Objectives Conducting research in clinical settings is challenging. The aim of this study was to increase our understanding of hearing care professionals’ perceptions of barriers to participating in such research.Design A modified group concept mapping approach was used to gain anonymous responses from 124 hearing care professionals to the statement: “One reason why it is hard to conduct intervention research studies in my centre/practice is….”. Participants were asked for reasons other than ‘time’ as this is universally reported as a barrier to clinical research.Results A total of 107 distinct reasons were provided by participants and these were sorted into 5 clusters: “Competing demands/pressures” (18 statements), “Not a priority for management/organisation” (14 statements), “Lack of opportunity/support” (19 statements), “Clinician’s knowledge, confidence, and beliefs” (24 statements), and “Recruitment/adherence to protocols is challenging” (32 statements). Identified barriers were generally similar to those reported in other healthcare settings, with unique barriers being those associated with a fear of scrutiny and lack of trust in the “academic elite”.Conclusion Findings highlight the importance of researchers, clinicians, and clinic managers working together at all stages of the research process in order for clinical research to be successful.
This study aimed to explore the experiences of adult clients with hearing loss and their audiologists in using an online tool, the Living Well Tool (LWT), during initial audiology appointments. The LWT is designed to help clients identify when and where it is most important for them to communicate effectively and live well with hearing loss. A total of 24 adult clients with hearing loss and two audiologists participated in this study. Clients were invited to complete the LWT prior to their next audiology appointment, however, most clients chose to use the LWT in-session with their audiologist. Following the appointment, clients and audiologists participated in individual qualitative semi-structured interviews to explore their experiences of using the LWT, and the extent to which the LWT facilitated person-centred care. Qualitative analysis five key themes which reflected participants’ experiences and perceptions of using the LWT: (1) the LWT enhances audiological care; (2) the LWT supports person-centred audiological care; (3) the use of the LWT should be individualised; (4) users value comprehensiveness; and (5) users value accessibility. This study demonstrated that the LWT supported the provision of person-centred audiological care, providing a flexible, comprehensive and accessible means for audiologists to gain an understanding of their clients’ needs and preferences. However, it was also noted that the use of a tool must be individualised and accessible for all.
Objective: The objective of the study was to discover the nature of parental lived experiences of the diagnostic process of Permanent Childhood Hearing Loss (PCHL) and to construct an emotional life-world of parent experience around PCHL.Design: Through an Interpretive Phenomenological Analytical (IPA) framework and subsequent purposive sampling, parents were invited to semi-structured interviews.Sample: Ten parents of children who were identified with PCHL as one or the only permanent childhood disability diagnosed during early childhood were interviewed.Results: Five themes emerged; (a) a received disability, (b) casualties, (c) acceptance in real-time, (d) the unique signature of family life, and (e) audiologists are essential and appreciated guides. The emotional landscape chronicled two concurrent, non-linear affective groupings: the spiral of disorientation, and protective states of righting.Conclusion: Parents require a level of emotional support that exceeds frameworks of counselling. We propose the Dual Process Model as an intermediary model of emotional literacy to address both grieving and coping during the passage from diagnosis to early management. We believe it provides an effortless articulation with the principles of Family-Centred Care philosophies (top down) and behaviours (bottom up) by providing a taxonomy of grieving, coping and parents' movement between the two orientations.
Nonverbal communication, specifically hand and arm movements (commonly known as gesture), has long been recognized and explored as a significant element in human interaction as well as potential compensatory behavior for individuals with communication difficulties. The use of gesture as a compensatory communication method in expressive and receptive human communication disorders has been the subject of much investigation. Yet within the context of adult acquired hearing loss, gesture has received limited research attention and much remains unknown about patterns of nonverbal behaviors in conversations in which hearing loss is a factor. This paper presents key elements of the background of gesture studies and the theories of gesture function and production followed by a review of research focused on adults with hearing loss and the role of gesture and gaze in rehabilitation. The current examination of the visual resource of co-speech gesture in the context of everyday interactions involving adults with acquired hearing loss suggests the need for the development of an evidence base to effect enhancements and changes in the way in which rehabilitation services are conducted.
