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  • 1.
    Gosling, Justine
    et al.
    WHO, Denmark; Univ Lucerne, Switzerland.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research Division. Linköping University, Faculty of Arts and Sciences. WHO, Denmark.
    Mishra, Satish
    WHO, Denmark.
    2023: The game changing year for rehabilitation in the WHO European Region?2023In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165Article in journal (Other academic)
  • 2.
    Mishra, Satish
    et al.
    WHO, Denmark.
    Gosling, Justine
    WHO, Denmark; Univ Lucerne, Switzerland.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research Division. Linköping University, Faculty of Arts and Sciences. WHO, Denmark.
    Zapata, Tomas
    WHO, Denmark.
    Muscat, Natasha Azzopardi
    WHO, Denmark.
    The need for rehabilitation services in the WHO European Region is substantial and growing2023In: The Lancet Regional Health: Europe, E-ISSN 2666-7762, Vol. 24, article id 100550Article in journal (Other academic)
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  • 3.
    Mishra, Satish
    et al.
    World Health Organization Regional Office for Europe, Copenhagen, Denmark.
    Laplante-Levesque, Ariane
    World Health Organization Regional Office for Europe, Copenhagen, Denmark.
    Barbareschi, Giulia
    Global Disability Innovation Hub, London, United Kingdom.
    Witte, Luc De
    Centre for Assistive Technology and Connected Healthcare, University of Sheffield, Sheffield, United Kingdom.
    Abdi, Sarah
    Centre for Assistive Technology and Connected Healthcare, University of Sheffield, Sheffield, United Kingdom.
    Spann, Alice
    Centre for Assistive Technology and Connected Healthcare, University of Sheffield, Sheffield, United Kingdom.
    Khasnabis, Chapal
    World Health Organization, Geneva, Switzerland.
    Allen, Michael
    United States Agency for International Development, Washington, DC, United States of America.
    Assistive technology needs, access and coverage, and related barriers and facilitators in the WHO European region: a scoping review2022In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115Article, review/survey (Refereed)
    Abstract [en]

    Purpose

    Globally, assistive technology (AT) is used by over 1 billion people, but the prevalence of needs and access to AT in specific countries or regions is largely unknown. This scoping review summarises the evidence available on the prevalence of needs, access and coverage of AT in the World Health Organisation European Region and the barriers and facilitators to its use.

    Methods

    Relevant publications were identified using a combination of two strategies: 1) a systematic search for AT publications in five scientific literature databases; and 2) consultations with 76 of the Region's AT experts.

    Result

    The search strategies yielded 103 publications, 62 of them identified by the systematic search. The included publications were predominantly from six countries, and 18 countries were unrepresented. Information on AT use for specific functional impairments was present in 57 publications: AT for hearing impairment in 14 publications; vision in 12; mobility, 12; communication, 11; self-care, 6; and cognition, 2. AT needs for vision and hearing impairment were more likely to be met (1–87% and 5–90%, respectively) compared with communication and cognition impairments (10–60% and 58%, respectively). The barriers and facilitators to AT access described were linked to accessibility, affordability and acceptability.

    Conclusion

    Data on AT prevalence and coverage are limited in both quantity and quality. Agreed-upon definitions of functional impairment and assistive product categories and standards for data collection are needed to facilitate data comparisons and to build a more representative picture of AT needs and coverage.

    Implications for rehabilitation

    • Comprehensive and disaggregated data concerning the prevalence of needs and coverage of AT is needed to enable the development of responsive policies and actions.
    • The literature available on the prevalence of needs and coverage of AT in the WHO European Region is primarily focussed on a small subset of countries and comparisons between studies are limited due to the use of different data collection strategies.
    • Evidence concerning barriers and facilitators to AT access across countries is more consistent and can be organised across the key themes of accessibility, affordability and acceptability of AT.
    • There is a need for consensus among multiple AT actors on standardised definitions for functional impairment and assistive product categories and standards for data collection to enable a more representative picture to be built of AT needs and coverage across the WHO European Region and globally.
  • 4.
    Bastos Cordeiro, Bianca
    et al.
    Univ Fed Bahia, Brazil.
    Banhara, Marcos Roberto
    Bahia State Univ, Brazil.
    Cardeal Mendes, Carlos Mauricio
    Univ Fed Bahia, Brazil.
    Danieli, Fabiana
    Oticon Med, Brazil.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon Med, Denmark.
    Karoui, Chadlia
    Oticon Med, France.
    Hoen, Michel
    Oticon Med, France.
    Ardoint, Marine
    Oticon Med, France.
    Gauvrit, Fanny
    French Natl Inst Hlth & Med Res, France; Lille Univ Hosp, France.
    Demullier, Romane
    French Natl Inst Hlth & Med Res, France; Lille Univ Hosp, France.
    Vincent, Christophe
    French Natl Inst Hlth & Med Res, France; Lille Univ Hosp, France.
    Adult Users of the Oticon Medical Neuro Cochlear Implant System Benefit from Beamforming in the High Frequencies2021In: Audiology Research, ISSN 2039-4330, E-ISSN 2039-4349, Vol. 11, no 2, p. 179-191Article in journal (Refereed)
    Abstract [en]

    The Oticon Medical Neuro cochlear implant system includes the modes Opti Omni and Speech Omni, the latter providing beamforming (i.e., directional selectivity) in the high frequencies. Two studies compared sentence identification scores of adult cochlear implant users with Opti Omni and Speech Omni. In Study 1, a double-blind longitudinal crossover study, 12 new users trialed Opti Omni or Speech Omni (random allocation) for three months, and their sentence identification in quiet and noise (+10 dB signal-to-noise ratio) with the trialed mode were measured. The same procedure was repeated for the second mode. In Study 2, a single-blind study, 11 experienced users performed a speech identification task in quiet and at relative signal-to-noise ratios ranging from -3 to +18 dB with Opti Omni and Speech Omni. The Study 1 scores in quiet and in noise were significantly better with Speech Omni than with Opti Omni. Study 2 scores were significantly better with Speech Omni than with Opti Omni at +6 and +9 dB signal-to-noise ratios. Beamforming in the high frequencies, as implemented in Speech Omni, leads to improved speech identification in medium levels of background noise, where cochlear implant users spend most of their day.

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  • 5.
    Laplante-Lévesque, Ariane
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon Med AS, Denmark.
    Dubno, Judy R.
    Med Univ South Carolina, SC 29425 USA.
    Mosnier, Isabelle
    Univ Paris, France; Sorbonne Univ, France.
    Ferrary, Evelyne
    Univ Paris, France; Sorbonne Univ, France.
    McRackan, Theodore R.
    Med Univ South Carolina, SC 29425 USA.
    Best Practices in the Development, Translation, and Cultural Adaptation of Patient-Reported Outcome Measures for Adults With Hearing Impairment: Lessons From the Cochlear Implant Quality of Life Instruments2021In: Frontiers in Neuroscience, ISSN 1662-4548, E-ISSN 1662-453X, Vol. 15, article id 718416Article in journal (Refereed)
    Abstract [en]

    This manuscript summarizes available evidence-based best practices in the development, translation, and cultural adaptation of one type of outcome measure for adults with hearing impairment, patient-reported outcome measures (PROMs). It presents the development of the Cochlear Implant Quality of Life (CIQOL) instruments and the ongoing translation and cultural adaptation of the CIQOL-35 Profile from English to French as case studies and discusses useful lessons for selecting, developing, translating, culturally adapting, and using PROMs. Relevant best practice guides are introduced, described and their steps are illustrated with examples. Future trends in hearing-related PROMs, including computerized adaptive testing, patient-reported experience measures (PREMs), economic evaluation and allocation of scarce resources, and PROMs in low-resource settings, are discussed. The manuscript concludes on the lessons that can be learned from implementation science for the successful and sustainable integration of PROMs in clinical practice.

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  • 6.
    Bolzer, Adrien
    et al.
    Service d'ORL et CCF, CHU Nancy, France.
    Hoen, Michel
    Scientific and Clinical Research Group Cochlear Implants, Oticon Medical, Vallauris, France.
    Montaut-Verient, Bettina
    Service d'ORL et CCF, CHU Nancy, France.
    Hoffmann, Charles
    Service d'ORL et CCF, CHU Nancy, France; Laboratoire Développement, Adaptation et Handicap (DevAH-EA 3450), Faculty of Medicine and Faculty of Sciences and Sport, University of Lorraine, Vandœuvre-lès-Nancy, France.
    Ardoint, Marine
    Scientific and Clinical Research Group Cochlear Implants, Oticon Medical, Vallauris, France.
    Laplante-Levesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research Division. Linköping University, Faculty of Arts and Sciences. Scientific and Clinical Research Group Cochlear Implants, Oticon Medical, Vallauris, France.
    Guevara, Nicholas
    IUFC GCS CHU Nice–Centre Antoine Lacassagne, France.
    Mom, Thierry
    Service ORL et CCF, CHU Gabriel Montpied, Clermont-Ferrand, France.
    Karoui, Chadlia
    Scientific and Clinical Research Group Cochlear Implants, Oticon Medical, Vallauris, France.
    Vincent, Christophe
    Service d'Otologie et Oto-neurologie, CHRU Lille, France.
    Parietti-Winkler, Cécile
    Service d'ORL et CCF, CHU Nancy, France; Laboratoire Développement, Adaptation et Handicap (DevAH-EA 3450), Faculty of Medicine and Faculty of Sciences and Sport, University of Lorraine, Vandœuvre-lès-Nancy, France.
    The Development of the “Telislife” Questionnaire for the Evaluation of Telephone Use in Cochlear Implant Users2021In: Journal of Speech, Language and Hearing Research, ISSN 1092-4388, E-ISSN 1558-9102, Vol. 64, no 1, p. 186-195Article in journal (Refereed)
    Abstract [en]

    Purpose For cochlear implant users, the ability to use the telephone is often seen as an important landmark during rehabilitation and an indicator of cochlear implant benefit. The goal of this study was to develop a short questionnaire exploring the ability to use the telephone in cochlear implant users, named Telislife, and test it in a group of experienced users.

