Una causa inusual de dolor lumbar en paciente con sepsis / An unusual cause of low back pain in a patient with sepsis

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Explicaciones al no uso de audífonos en un grupo de adultos mayores de Santiago de Chile. Un estudio cualitativo / Explanations for the non-use of hearing aids in a group of older adults. A qualitative study

Introducción: La hipoacusia es un trastorno que afecta a la comunicación e inserción social, aumentando su frecuencia a mayor edad. Las garantías explícitas en salud (GES) han ubicado a la hipoacusia del adulto mayor de 65 años como una prioridad sanitaria en Chile, garantizándoles la entrega de audífonos a aquellos que lo requieren. Sin embargo, se ha visto que la adherencia a su uso se ve mermada por diversas razones. Métodos: Estudio cualitativo para conocer los elementos relacionados a la adherencia del uso de audífonos. Se realizó entrevistas individuales y grupos focales desde junio a septiembre de 2012, en un Servicio de Otorrinolaringología de un hospital en Santiago, Chile. Resultados: Para los pacientes, el uso de audífonos ha resultado positivo, percibiendo una mejoría en su relación con el entorno, siendo relevantes la severidad de la hipoacusia y la vida social del mismo. Para los otorrinolaringólogos y los fonoaudiólogos destaca la baja percepción de necesidad de ayuda auditiva por parte de los pacientes. Se genera una discordancia entre expectativas y realidad de adaptación del paciente. Además se identifica como factor relevante la falta de un programa de rehabilitación. Conclusiones: Los elementos que influyen en la adherencia se asocian a 3 grupos: factores de los usuarios, factores audiológicos y factores dependientes del programa de salud. Los más relevantes desde la perspectiva de usuarios serían, el miedo a la incorrecta manipulación; desde los otorrinolaringólogos, la percepción sociocultural del usuario de audífono como discapacitado, y desde los fonoaudiólogos, la inadecuada adaptación protésica y la falta de un programa de rehabilitación adecuado (AU)

Introduction: Hearing loss is a condition that affects communication and social insertion, increasing in frequency with increasing age. Explicit Health Guarantees (GES) have placed hearing loss in adults over the age of 65 years as a health priority in Chile, guaranteeing access to hearing aids to those who need it. However, it has been seen that adherence to their use is hampered by several factors. Methodology: This was a qualitative study to find items related to the adherence to use of hearing aids. We performed individual and focus group interviews in the Department of Otolaryngology at a hospital in Santiago (Chile) from June to September 2012. Results: Using hearing aids was positive for patients, perceiving an improvement in their relationship with the environment. The severity of hearing loss and the patient's own social life was relevant. For otolaryngologists and audiologists the study highlights the low patient perception of the need for hearing help. Discordance between expectations and the reality of patient adaptation is generated. Another relevant factor identified was the lack of a rehabilitation programme. Conclusions: The elements that influence adherence are associated with 3 groups: patient factors, audiological factors and factors dependent on the health programme. The most important, from the perspective of patients, would be the fear of improper handling; for otolaryngologists, the socio-cultural perception of the hearing aid user as a disabled individual; for audiologists, inadequate prosthetic fitting and the lack of an appropriate rehabilitation programme (AU)

[Explanations for the non-use of hearing aids in a group of older adults. A qualitative study]. / Explicaciones al no uso de audífonos en un grupo de adultos mayores de Santiago de Chile. Un estudio cualitativo.

INTRODUCTION: Hearing loss is a condition that affects communication and social insertion, increasing in frequency with increasing age. Explicit Health Guarantees (GES) have placed hearing loss in adults over 65 years old as a health priority in Chile, guaranteeing access to hearing aids to those who need it. However, it has been seen that adherence to their use is hampered by several factors. METHODS: This was a qualitative study to find items related to the adherence to use of hearing aids. We performed individual and focus group interviews in the Department of Otolaryngology at a hospital in Santiago (Chile) from June to September 2012. RESULTS: Using hearing aids was positive for patients, perceiving an improvement in their relationship with the environment. The severity of hearing loss and the patient's own social life was relevant. For otolaryngologists and audiologists the study highlights the low patient perception of the need for hearing help. Discordance between expectations and the reality of patient adaptation is generated. Another relevant factor identified was the lack of a rehabilitation programme. CONCLUSIONS: The elements that influence adherence are associated with 3 groups: patient factors, audiological factors and factors dependent on the health programme. The most important, from the perspective of patients, would be the fear of improper handling; for otolaryngologists, the socio-cultural perception of the hearing aid user as a disabled individual; for audiologists, inadequate prosthetic fitting and the lack of an appropriate rehabilitation program.