician participation, funding and time (for the clinicians), and risks and benefits (for the participants). Discussion: The trial implementation showed that AR in addition to HA-fitting can be carried out in GCP using the Internet. Using an Internet-based RCT overcomes some of the challenges of implementing a trial in GCP.

  • 12.
    Molander, Peter
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Hesser, Hugo
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Weineland, Sandra
    Linköping University.
    Bergwall, Kajsa
    Linköping University.
    Buck, Sonia
    Linköping University.
    Hansson-Malmlof, Johan
    Linköping University.
    Lantz, Henning
    Linköping University.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Oticon AS, Denmark.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Internet-Based Acceptance and Commitment Therapy for Psychological Distress Experienced by People With Hearing Problems: Study Protocol for a Randomized Controlled Trial2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, p. 307-310Article in journal (Refereed)
    Abstract [en]

    Purpose: Psychological distress and psychiatric symptoms are prevalent among people with hearing loss or other audiological conditions, but psychological interventions for these groups are rare. This article describes the study protocol for a randomized controlled trial for evaluating the effect of a psychological treatment delivered over the Internet for individuals with hearing problems and concurrent psychological distress. Method: Participants who are significantly distressed will be randomized to either an 8-week Internet-delivered acceptance-based cognitive behavioral therapy (i.e., acceptance and commitment therapy [ACT]), or wait-list control. We aim to include measures of distress associated with hearing difficulties, anxiety, and depression. In addition, we aim to measure acceptance associated with hearing difficulties as well as quality of life. Conclusion: The results of the trial may further our understanding of how to best treat people who present problems with both psychological distress and hearing in using the Internet.

  • 13.
    Nielsen, Annette Cleveland
    et al.
    Oticon AS, Denmark.
    Rotger-Griful, Sergi
    Oticon AS, Denmark.
    Kanstrup, Anne Marie
    Aalborg Univ, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon Med, Denmark.
    User-Innovated eHealth Solutions for Service Delivery to Older Persons With Hearing Impairment2018In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 27, no 3, p. 403-416Article in journal (Refereed)
    Abstract [en]

    Purpose: The successful design and innovation of eHealth solutions directly involve end users in the process to seek a better understanding of their needs. This article presents user-innovated eHealth solutions targeting older persons with hearing impairment. Our research question was: What are the key users needs, expectations, and visions within future hearing rehabilitation service delivery? Method: We applied a participatory design approach to facilitate the design of future eHealth solutions via focus groups. We involved older persons with hearing impairment (n = 36), significant others (n = 10), and audiologists (n = 8) following 2 methods: (a) human-centered design for interactive systems and (b) user innovation management. Through 3 rounds of focus groups, we facilitated a process progressing from insights and visions for requirements phase 1), to app such as paper version wireframes (Phase 2), and to digital prototypes envisioning future eHealth solutions (Phase 3). Each focus group was video-recorded and photographed, resulting in a rich data set that was analyzed through inductive thematic analysis. Results: The results are presented via (a) a storyboard envisioning future client journeys, (b) 3 key themes for future eHealth solutions, (c) 4 levels of interest and willingness to invest time and effort in digital solutions, and (d) 2 technical savviness types and their different preferences for rehabilitation strategies. Conclusions: Future eHealth solutions must offer personalized rehabilitation strategies that are appropriate for every person with hearing impairment and their level of technical savviness. Thus, a central requirement is anchoring of digital support in the clients everyday life situations by facilitating easy access to personalized information, communication, and leaning milieus. Moreover, the participants visions for eHealth solutions call for providing both traditional analogue and digital services.

  • 14.
    Pichora-Fuller, Kathleen M.
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences. University of Toronto, Canada.
    Cognitive Decline and Hearing Health Care for Older Adults2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 2, p. 108-111Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this article is to consider the implications of age-related cognitive decline for hearing health care. Method: Recent research and current thinking about age-related declines in cognition and the links between auditory and cognitive aging are reviewed briefly. Implications of this research for improving prevention, assessment, and intervention in audiologic practice and for enhancing interprofessional teamwork are highlighted. Conclusions: Given the important connection between auditory and cognitive aging and given the high prevalence of both hearing and cognitive impairments in the oldest older adults, health care services could be improved by taking into account how both the ear and the brain change over the life span. By incorporating cognitive factors into audiologic prevention, assessment, and intervention, hearing health care can contribute to better hearing and communication as well as to healthy aging.