    Method This prospective multicenter study was based on the completion of self-administrated questionnaires. The Telislife includes 20 items using a 5-point Likert scale for answers. Speech recognition scores were obtained with monosyllabic word lists at 70 dB HL. Quality of life was evaluated with the Nijmegen Cochlear Implant Questionnaire. This study included 55 adult patients wearing a cochlear implant for over 1 year.

    Results The Telislife questionnaire showed excellent reliability (Cronbach's α = .91). A significant correlation was found between Telislife scores and Nijmegen Cochlear Implant Questionnaire scores (r = .69, p < .001) and speech recognition scores (r = .35, p = .007).

    Conclusion Given significant correlations between Telislife scores and both speech recognition and quality of life and given its short form, the Telislife questionnaire appears to be a reliable tool to evaluate cochlear implant outcomes in clinical practice.

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  • 7.
    Schonborn, Danielle
    et al.
    Univ Pretoria, South Africa.
    Asmail, Faheema Mahomed
    Univ Pretoria, South Africa.
    De Sousa, Karina C.
    Univ Pretoria, South Africa.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon Med, Denmark.
    Moore, David R.
    Cincinnati Childrens Hosp Med Ctr, OH 45229 USA; Univ Cincinnati, OH USA; Univ Manchester, England.
    Smits, Cas
    Vrije Univ Amsterdam, Netherlands.
    Swanepoel, De Wet
    Univ Pretoria, South Africa; Ear Sci Inst Australia, Australia.
    Characteristics and Help-Seeking Behavior of People Failing a Smart Device Self-Test for Hearing2020In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 29, no 3, p. 365-374Article in journal (Refereed)
    Abstract [en]

    Purpose: This study investigated user characteristics, help-seeking behavior, and follow-up actions of people who failed an app-based digits-in-noise hearing screening test, considering their stage of change. Method: Test and user characteristics of 3,092 listeners who failed the test were retrospectively analyzed. A posttest survey determining follow-up (verb) actions was sent to listeners who failed the test (n = 1,007), of which 59 responded. Results: The majority of listeners were in the precontemplation stage (75.5%). Age and stage of change were significant (p &lt; .05) predictors of the digits-in-noise speech recognition threshold (DIN SRT). Listeners in the precontemplation stage were significantly younger than in other stages (p &lt; .05). Posttest survey response rate was low (5.9%). Of those, most (82.4%) did not think they had a hearing loss. Only 13.6% followed up with an audiologist. Conclusion: Older people presented with poorer DIN SRTs and were typically in a more advanced stage of change. The majority of those who did not follow up after failing the screening test did not believe they had a hearing loss. A combination of factors, including poor DIN SRT, older age, and a more advanced stage of change inclined participants to follow up with audiological care.

  • 8.
    Schramm, David
    et al.
    Univ Ottawa, Canada.
    Chen, Joseph
    Sunnybrook Med Ctr, Canada.
    Morris, David P.
    Dalhousie Univ, Canada.
    Shoman, Nael
    Royal Univ Hosp, Canada.
    Philippon, Daniel
    Quebec Univ Hosp, Canada.
    Caye-Thomasen, Per
    Copenhagen Univ Hosp, Denmark; Univ Copenhagen, Denmark.
    Hoen, Michel
    Oticon Med, Denmark.
    Karoui, Chadlia
    Oticon Med, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon Med, Denmark.
    Gnansia, Dan
    Oticon Med, Denmark.
    Clinical efficiency and safety of the oticon medical neuro cochlear implant system: a multicenter prospective longitudinal study2020In: Expert Review of Medical Devices, ISSN 1743-4440, E-ISSN 1745-2422, Vol. 17, no 9, p. 959-967Article in journal (Refereed)
    Abstract [en]

    Objective This prospective longitudinal cohort study at six tertiary referral centers in Canada and Denmark describes the clinical efficiency and surgical safety of cochlear implantation with the Oticon Medical Neuro cochlear implant system, including the Neuro Zti implant, the EVO electrode array, and the Neuro One sound processor. Methods Patients were adult cochlear implant candidates with bilateral sensorineural hearing loss. Results The mean HINT scores in quiet pre-operatively and at 3, 6, and 12 months post-activation were 13%, 58%, 67%, and 72%, respectively, and in noise (+10 dB SNR) 13%, 46%, 53%, and 59%, respectively. The mean improvement from baseline to 6 months post-activation was 54% in quiet and 40% in noise. The surgical major complication incidence rate was 0% and the post-surgical major complication incidence rate (until 12 months post-activation) was 4%. There was no adverse event that was fatal, that required explantation, or that resulted in sound processor nonuse, and no implant failure. Conclusion Cochlear implantation with the Oticon Medical Neuro system enables speech identification both in quiet and in noise and audiologic outcomes continue to improve in the year following activation. No substantial adverse events occurred during the surgical implantation procedure and during the 12 months post-activation.

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  • 9.
    Ratanjee-Vanmali, Husmita
    et al.
    University of Pretoria (UP), Hearing Research Clinic, South Africa.
    Swanepoel, De Wet
    International Journal of Audiology, South Africa.
    Laplante-Levesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research Division. Linköping University, Faculty of Arts and Sciences.
    Digital Proficiency and Teleaudiology: Key Implications in Hearing Care2020In: The Hearing Journal®, ISSN 0745-7472, Vol. 73, no 9, p. 18-20Article in journal (Refereed)
  • 10.
    Ratanjee-Vanmali, Husmita
    et al.
    Univ Pretoria, South Africa.
    Swanepoel, De Wet
    Univ Pretoria, South Africa; Univ Western Australia, Australia; Ear Sci Inst Australia, Australia.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon Med AS, Denmark.
    Digital Proficiency Is Not a Significant Barrier for Taking Up Hearing Services With a Hybrid Online and Face-to-Face Model2020In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 29, no 4, p. 785-808Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to determine the effect of self-perceived digital proficiency on the uptake of hearing services through a hybrid online and face-to-face hearing health care model. Method: Adults were recruited via online methods to complete an online hearing screening test within the greater Durban area in South Africa. On submission of contact details after failing the screening, contact was made via telephone to assess readiness for further hearing care. If motivated and willing to continue, a face-to-face appointment for diagnostic hearing testing was confirmed, at which time an e-mail with an online mobile device and computer proficiency survey was sent. Hearing services were offered using combined online and face-to-face methods. Results: Within 2 years (June 2017 to June 2019), 1,259 people from the target location submitted their details for the clinic audiologist to contact, of whom 931 participants (73.95%) failed the screening test. Of these participants, 5.69% (53/931, 57.41 % men) attended a face-to-face diagnostic hearing evaluation. Mobile device and computer proficiency scores were not a predictor of acquiring hearing services. Age was the only significant predictor (p = .018) for those continuing with hearing care. Patients who continued with hearing care by acquiring hearing aids and support services were older (M = 73.63 years, SD = 11.62) and on average aware of their hearing loss for a longer time (M = 14.71 years, SD = 15.77), as compared to those who discontinued hearing health care who were younger (M = 59.21 years, SD = 14.42) and on average aware of their hearing loss for a shorter time (M = 6.37 years, SD = 9.26). Conclusions: Digital proficiency is not a predictor for acquiring hearing services through a hybrid online and face-to-face hearing care model. Hybrid services could allow professionals to assist patients in a combination of face-to-face and online services tailored to meet individual needs, including convenience and personalized care.

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  • 11.
    Percy-Smith, Lone
    et al.
    Decibel, Denmark.
    Wischmann, Signe
    Decibel, Denmark.
    Josvassen, Jane Lignel
    Decibel, Denmark.
    Hallstrom, Maria
    Decibel, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon Med, Denmark.
    Sorgenfrei, Maria Grube
    Oticon Med, Denmark.
    Caye-Thomasen, Per
    Rigshosp, Denmark.
    Evaluation of a sentence test in noise in children with hearing impairment2020In: Danish Medical Journal, E-ISSN 2245-1919, Vol. 67, no 1, article id A06190358Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: School-aged children with hearing impairment (HI) listen and learn in noisy environments. On-going monitoring of speech understanding in noise is essential to adjust clinical interventions accordingly. METHODS: The aim of this study was to assess Dantale II in a paediatric population. The secondary aims were identification of differences and similarities between groups of children with HI and normal hearing and between different hearing technologies; investigation of possible associations between Dantale II and verbal working memory. This was a longitudinal, prospective study comparing groups of children (n = 70) using the Dantale II with five-word sentences and verbal working memory with the Clinical Evaluation of Language Functioning-4. RESULTS: Dantale II seems clinically feasible from the age of six years. Children with NH outperformed children with HI both on completion of the tests and dB signal-to-noise ratio (SNR) scores. Children with hearing aids outperformed children with CI on dB SNR scores. A significant and moderately strong association between speech understanding in noise and verbal working memory was identified. CONCLUSIONS: Our study produced knowledge about a new generation of children with HI, who showed potentials not previously described. Future research on cognitive development of paediatric populations with HI is essential, as knowledge from adult populations cannot be transferred directly to paediatric populations.