Interprofessional collaboration is critical for optimal healthcare. Preparing for a collaborative, practice-ready workforce, the Interprofessional Learning Competencies (IPLCs) were adopted for accreditation of Australian entry-level health, nursing and medical tertiary training programs. In order to meet new accreditation standards, activities which facilitate and assess IPLC attainment must be identified. Interprofessional education programs have not evaluated student interprofessional learning activities using the Australian IPLCs. This project evaluates students' experiences of the IPLCs during 'Inspiring Health,' a community-based interprofessional placement, and determines whether reflections can effectively assess IPLC attainment. Forty-nine students from seven Flinders University health and social science programs completed written reflections about four self-selected IPLCs. The results indicated that students had opportunities to attain all the IPLCs. Their reflections were analyzed using thematic analysis. Three themes were identified: the processes by which students learned, the outcomes of their learning, and the factors that influenced their learning. Ultimately, these findings describe a beneficial community-based interprofessional learning activity for attainment of the Australian IPLCs and provide evidence that student reflections can be used to assess the Australian IPLCs.
Introduction The current qualitative systematic review identified and examined critically the literature on how persons with dementia experience transitions to long-term care. Results are intended to help develop guidelines for future care and research. Method A search was conducted of OvidSP, SCOPUS, Web of Science, ProQuest, PsycINFO, CINAHL, AgeLine and Informit databases. In total, 4705 articles were reviewed (published 1954–2018). A textual narrative approach was used to synthesise the findings of the included articles. Results Seven articles met inclusion criteria (five using data collected from interviews with persons with dementia and two using reports from a proxy). Overall, the findings showed that transition to long-term care possesses varied meanings for persons with dementia, is often not the decision of the persons with dementia, and is a process throughout which social connections remain important. Discussion Accounts of the experiences of persons with dementia regarding transitions from community to long-term care show that they and their families should be supported: with respect to their individual contexts, to share the positives and negatives of the transition experiences, to make decisions together, and to maintain old and establish new social connections.
Purpose: To explore the potential differential effect of auditory frequency discrimination (FD) difficulty on a range of reading and cognitive processes in children with Auditory Processing Disorders (APD). Methods: Sixteen children with APD (aged 7;5 to 10;2), eight with FD difficulty (FD-POOR group), and eight with age-appropriate FD (FD-TYPICAL group) were tested on measures of non-lexical and lexical reading, phonological processing (phonological awareness, phonological memory and rapid automatized naming), receptive language, auditory sustained attention, and executive function. Results: The results showed that children with poor FD experienced difficulty with tasks associated with non-lexical reading and phonological awareness. There were no significant differences between the groups on lexical reading, phonological memory and rapid automatized naming. Children with FD difficulty also showed poorer executive function. Specifically, they showed greater lag in reaction times (slower reaction times) on incongruent verses congruent trials on a modified Simon Task, indicating a larger Simon Effect. This suggests that these children were more affected by incongruency and showed poorer attention control. This finding was in the absence of significant differences in receptive language and auditory sustained attention. Conclusion: These findings support the notion that FD difficulty often co-exists with reading difficulty in children with APD. Extending the previous findings, the present results suggest that FD pertained largely with specific aspects of reading, namely the non-lexical reading process and phonological awareness. These findings are consistent with the current models of reading that non-lexical reading and phonological awareness are more dependent on AP abilities. Additionally, poorer executive function in children with poor FD support further investigation into the association between executive function, FD, and reading in children with APD.
Objectives: There are no agreed comprehensive tests for age-related changes to physical, emotional, mental and social functioning. Research into declining function focuses on those 75 years and older and little is known about age-related changes in younger people. The aims of this project were (1) to ascertain a comprehensive test battery that could underpin community-based health screening programmes for people aged 40–75 years and pilot both (2) community-based recruitment and (3) the utility, acceptability, response burden and logistics. Methods: A total of 11 databases were searched using a broad range of relevant terms. An identified comprehensive, recent, high-quality systematic review of screening instruments for detection of early functional decline for community-dwelling older people identified many relevant tools; however, not all body systems were addressed. Therefore, lower hierarchy papers identified in the rapid review were included and expert panel consultation was conducted before the final test battery was agreed. Broad networks were developed in one Australian city to aid pilot recruitment of community-dwellers 40–75 years. Recruitment and testing processes were validated using feasibility testing with 12 volunteers. Results: The test battery captured (1) online self-reports of demographics, health status, sleep quality, distress, diet, physical activity, oral health, frailty and continence; and (2) objective tests of anthropometry; mobility; lung function; dexterity; flexibility, strength and stability; hearing; balance; cognition and memory; foot sensation; and reaction time. Recruitment and testing processes were found to be feasible. Conclusion: This screening approach may provide new knowledge on healthy ageing in younger people.