  • 15.
    Pichora-Fuller, Kathleen M
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences. University of Toronto, Canada.
    Forum on the Brain and Hearing Aids2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 2, p. 112-112Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this article is to introduce and provide an overview of the 3 articles presented in the invited forum "The Brain and Hearing Aids." Method: The main ideas of the articles presented by the 3 panelists are identified, and a commentary is provided to synthesize the ideas. Conclusions: Benefits from hearing aids and auditory training entail higher-level cortical and cognitive processing involved in categorizing and remembering sound. New approaches to predicting, designing, and evaluating technological and behavioral interventions will need to consider the brain and not just the ears of listeners.

  • 16.
    Pienkowski, Martin
    et al.
    Salus University, Elkins Park, PA, USA.
    Tyler, Richard S
    University of Iowa, Iowa City, USA.
    Roncancio, Eveling Rojas
    University of Iowa, Iowa City, USA.
    Jun, Hyung Jin
    University of Iowa, Iowa City, USA.
    Brozoski, Tom
    Southern Illinois University School of Medicine, Springfield, USA.
    Dauman, Nicolas
    University of Poitiers, France.
    Coelho, Claudia Barros
    University of Iowa, Iowa City, USA.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Stockholm, Sweden.
    Keiner, Andrew J
    University of Iowa, Iowa City, USA.
    Cacace, Anthony T
    Wayne State University, Detroit, MI, USA.
    Martin, Nora
    University of Iowa, Iowa City, USA.
    Moore, Brian C J
    University of Cambridge, England.
    A review of hyperacusis and future directions: part II. Measurement, mechanisms, and treatment.2014In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 23, no 4, p. 420-436Article, review/survey (Refereed)
    Abstract [en]

    PURPOSE: Hyperacusis can be extremely debilitating, and at present, there is no cure. In this detailed review of the field, we consolidate present knowledge in the hope of facilitating future research.

    METHOD: We review and reference the literature on hyperacusis and related areas. This is the 2nd of a 2-part review.

    RESULTS: Hyperacusis encompasses a wide range of reactions to sounds, which can be grouped into the categories of excessive loudness, annoyance, fear, and pain. Reasonable approaches to assessing the different forms of hyperacusis are emerging, including brain-imaging studies. Researchers are only beginning to understand the many mechanisms at play, and valid animal models are still evolving. There are many counseling and sound-therapy approaches that some patients find helpful, but well-controlled studies are needed to measure their long-term efficacy and to test new approaches.

    CONCLUSIONS: Hyperacusis can make life difficult in this increasingly noisy world, forcing sufferers to dramatically alter their work and social habits. We believe this is an opportune time to explore approaches to better understand and treat hyperacusis.

  • 17.
    Preminger, Jill E.
    et al.
    Univ Louisville, KY 40292 USA.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon Med, Denmark.
    Saunders, Gabrielle H.
    Natl Ctr Rehabilitat Auditory Res, OR USA; Eriksholm Res Ctr, Denmark.
    Hughes, Michelle L.
    Univ Nebraska, NE 68583 USA.
    Internet and Audiology: A Review of the Third International Meeting2018In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 27, no 3, p. 373-375Article in journal (Other academic)
    Abstract [en]

    Purpose: In this introduction, the four members of the scientific committee for the Third International Meeting on Internet and Audiology describe the meeting that took place at the University of Louisville on July 27-28, 2017. Method: This special issue, with a decidedly clinical focus, includes 14 articles that arose from presentations given at the Third International Meeting on Internet and Audiology. All touch upon the theme of innovation as it pertains to teleaudiology and mobile health (mHealth), application of Big Data to audiology, and ethics of internet and telemedicine. Conclusion: Innovations in teleaudiology, mHealth, and Internet-based audiology are developing at a rapid pace and thus research in the field must continue. We invite readers to the next International Meeting on Internet and Audiology that will take place in Southampton, England, June 17-18, 2019.

  • 18.
    Pyykko, Ilmari
    et al.
    University of Tampere, Finland.
    Manchaiah, Vinaya
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Lamar University, TX 77705 USA; Audiol India, India; Manipal University, India.
    Kentala, Erna
    University of Helsinki, Finland.
    Levo, Hilla
    University of Helsinki, Finland.
    Juhola, Martti
    University of Tampere, Finland.
    Internet-Based Self-Help for Menieres Disease: Details and Outcome of a Single-Group Open Trial2017In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 26, no 4, p. 496-506Article in journal (Refereed)
    Abstract [en]

    Purpose: In this article, we present the details and the pilot outcome of an Internet-based self-help program for Menieres disease (MD).amp; para;amp; para;Method: The Norton-Kaplan model is applied to construct a strategic, person-focused approach in the enablement process. The program assesses the disorder profile and diagnosis. In the therapeutic component of the program, the participant defines vision and time frame, inspects confounding factors, determines goals, establishes a strategy, and starts to work on the important problems caused by the disorder. The program works interactively, utilizes collaboration with significant others, and enhances positive thinking. Participants took part in an Internet-based self-help program. Data were collected interactively using open-ended and structured questionnaires on various disease-specific and general health aspects. The pilot outcome of 41 patients with MD was evaluated.amp; para;amp; para;Results: The analysis of the pilot data showed statistically significant improvement in their general health-related quality of life (p amp;lt; .001). Also, the outcome of the Posttraumatic Growth Inventory (Cann et al., 2010) showed small to moderate change as a result of the intervention.amp; para;amp; para;Conclusions: The Internet-based self-help program can be helpful in the rehabilitation of patients with MD to supplement medical therapy.