  • 12.
    Ratanjee-Vanmali, Husmita
    et al.
    University of Pretoria (UP), Hearing Research Clinic, South Africa.
    Swanepoel, De Wet
    International Journal of Audiology, South Africa.
    Laplante-Levesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research Division. Linköping University, Faculty of Arts and Sciences.
    Implementing a Hybrid Model of Online and In-person Audiology Care2020In: The Hearing Journal®, ISSN 0745-7472, Vol. 73, no 8, p. 16-19Article in journal (Refereed)
  • 13.
    Ratanjee-Vanmali, Husmita
    et al.
    University of Pretoria (UP), South Africa; Hearing Research Clinic, South Africa.
    Swanepoel, De Wet
    University of Pretoria (UP), South Africa.
    Laplante-Levesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research Division. Linköping University, Faculty of Arts and Sciences.
    Optimizing Audiology Websites to Increase Patient Reach2020In: The Hearing Journal®, ISSN 0745-7472, Vol. 73, no 7, p. 31-33Article in journal (Refereed)
  • 14.
    Ratanjee-Vanmali, Husmita
    et al.
    Univ Pretoria, South Africa.
    Swanepoel, De Wet
    Univ Pretoria, South Africa; Univ Western Australia, Australia; Ear Sci Inst Australia, Australia.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon Med AS, Denmark.
    Patient Uptake, Experience, and Satisfaction Using Web-Based and Face-to-Face Hearing Health Services: Process Evaluation Study2020In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 22, no 3, article id e15875Article in journal (Refereed)
    Abstract [en]

    Background: Globally, access to hearing health care is a growing concern with 900 million people estimated to suffer from disabling hearing loss by 2050. Hearing loss is one of the most common chronic health conditions, yet access to hearing health care is limited. Incorporating Web-based (voice calling, messaging, or emailing) service delivery into current treatment pathways could improve access and allow for better scalability of services. Current electronic health studies in audiology have focused on technical feasibility, sensitivity, and specificity of diagnostic hearing testing and not on patient satisfaction, experiences, and sustainable models along the entire patient journey. Objective: This study aimed to investigate a hybrid (Web-based and face-to-face) hearing health service in terms of uptake, experience, and satisfaction in adult patients with hearing loss. Methods: A nonprofit hearing research clinic using online and face-to-face services was implemented in Durban, South Africa, using online recruitment from the clinics Facebook page and Google AdWords, which directed persons to an online Web-based hearing screening test. Web based and face-to-face care pathways included assessment, treatment, and rehabilitation. To evaluate the service, an online survey comprising (1) a validated satisfaction measurement tool (Short Assessment of Patient Satisfaction), (2) a process evaluation of all the 5 steps completed, and (3) personal preferences of communication methods used vs methods preferred was conducted, which was sent to 46 patients who used clinic services. Results: Of the patients invited, 67% (31/46) completed the survey with mean age 66 years, (SD 16). Almost all patients, 92% (30/31) reported that the online screening test assisted them in seeking hearing health care. Approximately 60% (18/31) of the patients accessed the online hearing screening test from an Android device. Patients stayed in contact with the audiologist mostly through WhatsApp instant messaging (27/31, 87%), and most patients (25/31, 81%) preferred to use this method of communication. The patients continuing with hearing health care were significantly older and had significantly poorer speech recognition abilities compared with the patients who discontinued seeking hearing health care. A statistically significant positive result (P=.007) was found between age and the number of appointments per patient. Around 61% (19/31) of patients previously completed diagnostic testing at other practices, with 95% (18/19) rating the services at the hybrid clinic as better. The net promoter score was 87, indicating that patients were highly likely to recommend the hybrid clinic to friends and family. Conclusions: This study applied Web-based and face-to-face components into a hybrid clinic and measured an overall positive experience with high patient satisfaction through a process evaluation. The findings support the potential of a hybrid clinic with synchronous and asynchronous modes of communication to be a scalable hearing health care model, addressing the needs of adults with hearing loss globally.

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  • 15.
    Ratanjee-Vanmali, Husmita
    et al.
    University of Pretoria, Pretoria, South Africa.
    Swanepoel, De Wet
    University of Pretoria, Pretoria, South Africa.
    Laplante-Levesque, Ariane
    University of Pretoria, Pretoria, South Africa.
    Strengthening the Role of the Audiologist in the Digital Age2020In: The Hearing Journal®, ISSN 0745-7472, Vol. 73, no 6, p. 38-39Article in journal (Refereed)
  • 16.
    Franco-Vidal, Valerie
    et al.
    Bordeaux Univ Hosp, France.
    Parietti-Winkler, Cecile
    Cent Univ Hosp, France.
    Guevara, Nicolas
    Univ Cote DAzur, France.
    Truy, Eric
    Lyon Univ Hosp, France.
    Loundon, Natalie
    Necker Univ Hosp Sick Children, France.
    Bailleux, Sonanda
    Nice Lenval Univ Hosp, France.
    Ardoint, Marine
    Oticon Med, France.
    Saai, Sonia
    Oticon Med, France.
    Hoen, Michel
    Oticon Med, France.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon Med, Denmark.
    Mosnier, Isabelle
    Pitie Salpetriere Univ Hosp, France.
    Bordure, Philippe
    Nantes Univ Hosp, France.
    Vincent, Christophe
    Lille Univ Hosp, France.
    The Oticon Medical Neuro Zti cochlear implant and the Neuro 2 sound processor: multicentric evaluation of outcomes in adults and children2020In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 59, no 2, p. 153-160Article in journal (Refereed)
    Abstract [en]

    Objective: This study evaluated the outcomes of the Oticon Medical Neuro Zti cochlear implant and the Neuro 2 sound processor. Design: Neuro One users were upgraded to Neuro 2. Monosyllabic word identification was evaluated in adults with Neuro One after &gt;= 5 months, with Neuro 2 at upgrade, and with Neuro 2 after 3 months. Self-reported listening ability, satisfaction, and usability were measured in adults and children. Study sample: Participants were 44 adults and 26 children. Results: Speech identification scores in quiet and noise were 58% and 45% with Neuro One and 67% and 55% with Neuro 2 after 3 months, respectively. Hearing impairment duration and number of active electrodes significantly predicted speech identification in noise with Neuro 2. Significantly higher questionnaire ratings were obtained for Neuro 2 than Neuro One regarding listening ability in complex listening situations, comfort and music, as well as nine aspects of satisfaction and usability. Conclusion: This study demonstrates the clinical superiority of the Neuro 2 sound processor over Neuro One in terms of speech identification in quiet and in noise and reported patient benefit and satisfaction. Given the study design, sources of improvement may include factors unrelated to the sound processor itself.

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  • 17.
    Ratanjee-Vanmali, Husmita
    et al.
    Department of Speech-Language Pathology and Audiology , University of Pretoria , Pretoria , South Africa; b Hearing Research Clinic Non-Profit Company , Durban , South Africa.
    Swanepoel, De Wet
    Department of Speech-Language Pathology and Audiology , University of Pretoria , Pretoria , South Africa; c Ear Sciences Centre , The University of Western Australia , Nedlands , Australia; d Ear Science Institute Australia , Subiaco , Australia.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon Medical , Oticon A/S, Copenhagen , Denmark.
    Characteristics, behaviours and readiness of persons seeking hearing healthcare online2019In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 58, no 2, p. 107-115Article in journal (Refereed)
    Abstract [en]

    Objective: This study describes characteristics, behaviours and readiness of people who are interested in seeking hearing healthcare (HHC) online.

    Design: A non-profit clinic was established from which services through a virtual clinic are offered. Most of the patient–audiologist interactions are conducted online. We used online means to invite individuals to take a free online digit-in-noise (DIN) test. Upon failing the test, individuals reported their readiness to seek HHC by using two tools: the line and the staging algorithm.

    Study sample: Individuals ≥18 years of age, within the greater Durban area, South Africa, were eligible to participate in the study.

    Results: A total of 462 individuals completed the online DIN test during the first 3 months. Of those, 58.66% (271/462) failed the test and 11.04% (51/462) submitted their details for further contact from the clinic audiologist. Five individuals proceeded to a comprehensive hearing evaluation and hearing aid trial: all those individuals showed readiness to seek further HHC on the measurement tools. These individuals have reported knowing of their hearing challenges prior to taking the test and have waited for a period of between 5 and 16 years before seeking HHC. A significant association between age and DIN test result was found.

    Conclusion: This explorative study is the first clinic to utilise digital tools across the entire patient journey in combination with face-to-face interactions in providing HHC. Internet-connected devices provide an opportunity for individuals to seek HHC and for providers to offer initial services to detect, counsel and support persons through the initial engagement process of seeking HHC. This may open up new audiology patient pathways through online hearing screening, assessment of readiness to seek further HHC and enhancement of service delivery using hybrid services by combining online and face-to-face modes of synchronous and asynchronous communication.

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  • 18.
    Bennett, Rebecca J.
    et al.
    Ear Sci Inst Australia, Australia; Univ Western Australia, Australia.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon Med, Denmark.
    Eikelboom, Robert H.
    Ear Sci Inst Australia, Australia; Univ Western Australia, Australia; Univ Pretoria, South Africa.
    How Do Hearing Aid Owners Respond to Hearing Aid Problems?2019In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 40, no 1, p. 77-87Article in journal (Refereed)
    Abstract [en]

    Background: Although hearing aids can improve hearing and communication, problems that arise following the acquisition of hearing aids can result in their disuse. This study aimed to gather perspectives of hearing aid owners and hearing health care clinicians about how hearing aid owners respond to problems that arise following hearing aid fitting, and then use these perspectives to generate a conceptual framework to better understand these responses. Methods: Seventeen hearing aid owners and 21 hearing health care clinicians generated, sorted, and rated statements regarding how hearing aid owners respond to problems associated with hearing aid use. Concept mapping was used to identify key themes and to develop a conceptual framework. Results: Participants identified four concepts regarding how hearing aid owners respond to problems associated with hearing aids: (1) Seeking External Help; (2) Problem Solving; (3) Putting Up with Problems; and (4) Negative Emotional Response. Participants described behaviors of the clinician and significant others that influenced their decision to seek help for hearing aid problems. Participants recognized that these behaviors could either have a helpful or unhelpful impact. Conclusions: Despite the ongoing support offered to clients after they acquire hearing aids, they are hesitant to seek help from their clinician and instead engage in a myriad of helpful and unhelpful behaviors in response to problems that arise with their hearing aid. Previous positive or negative experiences with the clinic, clinician, or significant other influenced these actions, highlighting the influential role of these individuals in the success of the rehabilitation program. The data generated from this study suggests that clinicians could improve hearing aid problem resolution by providing technical and emotional support, including to significant others, and promoting client empowerment and self-management.