The current paper addresses the nature of epistemic injustice as it may be experienced by persons with dementia. We describe how theoretical models of stigma align with the current model of epistemic injustice through a consideration of the concepts of ‘stereotype’, ‘prejudice’ and ‘discrimination’, shared by the two models. We draw on current understandings of dementia-related stigma to expand understandings of the epistemic injustice faced by persons with dementia. We discuss how these insights may inform the development of mechanisms to uphold the basic human right to speak, to be heard, and to be believed for persons with dementia.
"The experience of hearing loss: journey through aural rehabilitation." International Journal of Audiology, 57(5), p. 397
BACKGROUND Language and memory impairments affect everyday interactions between individuals with dementia and their communication partners. Impaired topic management, which compromises individuals' construction of relevant, meaningful discourse, is commonly reported amongst individuals with dementia. Currently, limited empirical evidence describes the sequential patterns of behaviour comprising topic-management practices in everyday conversation between individuals with dementia and their communication partners. AIMS To describe the sequential patterns of behaviour relating to the manifestation of topic-management impairments and facilitative behaviours in everyday interactions between individuals with dementia and their familiar communication partners (FCPs). METHODS & PROCEDURES Three 20-min conversations between individuals with moderate to severe dementia and their FCPs were recorded. Conversation Analysis was used to examine sequences in which topic-management appeared to be impaired. OUTCOMES & RESULTS Conversational behaviours that reflected a difficulty in contributing on-topic talk were pervasive in the talk of the three individuals with dementia. FCPs responded to these conversational difficulties by using two categories of facilitative behaviours. The first involved responding to an individual with dementia's explicit repair-initiation by performing repair. In the second category, explicit repair-initiation was absent; instead, the distance of the conversational difficulty from the prior topic-shifting turn mediated the form and outcome of the FCPs' facilitative behaviours. Each category successfully facilitated the individual with dementia to contribute on-topic talk. CONCLUSIONS & IMPLICATIONS The findings contribute to a growing understanding of topic-management abilities in everyday interactions involving individuals with dementia. Individuals with dementia took a proactive role in eliciting topic-management support. The FCPs responded with turns that facilitated the individuals with dementia to talk on-topic. Clinically, the results support and extend the current topic-management recommendations available in communication partner training programmes, and promote conversations which attend to the personhood of the individual with dementia.
Community and professional engagement describes a collaborative model of interaction between institutions of higher education and the communities in which they operate. This qualitative study aimed to examine how professional and community engagement is understood and incorporated into the role of staff members within the School of Health Sciences of one university. Twenty-one academic and professional staff were interviewed. Participants identified a range of definitions for both 'community' and 'professional' engagement, as well as the benefits and limitations of such engagement. Ability to conduct engagement was limited by time capacity when competing with other role requirements. Integration of community engagement with research and teaching requires development of a framework that addresses both the common barriers and facilitators to engagement.
Background: Hearing impairment is prevalent in older adults. Motivation is important in people's choice to seek help for their hearing and whether to adopt or not adopt hearing aids.Purpose: To investigate associations between sociodemographic and audiometric characteristics and autonomous and controlled motivation among a sample of hearing help-seekers..Research Design: A quantitative approach was taken for this cross-sectional cohort study.Study Sample: A total of 253 adult first-time hearing help-seekers were recruited to the study.Data Collection and Analysis: Participants provided sociodemographic information and completed questionnaires adapted from self-determination theory that measured autonomous motivation (motivation that originates from within the self and is aligned with personal values and beliefs) and controlled motivation (motivation that stems from external pressures such as rewards or punishment, or conflicted inner feelings such as guilt or shame).Results: Participants with higher autonomous motivation scores were younger, wanted hearing aids more, and reported greater hearing difficulty in everyday life than those with lower scores. Participants with higher controlled motivation scores were more often referred to the service by others and wanted hearing aids more than those with lower controlled motivation scores. Controlled motivation scores were not associated with perceptions of hearing difficulty in everyday life.Conclusion: Relationships among motivation and sociodemographic factors highlight the importance of characterizing autonomous and controlled motivation in first-time hearing help-seekers. Attention to personal characteristics in order to understand motivational processes involved in rehabilitation decisions such as hearing aid adoption may aid in consultations.