  • 19.
    Sundewall Thoren, Elisabet
    et al.
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Öberg, Marie
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Internet Interventions for Hearing Loss2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, p. 316-319Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of the two studies presented in this research forum article was to develop audiological rehabilitation programs for experienced hearing aid users and evaluate them in online versions. In this research forum article, the differences between the two studies are discussed. Method: Two randomized controlled trials (RCTs) were performed evaluating the efficacy of online rehabilitation, including professional guidance by an audiologist. In each RCT, the effects of the online programs were compared with the effects measured in a control group. Results: The results from the first RCT showed a significant increase in activity and participation for both groups with participants in the intervention group improving more than those in the control group. At the 6-month follow-up, after the study, the significant increase was maintained; however, amounts of increase in the two groups were no longer significantly different. The results from the second RCT showed significant increase in activity and participation for the intervention group, although the control group did not improve. Conclusions: The results from the RCTs provide evidence that the Internet can be used to deliver rehabilitation to hearing-aid users and that their problems are reduced by the intervention; however, the content of the online rehabilitation program requires further investigation.

  • 20.
    Thodi, Chryssola
    et al.
    European University Cyprus, Nicosia.
    Parazzini, M.
    Istituto di Ingegneria Biomedica, Milano, Italy.
    Kramer, Sophia
    VU University Medical Center, Amsterdam, The Netherlands.
    Davis, Adrian
    Royal Free London NHS Foundation Trust, London, UK.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Janssen, Thomas
    Technische Universitaet Muenchen, Germany.
    Smith, Pauline
    Royal Free London NHS Foundation Trust, London, UK.
    Stevens, Dye
    Cardiff University, Wales, UK.
    Pronk, Marieke
    VU University Medical Center, Amsterdam, The Netherlands.
    Anteunis, L. I.
    University Medical Centre, Maastricht, The Netherlands .
    Schirkonyer, Volker
    Technische Universitaet Muenchen, Germany.
    Grandori, Ferdinando
    Istituto di Ingegneria Biomedica, Milano, Italy.
    Adult Hearing Screening: Follow-Up and Outcomes2013In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 22, p. 183-185Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    To screen hearing and evaluate outcomes in community-dwelling older adults.

    METHOD:

    Three thousand and twenty-five adults responded to an invitation to be screened by questionnaire, otoscopy, and pure-tone audiometry. Pure-tone average (PTA) >35 dB HL in the worse ear, unilateral hearing loss, or otoscopic findings were the criteria for referral for services. A questionnaire related to compliance with referral recommendations was completed by telephone interview for 160 randomly selected participants after 1-2 years from referral.

    RESULTS:

    The referral rate for audiologic/hearing aid evaluation was 46%, and referral for cerumen removal/medical evaluation was 17%. Of the people referred for audiologic/hearing aid evaluation, 18% tried a hearing aid; 2 years later, 11% were using a hearing aid. Screening recommendations affected participants' decision to seek help. Study participants stated that the screening was helpful, it should be offered to everybody, and they would participate in future screenings.

    CONCLUSION:

    Although adult hearing screening offered timely identification of hearing loss for adults seeking help, follow-up with hearing aid treatment was low.

  • 21.
    Tyler, Richard S
    et al.
    University of Iowa, Iowa City, USA.
    Pienkowski, Martin
    Salus University, Elkins Park, PA, USA.
    Roncancio, Eveling Rojas
    University of Iowa, Iowa City, USA.
    Jun, Hyung Jin
    University of Iowa, Iowa City, USA.
    Brozoski, Tom
    Southern Illinois University School of Medicine, Springfield, USA.
    Dauman, Nicolas
    University of Poitiers, France.
    Barros Coelho, Claudia
    University of Iowa, Iowa City, USA.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Stockholm, Sweden.
    Keiner, Andrew J
    University of Iowa, Iowa City, USA.
    Cacace, Anthony T
    Wayne State University, Detroit, MI, USA.
    Martin, Nora
    University of Iowa, Iowa City, USA.
    Moore, Brian C J
    University of Cambridge, England.
    A review of hyperacusis and future directions: part I. Definitions and manifestations.2014In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 23, no 4, p. 402-19Article, review/survey (Refereed)
    Abstract [en]

    PURPOSE: Hyperacusis can be extremely debilitating, and at present, there is no cure. We provide an overview of the field, and possible related areas, in the hope of facilitating future research.