  • 19.
    Hickson, Louise
    et al.
    Univ Queensland, Australia.
    Worrall, Linda
    Univ Queensland, Australia.
    Scarinci, Nerina
    Univ Queensland, Australia.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon Med, Denmark.
    Individualised active communication education (I-ACE): another clinical option for adults with hearing impairment with a focus on problem solving and self-management2019In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 58, no 8, p. 504-509Article in journal (Refereed)
    Abstract [en]

    Objective: This clinical note describes the Individualised - Active Communication Education (I-ACE) programme designed to improve problem solving and self-management in adults with hearing impairment. Design: The I-ACE was offered to adult clients seeking help for the first time and effects were measured for participants using self-report questionnaires: the Client Oriented Scale of Improvement (goal attainment), the Hearing Handicap Questionnaire (hearing disability), and the International Outcome Inventory - Alternative Interventions (outcomes) immediately after programme completion and 3 months later. Participants also provided qualitative feedback about I-ACE. Study sample: Twenty-three participants completed I-ACE, with 22 completing all self-report questionnaires and 23 participants providing qualitative feedback. Results: The participants reported positive outcomes and goal attainment, but no change in hearing disability post-programme. The effects were maintained 3 months later. Qualitative feedback indicated that I-ACE supported participants in recognising and increasing awareness of their hearing difficulties and in developing potential solutions to these difficulties. Participants also enjoyed the opportunity to involve communication partners. Conclusion: I-ACE is an appropriate option for adults with hearing impairment who wish to become more aware of their hearing difficulties and how to solve them.

  • 20.
    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.

  • 21.
    Dritsakis, Giorgos
    et al.
    Ear Institute, University College London, London, UK; Royal National Throat Nose & Ear Hospital, London, UK.
    Kikidis, Dimitris
    1st Department of Otolaryngology, National and Kapodistrian University of Athens, Hippocrateion Hospital, Athens, Greece.
    Koloutsou, Nina
    Guy’s and St Thomas’ NHS Foundation Trust, London, UK.
    Murdin, Louisa
    Guy’s and St Thomas’ NHS Foundation Trust, London, UK.
    Bibas, Athanasios
    1st Department of Otolaryngology, National and Kapodistrian University of Athens, Hippocrateion Hospital, Athens, Greece.
    Ploumidou, Katherine
    Athens Medical Center, Athens, Greece.
    Laplante-Levesque, Ariane
    Eriksholm Research Centre, Elsinore, Denmark.
    Pontoppidan, Niels Henrik
    Eriksholm Research Centre, Elsinore, Denmark.
    Bamiou, Doris-Eva
    Ear Institute, University College London, London, UK; Royal National Throat Nose & Ear Hospital, London, UK; NIHR University College London Hospitals Biomedical Research Centre, London, UK.
    Clinical validation of a public health policy-making platform for hearing loss (EVOTION): protocol for a big data study2018In: BMJ Open, E-ISSN 2044-6055, Vol. 8, no 2, article id e020978Article in journal (Refereed)
    Abstract [en]

    Introduction

    The holistic management of hearing loss (HL) requires an understanding of factors that predict hearing aid (HA) use and benefit beyond the acoustics of listening environments. Although several predictors have been identified, no study has explored the role of audiological, cognitive, behavioural and physiological data nor has any study collected real-time HA data. This study will collect ‘big data’, including retrospective HA logging data, prospective clinical data and real-time data via smart HAs, a mobile application and biosensors. The main objective is to enable the validation of the EVOTION platform as a public health policy-making tool for HL.

    Methods and analysis

    This will be a big data international multicentre study consisting of retrospective and prospective data collection. Existing data from approximately 35 000 HA users will be extracted from clinical repositories in the UK and Denmark. For the prospective data collection, 1260 HA candidates will be recruited across four clinics in the UK and Greece. Participants will complete a battery of audiological and other assessments (measures of patient-reported HA benefit, mood, cognition, quality of life). Patients will be offered smart HAs and a mobile phone application and a subset will also be given wearable biosensors, to enable the collection of dynamic real-life HA usage data. Big data analytics will be used to detect correlations between contextualised HA usage and effectiveness, and different factors and comorbidities affecting HL, with a view to informing public health decision-making.

    Ethics and dissemination

    Ethical approval was received from the London South East Research Ethics Committee (17/LO/0789), the Hippokrateion Hospital Ethics Committee (1847) and the Athens Medical Center’s Ethics Committee (KM140670). Results will be disseminated through national and international events in Greece and the UK, scientific journals, newsletters, magazines and social media. Target audiences include HA users, clinicians, policy-makers and the general public.

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  • 22.
    Paglialonga, Alessia
    et al.
    Natl Res Council Italy CNR, Italy.
    Nielsen, Annette Cleveland
    Oticon AS, Denmark.
    Ingo, Elisabeth
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Barr, Caitlin
    Univ Melbourne, Australia.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark; Oticon Med, France.
    eHealth and the hearing aid adult patient journey: a state-of-the-art review2018In: Biomedical engineering online, E-ISSN 1475-925X, Vol. 17, article id 101Article, review/survey (Refereed)
    Abstract [en]

    The number and variety of eHealth services for adults and older adults who use hearing aids (HAs) are growing rapidly. This area holds promise to increase cost-efficiency, enable better access to care, and improve patient outcomes and satisfaction. Despite the increasing interest in this field, an up-to-date picture of recent research in the area of eHealth for adults with HAs is lacking. In this state-of-the-art review we assessed the literature from the past decade about eHealth use in the HA adult patient journey. Systematic searches were conducted in CINAHL, PubMed, Scopus, and Web of Science. A total of 34 peer-reviewed empirical records were identified from the searches and from the reference lists of searched records. Records were characterized based on: eHealth platform (i.e.: offline, Internet-based, or mobile-based), service [i.e.: education and information, screening and assessment, hearing rehabilitation, or general (teleaudiology)], and phase of the patient journey (i.e.: pre-fitting, fitting, or post-fitting). The review highlighted a growing interest in the field, as revealed by an increasing trend over the search period, from 2 records in 2009-2010 up to 17 records in 2015-2016. Internet-based platforms were the most frequently used (present in more than half of the included records), with a stable trend in the period. About one-third of the records introduced services over offline platforms, whereas mobile-based platforms were used only in 6 out of 34 records, suggesting that the clinical uptake of mobile services is still limited compared to more mature offline and Internet-based platforms. Most of the eHealth services observed were related to the areas of education and information (42.5%) and hearing rehabilitation (40.4%), whereas 10.7% were related to screening and assessment, and 6.4% to general tele-audiology services. Many services covered different phases of the patient journey, especially the fitting and post-fitting phases. Overall, this review showed that the field of eHealth in the context of HA rehabilitation in adults has grown in the recent past. Research is still needed to increase the uptake and efficacy of eHealth in clinical practice, especially in terms of technology developments, technical and clinical validation, and optimization of strategies for service delivery.

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  • 23.
    Bennett, Rebecca J.
    et al.
    Ear Sci Inst Australia, Australia; Univ Western Australia, Australia.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Res Ctr, Denmark.
    Meyer, Carly J.
    Univ Queensland, Australia.
    Eikelboom, Robert H.
    Ear Sci Inst Australia, Australia; Univ Western Australia, Australia; Univ Pretoria, South Africa.
    Exploring Hearing Aid Problems: Perspectives of Hearing Aid Owners and Clinicians2018In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 39, no 1, p. 172-187Article in journal (Refereed)
    Abstract [en]

    Objectives: To gather perspectives of hearing aid owners and hearing healthcare clinicians with regard to problems that arise after hearing aid fitting and use these perspectives to generate a conceptual framework to gain a better understanding of these problems. Design: Participants included a group of 17 hearing aid owners and a group of 21 hearing healthcare clinicians; data collection occurred separately for each group. Participants each attended two group sessions in Perth, Western Australia, wherein they: (1) generated statements describing the problems associated with hearing aids and (2) grouped and rated the statements to identify key themes. Concept mapping was used to generate a conceptual framework. Results: Participants identified four concepts regarding hearing aid problems as follows: (1) hearing aid management; (2) hearing aid sound quality and performance; (3) feelings, thoughts, and behaviors; and (4) information and training. While hearing aid owners and clinicians generated similar results regarding the concepts derived, the clinicians reported that the problems identified had a greater negative impact on hearing aid success than did hearing aid owners. Conclusions: The magnitude and diversity of hearing aid problems identified in this study highlight the ongoing challenges that hearing aid owners face and suggest that current processes for hearing aid fitting can be improved. Problems relating to hearing aid management were most often deemed to have the greatest impact on hearing aid success and be the most preventable/solvable, and thus are a good starting point when addressing hearing aid-related problems.

  • 24.
    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.

  • 25.
    Frederick, M
    et al.
    VA RR&D National Center for Rehabilitative Auditory Research, Portland, Oregon, United States.
    Silverman, S
    VA RR&D National Center for Rehabilitative Auditory Research, Portland, OR, USA.
    Laplante-Levesque, Ariane
    Oticon Medical, Copenhagen, Denmark.
    Nielsen, C
    Eriksholm Research Center, Snekkersten, Denmark.
    Saunders, G
    VA RR&D National Center for Rehabilitative Auditory Research, Portland, OR, USA.
    Promoting hearing health behavior change in adults2018In: Innovation in Aging, E-ISSN 2399-5300, Vol. 2, no suppl_1, p. 361-361Article in journal (Refereed)
    Abstract [en]

    Uptake of hearing rehabilitation is impacted by a person’s beliefs about hearing disability and hearing aids. Data show that interventions such as hearing aids result in positive outcomes, yet only about 25% of individuals with hearing impairment seek help for their hearing. To address this, we developed a brief photo-based intervention based on constructs from the Health Belief Model, the Transtheoretical Stages of Change Model and Self Determination Theory. The intervention is designed for use in any health-care setting in which a health-care provider can facilitate a conversation. It targets individuals who have not sought professional hearing evaluation despite perceiving hearing difficulties. One hundred one adults who perceived hearing difficulties but had not sought help were randomly assigned to either receive the intervention or not. Their help seeking behavior was followed up 6-months later. In the presentation we will describe the intervention and present findings from the study.

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  • 26.
    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.

  • 27.
    Saunders, Gabrielle H.
    et al.
    Portland VA Med Ctr, OR 56210 USA; Oregon Hlth and Sci Univ, OR 97201 USA.
    Frederick, Melissa T.
    Portland VA Med Ctr, OR 56210 USA.
    Silverman, ShienPei C.
    Portland VA Med Ctr, OR 56210 USA.
    Nielsen, Claus
    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.
    Development and Pilot Evaluation of a Novel Theory-Based Intervention to Encourage Help-Seeking for Adult Hearing Loss2017In: Journal of american academy of audiology, ISSN 1050-0545, E-ISSN 2157-3107, Vol. 28, no 10, p. 920-931Article in journal (Refereed)
    Abstract [en]

    Background: Health behavior theories can provide an understanding of hearing health behaviors and, more importantly, can be used to develop theoretically based strategies to change these health behaviors. Purpose: To develop a theory-based brief intervention to increase help-seeking for adult hearing loss and to conduct a pilot study to evaluate its feasibility, effectiveness, and impact on hearing beliefs and behaviors. Research Design: An intervention was designed that could be easily administered by a health-care provider who does not have expertise in audiology-such as a primary care physician, community nurse, or social worker. The intervention aims to alter perceived benefit, severity, cues to action, and self-efficacy for seeking help by providing experiential/affective messaging and simultaneously providing intrinsic motivation for the recipient to seek hearing help. To first determine whether this intervention changed beliefs and increased help-seeking behavior, this study was conducted in a hearing research laboratory setting. Study Sample: A total of 101 adults aged 50-89 yr were recruited within 6 months of having attended an appointment at a primary care clinic at the VA Portland Health Care System. All were sent a letter inviting them to participate in a study if they had trouble with their hearing but had not had a scheduled hearing test or worn hearing aids in the prior 5 yr and also had functional oral and written English. Data from 87 individuals were available for analysis. Intervention: The intervention is designed for use in any health-care setting in which a health-care provider can facilitate a conversation about hearing. On arrival at a health-care facility, recipients are provided with nine emotionally evocative color photographs to prompt reflection on ways in which hearing difficulties impact them. A discussion with a health-care provider (facilitator) follows, during which recipients may identify the negative impacts of their hearing loss. If the recipient identifies negative impacts, the facilitator suggests that he or she consider having a hearing test and provides a list of local hearing-health professionals. Data Collection and Analysis: Participants completed baseline questionnaires assessing hearing beliefs and attitudes. They were then randomly assigned either to the group receiving the study intervention or to a control group. Six months after study enrollment, participants reported whether they had sought help for their hearing and completed a second set of questionnaires. Results: Twelve of 41 individuals (29.3%) in the intervention group and 7 of 46 individuals (15.2%) in the control group sought help within the 6-month follow-up period. A chi(2) test showed these numbers did not differ significantly; however, the odds ratio of having had a hearing test were 2.3 times greater for those who received the intervention than for those who did not. Conclusions: Despite not reaching statistical significance, the odds ratio suggests that the theory-based brief intervention is worthy of additional examination. We intend to work with health-care providers to conduct a larger study to investigate whether the intervention has value in the real world.

  • 28.
    Ingo, Elisabeth
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Brännström, K. Jonas
    Linköping University, The Swedish Institute for Disability Research. Department of logopedics, phoniatrics and audiology, Lund University, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    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.
    Stages of change in audiology: comparison of three self-assessment measures2017In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 56, no 7, p. 516-520Article in journal (Refereed)
    Abstract [en]

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

  • 29.
    Pryce, Helen
    et al.
    Aston University, England.
    Hall, Amanda
    St Michaels Hospital, England.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Centre, Denmark.
    Clark, Elizabeth
    St Martins Hospital, England.
    A qualitative investigation of decision making during help-seeking for adult hearing loss2016In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 55, no 11, p. 658-665Article in journal (Refereed)
    Abstract [en]

    Objective: The Any Qualified Provider framework in the National Health Service has changed the way adult audiology services are offered in England. Under the new rules, patients are being offered a choice in geographical location and audiology provider. This study aimed to explore how choices in treatment are presented and to identify what information patients need when they are seeking help with hearing loss. Design: This study adopted qualitative methods of ethnographic observations and focus group interviews to identify information needed prior to, and during, help-seeking. Observational data and focus group data were analysed using the constant comparison method of grounded theory. Study sample: Participants were recruited from a community Health and Social Care Trust in the west of England. This service incorporates both an Audiology and a Hearing Therapy service. Twenty seven participants were involved in focus groups or interviews. Results: Participants receive little information beyond the detail of hearing aids. Participants report little information that was not directly related to uptake of hearing aids. Conclusions: Participant preferences were not explored and limited information resulted in decisions that were clinician-led. The gaps in information reflect previous data on clinician communication and highlight the need for consistent information on a range of interventions to manage hearing loss.

  • 30.
    Saunders, Gabrielle H.
    et al.
    Portland VA Medical Centre, OR USA; Oregon Health and Science University, OR 97201 USA.
    Frederick, Melissa T.
    Portland VA Medical Centre, OR USA.
    Silverman, ShienPei C.
    Portland VA Medical Centre, OR USA.
    Nielsen, Claus
    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.
    Description of Adults Seeking Hearing Help for the First Time According to Two Health Behavior Change Approaches: Transtheoretical Model (Stages of Change) and Health Belief Model2016In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 37, no 3, p. 324-333Article in journal (Refereed)
    Abstract [en]

    Objectives: Several models of health behavior change are commonly used in health psychology. This study applied the constructs delineated by two models-the transtheoretical model (in which readiness for health behavior change can be described with the stages of precontemplation, contemplation and action) and the health belief model (in which susceptibility, severity, benefits, barriers, self-efficacy, and cues to action are thought to determine likelihood of health behavior change)-to adults seeking hearing help for the first time. Design: One hundred eighty-two participants (mean age: 69.5 years) were recruited following an initial hearing assessment by an audiologist. Participants mean four-frequency pure-tone average was 35.4 dB HL, with 25.8% having no hearing impairment, 50.5% having a slight impairment, and 23.1% having a moderate or severe impairment using the World Health Organization definition of hearing loss. Participants hearing-related attitudes and beliefs toward hearing health behaviors were examined using the University of Rhode Island Change Assessment (URICA) and the health beliefs questionnaire (HBQ), which assess the constructs of the transtheoretical model and the health belief model, respectively. Participants also provided demographic information, and completed the hearing handicap inventory (HHI) to assess participation restrictions, and the psychosocial impact of hearing loss (PIHL) to assess the extent to which hearing impacts competence, self-esteem, and adaptability. Results: Degree of hearing impairment was associated with participation restrictions, perceived competence, self-esteem and adaptability, and attitudes and beliefs measured by the URICA and the HBQ. As degree of impairment increased, participation restrictions measured by the HHI, and impacts of hearing loss, as measured by the PIHL, increased. The majority of first-time help seekers in this study were in the action stage of change. Furthermore, relative to individuals with less hearing impairment, individuals with more hearing impairment were at more advanced stages of change as measured by the URICA (i.e., higher contemplation and action scores relative to their precontemplation score), and they perceived fewer barriers and more susceptibility, severity, benefits and cues to action as measured by the HBQ. Multiple regression analyses showed participation restrictions (HHI scores) to be a highly significant predictor of stages of change explaining 30% to 37% of the variance, as were duration of hearing difficulty, and perceived benefits, severity, self-efficacy and cues to action assessed by the HBQ. Conclusions: The main predictors of stages of change in first-time help seekers were reported participation restrictions and duration of hearing difficulty, with constructs from the health belief model also explaining some of the variance in stages of change scores. The transtheoretical model and the health belief model are valuable for understanding hearing health behaviors and can be applied when developing interventions to promote help seeking.

  • 31.
    Saunders, Gabrielle H.
    et al.
    Portland VA Medical Centre, ME USA; Oregon Health and Science University, OR 97201 USA.
    Frederick, Melissa T.
    Portland VA Medical Centre, ME USA.
    Silverman, ShienPei C.
    Portland VA Medical Centre, ME USA.
    Nielsen, Claus
    Oticon AS, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Portland VA Medical Centre, ME USA.
    Health behavior theories as predictors of hearing-aid uptake and outcomes2016In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 55, p. S59-S68Article in journal (Refereed)
    Abstract [en]

    Objective: To understand hearing behaviors of adults seeking help for the first time through the application of two models of health behavior change: the transtheoretical model and the health belief model. Design: The relationships between attitudes and beliefs were examined relative to hearing-aid uptake and outcomes six months later. Study sample: One hundred and sixty adults completed the University of Rhode Island change assessment (targeting the transtheoretical model), and the hearing beliefs questionnaire (targeting the health belief model), as well as the hearing handicap inventory and the psychosocial impact of hearing loss scale, within two months of an initial hearing assessment. Six months later, participants completed these same questionnaires, while those who had taken up hearing aids also completed hearing-aid outcome questionnaires. Results: (1) Attitudes and beliefs were associated with future hearing-aid uptake, and were effective at modeling this behavior; (2) attitudes and beliefs changed following behavior change, and (3) attitudes and beliefs following behavior change were better predictors of hearing-aid outcomes than pre-behavior change attitudes and beliefs. Conclusion: A counseling-based intervention targeting the attitudes and beliefs assessed by the transtheoretical model and the health belief model has the potential to increase uptake of hearing health care.