    METHOD: We review and reference literature on hyperacusis and related areas. We have divided the review into 2 articles. In Part I, we discuss definitions, epidemiology, different etiologies and subgroups, and how hyperacusis affects people. In Part II, we review measurements, models, mechanisms, and treatments, and we finish with some suggestions for further research.

    RESULTS: Hyperacusis encompasses a wide range of reactions to sound, which can be grouped into the categories of excessive loudness, annoyance, fear, and pain. Many different causes have been proposed, and it will be important to appreciate and quantify different subgroups. Reasonable approaches to assessing the different forms of hyperacusis are emerging, including psychoacoustical measures, questionnaires, and brain imaging.

    CONCLUSIONS: Hyperacusis can make life difficult for many, forcing sufferers to dramatically alter their work and social habits. We believe this is an opportune time to explore approaches to better understand and treat hyperacusis.

  • 22.
    Vlaescu, George
    et al.
    Linköping University, Sweden.
    Carlbring, Per
    University of Stockholm, Sweden.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Denmark; Karolinska Institute, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    An E-Platform for Rehabilitation of Persons With Hearing Problems2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, p. 271-275Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this research forum article was to describe a feasible web-based solution for improving the quality of life of persons with hearing problems, such as hearing loss or tinnitus. The online platform was developed at the Department of Behavioural Sciences and Learning at Linkoping University, Sweden, and has been running for a number of years and used in numerous studies and treatments. Method: The security aspects of the platform as well as the process flow for running a study or treatment are described, focusing primarily on the technical and practical considerations. Also presented are the design characteristics and the main features and functions available in the platform. Results: We point out the many advantages of running Internet-assisted intervention treatments, the challenges that we have faced, and some intended developments. Many of our research colleagues, both from Sweden and other countries, have already implemented or intend to implement their own studies on this platform. Conclusions: Audiological rehabilitation can be delivered via the Internet using a stable online platform. Security and usability are important factors to have in mind for the design as well as adaptability to the patients. A next development step is to implement and test blended treatments using video conferencing inside the platform.

  • 23.
    Weineland, Sandra
    et al.
    Linköping University.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Oticon AS, Denmark.
    Carlbring, Per
    Stockholm University, Sweden.
    Hesser, Hugo
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Ingo, Elisabeth
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Molander, Peter
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Nordqvist, Peter
    Horselskadades Riksforbund, Sweden.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Bridging the Gap Between Hearing Screening and Successful Rehabilitation: Research Protocol of a Randomized Controlled Trial of Motivational Interviewing via Internet2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, p. 302-306Article in journal (Refereed)
    Abstract [en]

    Purpose: Studies point to low help-seeking after a failed hearing screening. This research forum article presents the research protocol for a randomized controlled trial of motivational interviewing via the Internet to promote help-seeking in people who have failed an online hearing screening. Method: Adults who fail a Swedish online hearing screening, including a speech-in-noise recognition test, will be randomized to either an intervention group (participating in motivational interviewing) or an active control group (reading a book on history of hearing aids). Both of the conditions will be delivered via the Internet. The primary outcome is experience with seeking health care and using hearing aids 9 months after the intervention. Secondary outcomes are changes in before and after measures of self-reported hearing difficulties, anxiety, depression, and quality of life. Stages of change and self-efficacy in hearing help-seeking are measured immediately after intervention and at a 9-month follow-up for the purpose of mediation analysis. Results: The results of this randomized controlled trial may help bridge the gap between hearing screening and successful hearing rehabilitation. Conclusion: Although no large instantaneous benefits are expected, a slow change toward healthy behaviors-seeking health care and using hearing aids-would shed light on how to use the Internet to assist people with hearing impairment.

  • 24.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Hearing Care for Older Adults: Beyond the Audiology Clinic2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 2, p. 104-107Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this article is to highlight the importance of hearing health care beyond the clinic for older people with impaired hearing. Method: This article emphasizes factors affecting the success of audiologic rehabilitation for older people and describes practical clinical and community-based strategies for promoting successful hearing health care. Results: Older people are not always aware of the extent of their hearing loss, may not always expect to benefit from using a hearing aid, and often have low self-efficacy for managing to learn to use hearing aids. Increased knowledge and support from other health professionals, family caregivers, and significant others could optimize older peoples participation in everyday activities. Conclusion: Further work is needed to develop new interventions for older people with impaired hearing and to increase collaboration with general practitioners as well as other health care professionals.

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