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  • 32.
    Laplante-Lévesque, Ariane
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Abrams, Harvey
    Starkey Hearing Technology Inc, MN USA.
    Bulow, Maja
    Widex AS, Denmark.
    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.
    Nelson, John
    GN ReSound, IL USA.
    Kamaric Riis, Soren
    Oticon Medical AS, Denmark.
    Vanpoucke, Filiep
    Cochlear Technology Centre, Belgium.
    Hearing Device Manufacturers Call for Interoperability and Standardization of Internet and Audiology2016In: AMERICAN JOURNAL OF AUDIOLOGY, ISSN 1059-0889, Vol. 25, no 3, p. 260-263Article in journal (Refereed)
    Abstract [en]

    Purpose: This article describes the perspectives of hearing device manufacturers regarding the exciting developments that the Internet makes possible. Specifically, it proposes to join forces toward interoperability and standardization of Internet and audiology. Method: A summary of why such a collaborative effort is required is provided from historical and scientific perspectives. A roadmap toward interoperability and standardization is proposed. Results: Information and communication technologies improve the flow of health care data and pave the way to better health care. However, hearing-related products, features, and services are notoriously heterogeneous and incompatible with other health care systems (no interoperability). Standardization is the process of developing and implementing technical standards (e.g., Noah hearing database). All parties involved in interoperability and standardization realize mutual gains by making mutually consistent decisions. De jure (officially endorsed) standards can be developed in collaboration with large national health care systems as well as spokespeople for hearing care professionals and hearing device users. The roadmap covers mutual collaboration; data privacy, security, and ownership; compliance with current regulations; scalability and modularity; and the scope of interoperability and standards. Conclusions: We propose to join forces to pave the way to the interoperable Internet and audiology products, features, and services that the world needs.

  • 33.
    Laplante-Lévesque, Ariane
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    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.
    Preminger, Jill E.
    University of Louisville, KY 40292 USA.
    Internet and Audiology: A Review of the Second International Meeting2016In: AMERICAN JOURNAL OF AUDIOLOGY, ISSN 1059-0889, Vol. 25, no 3, p. 257-259Article, review/survey (Refereed)
    Abstract [en]

    Purpose: This article describes the Second International Meeting on Internet and Audiology, which took place at the Eriksholm Research Centre, Oticon A/S, Denmark September 24 to 25, 2015, and introduces the research forum arising from the meeting. Method: The potential gains of the Internet within audiology are framed within the central role of quality connections among people, ideas, and objects. First, the meeting is summarized. Second, the 11 articles arising from the meeting and collected in this research forum are grouped into 2 themes: design and evaluation. Last, the benefits of interoperability and standardization are discussed. Conclusion: We look forward to the day when the Internet is an integral part of audiology, and we invite readers to attend future editions of the International Meeting on Internet and Audiology.

  • 34.
    Ingo, Elisabeth
    et al.
    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.
    Brännström, K Jonas
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences. Department of Logopedics, Phoniatrics and Audiology, Lund University, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Department of Clinical Neuroscience, Karolinska Institute, Sweden; Eriksholm Research Centre, Oticon a/S, Denmark.
    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. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon a/S, Denmark.
    Measuring motivation using the transtheoretical (stages of change) model: A follow-up study of people who failed an online hearing screening.2016In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 55, no Suppl 3, p. S52-S58Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Acceptance and readiness to seek professional help have shown to be important factors for favourable audiological rehabilitation outcomes. Theories from health psychology such as the transtheoretical (stages-of-change) model could help understand behavioural change in people with hearing impairment. In recent studies, the University of Rhode Island change assessment (URICA) has been found to have good predictive validity.

    DESIGN: In a previous study, 224 Swedish adults who had failed an online hearing screening completed URICA and two other measures of stages of change. This follow-up aimed to: (1) determine prevalence of help-seeking at a hearing clinic and hearing aid uptake, and (2) explore the predictive validity of the stages of change measures by a follow-up on the 224 participants who had failed a hearing screening 18 months previously.

    STUDY SAMPLE: A total of 122 people (54%) completed the follow-up online questionnaire, including the three measures and questions regarding experience with hearing help-seeking and hearing aid uptake.

    RESULTS: Since failing the online hearing screening, 61% of participants had sought help. A good predictive validity for a one-item measure of stages of change was reported.

    CONCLUSIONS: The Staging algorithm was the stages of change measure with the best ability to predict help-seeking 18 months later.

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  • 35.
    Brännström, Jonas
    et al.
    Clinical Sciences Lund, Sweden.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, Faculty of Medicine and Health Sciences.
    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 Institutet, Department of Clinical Neuroscience, 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. Snekkersten, Oticon A/S, Eriksholm Research Centre, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Snekkersten, Oticon A/S, Eriksholm Research Centre, Denmark.
    The initial evaluation of an internet-based support system for audiologists and first-time hearing aid clientsThe process of developing an internet-based support system for audiologists and first-time hearing aid clients2016In: Internet Interventions, ISSN 2214-7829, Vol. 4, no 1, p. 82-91Article in journal (Refereed)
  • 36.
    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.

  • 37.
    Grenness, Caitlin
    et al.
    HEARing CRC, Australia; University of Melbourne, Australia.
    Hickson, Louise
    HEARing CRC, Australia; University of Queensland, Australia.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Center, Oticon AS, Denmark.
    Meyer, Carly
    HEARing CRC, Australia; University of Queensland, Australia.
    Davidson, Bronwyn
    University of Melbourne, Australia.
    Communication Patterns in Audiologic Rehabilitation History-Taking: Audiologists, Patients, and Their Companions2015In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 36, no 2, p. 191-204Article in journal (Refereed)
    Abstract [en]

    Objectives: The nature of communication between patient and practitioner influences patient outcomes. Specifically, the history-taking phase of a consultation plays a role in the development of a relationship and in the success of subsequent shared decision making. There is limited research investigating patient-centered communication in audiology, and this study may be the first to investigate verbal communication in an adult audiologic rehabilitation context. This research aimed, first, to describe the nature of verbal communication involving audiologists, patients, and companions in the history-taking phase of initial audiology consultations and, second, to determine factors associated with communication dynamics. Design: Sixty-three initial audiology consultations involving patients over the age of 55, their companions when present, and audiologists were audio-video recorded. Consultations were coded using the Roter Interaction Analysis System and divided into three consultation phases: history, examination, and counseling. This study analyzed only the history-taking phase in terms of opening structure, communication profiles of each speaker, and communication dynamics. Associations between communication dynamics (verbal dominance, content balance, and communication control) and 11 variables were evaluated using Linear Mixed Model methods. Results: The mean length of the history-taking phase was 8.8 min (range 1.7 to 22.6). A companion was present in 27% of consultations. Results were grouped into three areas of communication: opening structure, information exchange, and relationship building. Examination of the history opening structure revealed audiologists tendency to control the agenda by initiating consultations with a closed-ended question 62% of the time, followed by interruption of patient talk after 21.3 sec, on average. The aforementioned behaviors were associated with increased verbal dominance throughout the history and increased control over the content of questions. For the remainder of the history, audiologists asked 97% of the questions and did so primarily in closed-ended form. This resulted in the audiologist talking as much as the patient and much more than the companions when they were present. Questions asked by the audiologist were balanced in topic: biomedical and psychosocial/lifestyle; however, few emotionally focused utterances were observed from any speaker (less than 5% of utter ances). Conclusions: Analysis of verbal communication involving audiologists, patients, and companions in the history-taking phase in 63 initial audiology consultations revealed a communicative exchange that was audiologist-controlled and structured, but covered both medical and lifestyle content. Audiologists often attempted to create a relationship with their patients; however, little emotional relationship building occurred, which may have implications later in the consultation when management decisions are being made. These results are not in line with patient-centered communication principles. Further research and changes to clinical practice are warranted to transform patient-centered communication from an ideal to a reality.

  • 38.
    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.

  • 39.
    Preminger, Jill E.
    et al.
    University of Louisville, KY 40292 USA.
    Oxenboll, Maria
    Oticon AS, Denmark.
    Barnett, Margaret B.
    University of Louisville, KY 40292 USA.
    Jensen, Lisbeth D.
    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.
    Perceptions of adults with hearing impairment regarding the promotion of trust in hearing healthcare service delivery2015In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 54, no 1, p. 20-28Article in journal (Refereed)
    Abstract [en]

    Objective: This paper describes how trust is promoted in adults with hearing impairment within the context of hearing healthcare (HHC) service delivery. Design: Data were analysed from a previously published descriptive qualitative study that explored perspectives of adults with hearing impairment on hearing help-seeking and rehabilitation. Study sample: Interview transcripts from 29 adults from four countries with different levels of hearing impairment and different experience with the HHC system were analysed thematically. Results: Patients enter into the HHC system with service expectations resulting in a preconceived level of trust that can vary from low to high. Relational competence, technical competence, commercialized approach, and clinical environment (relevant to both the clinician and the clinic) influence a patients resulting level of trust. Conclusions: Trust is evolving rather than static in HHC: Both clinicians and clinics can promote trust. The characteristics of HHC that engender trust are: practicing good communication, supporting shared decision making, displaying technical competence, offering comprehensive hearing rehabilitation, promoting self-management, avoiding a focus on hearing-aid sales, and offering a professional clinic setting.

  • 40.
    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.

  • 41.
    Laplante-Lévesque, Ariane
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Brannstrom, Jonas K.
    Lund University, Sweden.
    Ingo, Elisabeth
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. 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, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Stages of Change in Adults Who Have Failed an Online Hearing Screening2015In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 36, no 1, p. 92-101Article in journal (Refereed)
    Abstract [en]

    Objectives: Hearing screening has been proposed to promote help-seeking and rehabilitation in adults with hearing impairment. However, some longitudinal studies point to low help-seeking and subsequent rehabilitation after a failed hearing screening (positive screening result). Some barriers to help-seeking and rehabilitation could be intrinsic to the profiles and needs of people who have failed a hearing screening. Theories of health behavior change could help to understand this population. One of these theories is the transtheoretical (stages-of-change) model of health behavior change, which describes profiles and needs of people facing behavior changes such as seeking help and taking up rehabilitation. According to this model, people go through distinct stages toward health behavior change: precontemplation, contemplation, action, and finally, maintenance. The present study describes the psychometric properties (construct validity) of the stages of change in adults who have failed an online hearing screening. Stages of change were measured with the University of Rhode Island Change Assessment (URICA). Principal component analysis is presented, along with cluster analysis. Internal consistency was investigated. Finally, relationships between URICA scores and speech-in-noise recognition threshold, self-reported hearing disability, and self-reported duration of hearing disability are presented. Design: In total, 224 adults who had failed a Swedish online hearing screening test (measure of speech-in-noise recognition) completed further questionnaires online, including the URICA. Results: A principal component analysis identified the stages of precontemplation, contemplation, and action, plus an additional stage, termed preparation (between contemplation and action). According to the URICA, half (50%) of the participants were in the preparation stage of change. The contemplation stage was represented by 38% of participants, while 9% were in the precontemplation stage. Finally, the action stage was represented by approximately 3% of the participants. Cluster analysis identified four stages-of-change clusters: they were named decision making (44% of sample), participation (28% of sample), indecision (16% of sample), and reluctance (12% of sample). The construct validity of the model was good. Participants who reported a more advanced stage of change had significantly greater self-reported hearing disability. However, participants who reported a more advanced stage of change did not have a significantly worse speech-in-noise recognition threshold or reported a significantly longer duration of hearing impairment. Conclusions: The additional stage this study uncovered, and which other studies have also uncovered, preparation, highlights the need for adequate guidance for adults who are yet to seek help for their hearing. The fact that very few people were in the action stage (approximately 3% of the sample) signals that screening alone is unlikely to be enough to improve help-seeking and rehabilitation rates. As expected, people in the later stages of change reported significantly greater hearing disability. The lack of significant relationships between stages-of-change measures and speech-in-noise recognition threshold and self-reported duration of hearing disability highlights the complex interplay between impairment, disability, and behaviors in adults who have failed an online hearing screening and who are yet to seek help.

  • 42.
    Grenness, Caitlin
    et al.
    HEARing CRC, Australia; University of Melbourne, Australia.
    Hickson, Louise
    HEARing CRC, Australia; University of Queensland, Australia.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Meyer, Carly
    HEARing CRC, Australia; University of Queensland, Australia.
    Davidsont, Bronwyn
    University of Melbourne, Australia.
    The Nature of Communication throughout Diagnosis and Management Planning in Initial Audiologic Rehabilitation Consultations2015In: JOURNAL OF THE AMERICAN ACADEMY OF AUDIOLOGY, ISSN 1050-0545, Vol. 26, no 1, p. 36-50Article in journal (Refereed)
    Abstract [en]

    Background: Effective practitioner-patient communication throughout diagnosis and management planning positively influences patient outcomes. A patient-centered approach whereby patient involvement in decision making is facilitated, a therapeutic relationship is developed, and information is bilaterally exchanged in an appropriate manner, leads to improved patient satisfaction, adherence to treatment, and self-management. Despite this knowledge, little is known about the nature of audiologist-patient communication throughout diagnosis and management planning. Purpose: This research aimed to explore verbal communication between audiologists and patients/ companions throughout diagnosis and management planning in initial audiology consultations. Specifically, this study aimed to describe the nature and dynamics of communication by examining the number, proportion, and type of verbal utterances by all speakers (audiologist, patient, and companion when present). In addition, this study aimed to investigate the influence of audiologist, patient, and consultation factors, such as verbal dominance, content balance, and communication control, on the dynamics of communication. Study Sample: A total of 62 initial audiological rehabilitation consultations (involving 26 different audiologists) were filmed and analyzed using the Roter Interaction Analysis System. All patients were older than 55 yr, and a companion was present in 17 consultations. Data Collection and Analysis: This study focused solely on the communication relating to diagnosis and management planning (referred to as the "counseling phase"). Diagnosis, recommendations, rehabilitation options, and patient decisions were recorded along with the communication profiles and communication dynamics measured using the Rotor Interaction Analysis System. Associations between communication dynamics (content balance, communication control, and verbal dominance) and eight variables were evaluated with Linear Mixed Model methods. Results: The mean length of time for diagnosis and management planning was 29.0 min (range, 2.2- 78.5 min). Communication profiles revealed that patient-centered communication was infrequently observed. First, opportunities to build a relationship were missed, such that patients psychosocial concerns were rarely addressed and patients/companions showed little involvement in management planning. Second, the amount of talk was asymmetrical and the majority of audiologists education and counseling utterances related to hearing aids; yet, only 56% of patients decided to obtain hearing aids at the conclusion of the consultation. Hearing aids were recommended in 83% of consultations where a hearing loss was diagnosed and alternative options were rarely provided. Thus, shared decision making rarely occurred, and audiologists often diagnosed a hearing loss and recommended hearing aids without patient involvement. In addition, when a greater proportion of time was dedicated to diagnosis and management planning, patients had greater input and control by asking more questions and requesting further information. Conclusions: Patient-centered communication was rarely observed in the 62 consultations. Thus, although not measured in this study, patient outcomes are likely to be affected. Future research should examine the influence of audiologist communication on outcomes and encourage a shift toward patient-centered audiological rehabilitation.

  • 43.
    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.

  • 44.
    Laplante-Lévesque, Ariane
    et al.
    Eriksholm Research Centre, Snekkersten, Denmark.
    Hickson, Louise
    HEARing Cooperative Research Centre, Melbourne, Victoria, Australia.
    Grenness, Caitlin
    HEARing Cooperative Research Centre, Melbourne, Victoria, Australia.
    An Australian survey of audiologists’ preferences for patient-centredness2014In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 53, no S1, p. S76-S82Article in journal (Refereed)
    Abstract [en]

    Objective: Patient-centredness is becoming a core value of health services worldwide, however it remains largely unexplored in audiology. This study investigated audiologists’ preferences for patient-centredness and identified factors that explain audiologists’ preferences for patient-centredness. Design: All members of the Audiological Society of Australia received two questionnaires: (1) a descriptive questionnaire (e.g. age, gender, place of residence, years in practice, employment characteristics), and (2) a modified patient-practitioner orientation scale (PPOS; Krupat et al, 2000) which measures preferences for two aspects of patient-centredness, sharing and caring. Study sample: In total 663 (46%) audiologists returned both questionnaires fully completed. Results: Mean PPOS scores indicated that audiologists prefer patient-centredness. Linear regression modelling identified that older audiologists, that had practiced longer, and who worked in community education, industrial audiology, or teaching had a signifi cantly greater preference for patient-centredness than their peers. In contrast, audiologists who practiced in a private environment and who worked in the area of assessment of adults had a significantly lesser preference for patient-centredness than their peers. Conclusions: Audiologists prefer client-centredness and age, years of experience, and employment characteristics can partly explain preferences for patient-centredness. Future research should explore the relationships between patient-centredness and intervention outcomes in audiology.

  • 45.
    Grenness, Caitlin
    et al.
    HEARing Cooperative Research Centre, Melbourne, Australia.
    Hickson, Louise
    HEARing Cooperative Research Centre, Melbourne, Australia.
    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, Snekkersten, Denmark.
    Davidson, Bronwyn
    University of Melbourne, Carlton, Australia.
    Patient-centred audiological rehabilitation: Perspectives of older adults who own hearing aids2014In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 53, no S1, p. S68-S75Article in journal (Refereed)
    Abstract [en]

    Objective: Patient-centred care is a term frequently associated with quality health care. Despite extensive literature from a range of health-care professions that provide description and measurement of patient-centred care, a definition of patient-centredness in audiological rehabilitation is lacking. The current study aimed to define patient-centred care specific to audiological rehabilitation from the perspective of older adults who have owned hearing aids for at least one year. Design: Research interviews were conducted with a purposive sample of older adults concerning their perceptions of patient-centredness in audiological rehabilitation, and qualitative content analysis was undertaken. Study sample: The participant sample included ten adults over the age of 60 years who had owned hearing aids for at least one year. Results: Data analysis revealed three dimensions to patient-centred audiological rehabilitation: the therapeutic relationship, the players (audiologist and patient), and clinical processes. Individualised care was seen as an overarching theme linking each of these dimensions. Conclusions: This study reported two models: the first model describes what older adults with hearing aids believe constitutes patient-centred audiological rehabilitation. The second provides a guide to operationalised patient-centred care. Further research is required to address questions pertaining to the presence, nature, and impact of patient-centred audiological rehabilitation.

  • 46.
    Grenness, Caitlin
    et al.
    HEARing Cooperative Research Centre, Melbourne, Australia.
    Hickson, Louise
    HEARing Cooperative Research Centre, Melbourne, Australia.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Centre, Snekkersten, Denmark.
    Davidson, Bronwyn
    University of Melbourne, Australia.
    Patient-centred care: A review for rehabilitative audiologists2014In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 53, no S1, p. S60-S67Article in journal (Refereed)
    Abstract [en]

    Objective: This discussion paper aims to synthesise the literature on patient-centred care from a range of health professions and to relate this to the field of rehabilitative audiology. Through review of the literature, this paper addresses five questions: What is patient-centred care? How is patient-centred care measured? What are the outcomes of patient-centred care? What are the factors contributing to patient-centred care? What are the implications for audiological rehabilitation? Design: Literature review and synthesis. Study sample: Publications were identified by structured searches in PubMed, Cinahl, Web of Knowledge, and PsychInfo, and by inspecting the reference lists of relevant articles. Results: Few publications from within the audiology profession address this topic and consequently a review and synthesis of literature from other areas of health were used to answer the proposed questions. Conclusion: This paper concludes that patient-centred care is in line with the aims and scope of practice for audiological rehabilitation. However, there is emerging evidence that we still need to inform the conceptualisation of patient-centred audiological rehabilitation. A definition of patient-centred audiological rehabilitation is needed to facilitate studies into the nature and outcomes of it in audiological rehabilitation practice.

  • 47.
    Laplante-Lévesque, Ariane
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Nielsen, Claus
    Oticon AS, Denmark .
    Dons Jensen, Lisbeth
    Oticon AS, Denmark .
    Naylor, Graham
    Oticon AS, Denmark .
    Patterns of Hearing Aid Usage Predict Hearing Aid Use Amount (Data Logged and Self-Reported) and Overreport2014In: JOURNAL OF THE AMERICAN ACADEMY OF AUDIOLOGY, ISSN 1050-0545, Vol. 25, no 2, p. 187-198Article in journal (Refereed)
    Abstract [en]

    Background: Previous studies found that, on average, users overreport their daily amount of hearing aid use compared to objective measures such as data logging. However, the reasons for this are unclear. Purpose: This study assessed data-logged and self-reported amount of hearing aid use in a clinical sample of hearing aid users. It identified predictors of data-logged hearing aid use, self-reported hearing aid use, and hearing aid use overreport. Research Design: This observational study recruited adult hearing aid users from 22 private dispensers in the Netherlands and in Denmark. Study Sample: The sample consisted of 228 hearing aid users. Typical participants were over the age of 65 and retired, were fitted binaurally, and had financially contributed to the cost of their hearing aids. Participants had on average a mild-to-severe sloping bilateral hearing impairment. Data Collection and Analysis: Participants completed a purposefully designed questionnaire regarding hearing aid usage and the International Outcome Inventory Hearing Aids. Dispensers collected audiometric results and data logging. Multiple linear regression identified predictors of data-logged hearing aid use, self-reported hearing aid use, and hearing aid use overreport when controlling for covariates. Results: Data logging showed on average 10.5 hr of hearing aid use (n = 184), while participants reported on average 11.8 hr of daily hearing aid use (n = 206). In participants for which both data-logged and self-reported hearing-aid use data were available (n = 166), the average absolute overreport of daily hearing aid use was 1.2 (1 hr and 11 min). Relative overreport was expressed as a rate of absolute overreport divided by data-logged hearing aid use. A positive rate denotes hearing aid use overreport: the average overreport rate was .38. Cluster analysis identified two data-logged patterns: "Regular," where hearing aids are typically switched on for between 12 and 20 hr before their user powers them off (57% of the sample), and "On-off," where hearing aids are typically switched on for shorter periods of time before being powered off (43% of the sample). In terms of self-report, 77% of the sample described their hearing aid use to be the same every day, while 23% of the sample described their hearing aid use to be different from day to day. Participants for whom data logging showed an On-off pattern or who reported their hearing aid use to be different from day to day had significantly fewer data-logged and self-reported hours of Hearing aid use. Having an On-off data-logging pattern or describing hearing aid use as the same every day was associated with a significantly greater hearing aid use overreport. Conclusions: Data-logged and self-reported usage patterns significantly predicted data-logged hearing aid use, self-reported hearing aid use, and overreport when controlling for covariates. The results point to patterns of hearing aid usage as being at least as important a concept as amount of hearing aid use. Dispensers should discuss not only the "how much", but also the "how" of hearing aid usage with their clients.

  • 48.
    Preminger, Jill E.
    et al.
    University of Louisville, Kentucky, USA.
    Laplante-Lévesque, Ariane
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Perceptions of age and brain in relation to hearing help seeking and rehabilitation2014In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 35, no 1, p. 19-29Article in journal (Refereed)
    Abstract [en]

    Objectives:

    This study used a qualitative approach to explore the perspectives of adults with hearing impairment on hearing help-seeking and rehabilitation. Two superordinate themes, Age and Brain, emerged from prior analyses and are investigated in the present article.

    Design:

    In-depth semistructured interviews were completed in four countries with 34 adults (aged 26 to 96 years) with hearing impairment. Participants were asked to “Tell the story of your hearing.” Participants included individuals with different levels of experiences in hearing help-seeking and rehabilitation. The themes of Age and Brain emerged from the data based on qualitative content analysis. These major themes were analyzed further using interpretative phenomenology to create models of themes and subthemes as they related to hearing help-seeking and rehabilitation expectations and experience.

    Results:

    Age was discussed by 68% of the 34 participants. The data were sorted into three themes: Expectations, Self-Image, and Ways of Coping. Brain was discussed by 50% of the participants. The data were sorted into three themes: Cognitive Operations, Plasticity, and Mental Effort.

    Conclusions:

    Adults with hearing impairment think of their age and their brain as contributing to their hearing impairment, disability, help-seeking, and rehabilitation. Although hearing impairment associated with older age was typically construed as a stigma, not all perceptions of aging and hearing impairment were negative. Some participants viewed older age and its influence on relationships or priorities as a reason for seeking out hearing health care or as the determining factor in deciding to wear hearing aids (HAs). Some expected hearing impairment with older age, thus they found it easier to accept wearing HAs than they may have at a younger age. They discussed the brain in terms of the cognitive operations that may either inhibit or improve speech communication. Participants believed that they could train their brains to improve their communication (and sometimes avoid the need for HAs) or to increase their HA benefit. Age and Brain interconnected in a number of ways. Participants believed that older age led to cognitive decline, which resulted in decreased speech understanding. Participants also believed that the cognitive decline that accompanies older age may limit HA benefit. Hearing healthcare providers may wish to clarify negative messages about age and brain with their patients and provide information about how older brains are capable of changing and benefiting from HA use and comprehensive audiologic rehabilitation programs.

  • 49.
    Wänström, Gunilla
    et al.
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Rydberg, Emelie
    Swedish Institute for Disability Research, School of Health and Medical Science, Linnaeus Centre HEAD, Örebro 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. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Laplante-Lévesque, Ariane
    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.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    The psychological process from avoidance to acceptance in adults with acquired hearing impairment2014In: Hearing, Balance and Communication, ISSN 2169-5717, Vol. 12, no 1, p. 27-35Article in journal (Refereed)
    Abstract [en]

    Objective: This study explored the psychological process from avoidance to acceptance in adults with acquired hearing impairment. Study design: A descriptive qualitative interview study was conducted in Sweden in 2010. Participants were 18 adults with an acquired sensorineural hearing impairment aged 50-70 years, who had recently obtained hearing aids at the Audiology Clinic of the Örebro University Hospital. The sample included both first-time hearing aid users (n = 10) and experienced hearing aid users (n = 8). Each participant took part in one semi-structured interview. Qualitative content analysis was performed on the manifest content of the interview transcripts. Results: Participants described the process from avoidance to acceptance as a slow and gradual process rooted in the awareness of the frequency and severity of hearing disability and of its psychological consequences. Facilitators included adaptive coping mechanisms, other peoples comments and positive experiences, accessibility of help-seeking and routine health assessments. In contrast, barriers included maladaptive coping mechanisms and stigma. Conclusions: Participants described the process of acceptance as a personal process that involved, to some extent, their social network of family, friends and colleagues. It was also a trade-off between the consequences of untreated hearing impairment and the threat to normal identity that, through stigma, hearing impairment carries. Further studies are needed to fully investigate the role of access to information on hearing impairment acceptance. How professionals and society can facilitate the process of acceptance should also be a focus of future research efforts. 

  • 50.
    Knudsen, Line V.
    et al.
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Nielsen, Claus
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Kramer, Sophia E.
    VU University Medical Center, EMGO+ Institute, Amsterdam, The Netherlands.
    Jones, Lesley
    University of York, UK.
    Laplante-Lévesque, Ariane
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Client labor: adults with hearing impairment describing their participation in their hearing help-seeking and rehabilitation2013In: Journal of the American Academy of Audiology, ISSN 1050-0545, Vol. 24, no 3, p. 192-204Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    The uptake and use of hearing aids is low compared to the prevalence of hearing impairment. People who seek help and take part in a hearing aid rehabilitation process participate actively in this process in several ways.

    PURPOSE:

    In order to gain more knowledge on the challenges of hearing help-seeking and hearing aid use, this qualitative study sought to understand the ways that people with hearing impairment describe themselves as active participants throughout the hearing aid rehabilitation process.

    RESEARCH DESIGN:

    In this qualitative interview study we examined the hearing rehabilitation process from the perspective of the hearing impaired. In this article we describe how the qualitative interview material was interpreted by a pragmatic qualitative thematic analysis. The analysis described in this article focused on the efforts, initiatives, actions, and participation the study participants described that they had engaged in during their rehabilitation.

    STUDY SAMPLE:

    Interviews were conducted with people with hearing impairment in Australia, Denmark, the United Kingdom, and the United States. The 34 interview participants were distributed equally between the sites, just as men and women were almost equally represented (56% women). The average age of the participants was 64. All participants had a hearing impairment in at least one ear. The participants were recruited to represent a range of experiences with hearing help-seeking and rehabilitation.

    DATA COLLECTION AND ANALYSIS:

    With each participant one qualitative semistructured interview ranging between 1 and 2 hr was carried out. The interviews were transcribed verbatim, read through several times, and themes were identified, defined, and reviewed by an iterative process.

    RESULTS:

    From this thematic focus a concept called "client labor" has emerged. Client labor contains nine subthemes divided into three overarching groups: cognitive labor, emotional labor, and physical labor. The participants' experiences and meaning-making related to these conceptual types of efforts is described.

    CONCLUSIONS:

    The study findings have implications for the clinical encounter between people with hearing impairment and hearing health-care professionals. We suggest that a patient-centered approach that bears in mind the client's active participation could help toward improving clinical dispensing, fitting, and counseling practices with the end goal to increase hearing aid benefit and satisfaction

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