Quality and readability of English-language internet information for aphasia.

PURPOSE: Little is known about the quality and readability of treatment information in specific neurogenic disorders, such as aphasia. The purpose of this study was to assess quality and readability of English-language Internet information available for aphasia treatment. METHOD: Forty-three aphasia treatment websites were aggregated using five different country-specific search engines. Websites were then analysed using quality and readability assessments. Statistical calculations were employed to examine website ratings, differences between website origin and quality and readability scores, and correlations between readability instruments. RESULT: Websites exhibited low quality with few websites obtaining Health On the Net (HON) certification or clear, thorough information as measured by the DISCERN. Regardless of website origin, readability scores were also poor. Approximate educational levels required to comprehend information on aphasia treatment websites ranged from 13 to 16 years of education. Significant differences were found between website origin and readability measures with higher levels of education required to understand information on websites of non-profit organisations. CONCLUSION: Current aphasia treatment websites were found to exhibit low levels of quality and readability, creating potential accessibility problems for people with aphasia and significant others. Websites including treatment information for aphasia must be improved in order to increase greater information accessibility.

Quality and Readability of English-Language Internet Information for Tinnitus.

BACKGROUND: Because of the wealth of information available on the internet and increasing numbers of individuals relying on websites as a primary source of information for health-related questions, it is important that the readability of their content is within the comprehension level of most readers. OBJECTIVE: The study evaluated the quality and readability of English-language Internet information for tinnitus. RESEARCH DESIGN: Analysis of Internet websites on tinnitus. STUDY SAMPLE: A total of 134 websites with tinnitus information. DATA COLLECTION AND ANALYSIS: Three key words (i.e., tinnitus, ringing in the ear, and buzzing in the ear) were entered in five country-specific versions of the most commonly used internet search engine in August 2016. For each of the 15 searches, the first 20 relevant websites were examined. After removing duplicates, a total of 134 websites were assessed. Their origin (commercial, nonprofit organization, government, personal, or university), quality (Health On the Net [HON] certification and DISCERN scores), and readability (Flesch Reading Ease score, Flesch-Kincaid Reading Grade Level Formula, and Simple Measure of Gobbledygook) were assessed. RESULTS: Most websites were of commercial (49.3%) or nonprofit organization (38.8%) origin. Their quality and readability was highly variable. Only 13.5% of websites had HON certification. χ² analysis showed that there was significant association between website origin and HON certification [χ²(4) = 132.9, p < 0.0001]. The mean DISCERN scores were 2.39. No association between DISCERN scores and website origin was found. Readability measures showed that on average, only people with at least 10-12 yr of education could read and understand the internet information for tinnitus in websites. Almost all the websites exceeded the most stringent reading level recommended for health information. CONCLUSIONS: The results highlight great variability in the quality and readability of health information, specifically for tinnitus in the internet. These findings underscores the need for stakeholders (e.g., web-developers, clinicians) to be aware of this and to develop more user-friendly health information on websites to make it more accessible for people with low literacy.

Communication between Audiologist, Patient, and Patient's Family Members during Initial Audiology Consultation and Rehabilitation Planning Sessions: A Descriptive Review.

BACKGROUND: Communication during clinical consultations is an important factor that facilitates decision-making by patients and family members. For clinicians, these interactions are opportunities to build rapport and to facilitate appropriate decision-making. PURPOSE: This article presents the literature review of studies focusing on communication between audiologist, patients, and their family members during initial audiology consultations and rehabilitation planning sessions. RESEARCH DESIGN: A literature review was conducted. STUDY SAMPLE: The review included eight empirical studies. DATA COLLECTION AND ANALYSIS: A systematic search of the CINAHL Complete, MEDLINE, and PsychInfo databases was used to identify relevant articles for review. Quality of the included studies was assessed using the Rating of Qualitative Research (RQR) scale. RESULTS: The average consultation length was 57.4 min (ranged 27.3-111 min), in which the mean length of case history discussion was 8.8 min (ranged 1.7-22.6 min) and the mean length of diagnosis and management planning was 29 min (ranged 2.2-78.5 min). Utterances spoken by audiologists were greater (about 51%) than patients (37%), whereas family members spoke the fewest utterances (12%) during interactions. Patients raised concerns (typically psychological in nature with negative emotional stance) about hearing aids in half of the appointments where hearing aids were recommended as the rehabilitation option. However, audiologists missed opportunities to build relationships as these concerns of patients were not typically addressed. Also, audiologists' language was associated with hearing aid uptake (i.e., patients were less likely to uptake hearing aids when audiologists used complex language). CONCLUSIONS: The review highlights that audiologists dominate the conversation during audiology consultations and rehabilitation planning sessions. Audiologists did not take advantage of the opportunity to develop patient-centered communication and shared decision-making. Implications of these findings to both clinical practice and to audiology education and training are discussed.

Noncongruence between Audiologist and Patient Preferences for Patient-Centeredness.

BACKGROUND: Trends in preferences of both healthcare providers and patients to patient-centeredness have been emphasized in research. However, an understanding of the nature of preferences to patient-centeredness within the context of the audiologist-patient relationship is needed. PURPOSE: The purpose of this study is to explore the congruence between audiologist and patient preferences for patient-centeredness. RESEARCH DESIGN: A cross-sectional survey design was used to gather data from audiologists and patients with hearing loss. STUDY SAMPLE: Participants included 75 audiologists and 105 consecutive patients with hearing loss. DATA COLLECTION AND ANALYSIS: Participants completed the modified Patient-Practitioner Orientation Scale (PPOS) and provided selected demographic information. Data were analyzed using an independent sample t test to evaluate the differences between audiologist and patient congruence. Regression analysis was performed to evaluate factors contributing to preferences for patient-centeredness. RESULTS: Patients had significantly lower scores in PPOS full scale when compared to the audiologists [t(170) = 0.78; p ≤ 0.001] with a very large effect size (Cohen's d = 1.43). Patients also had significantly lower scores when compared to the audiologists on both the sharing [t(170) = 1.01; p ≤ 0.001] and caring [t(170) = 0.56; p ≤ 0.001] subscales. Statistically significant lower scores were noted for patients when compared to audiologists on 12 items on the PPOS. No relationship between any demographic factors and preferences for patient-centeredness were found. CONCLUSIONS: The current study results indicated noncongruence in preferences for patient-centeredness among audiologists and patients with hearing loss. Results point toward the need for more research considering the nature and impact of patient-centered audiology practice.

Examination of an Audiologist's Response to Patient's Expression of Symptoms: A Pilot Study.

This pilot study explores audiologist-patient interactions during initial evaluations or consultations. In particular, an audiologist's response to patient symptoms is examined. Conversations between audiologist and patients were recorded using a digital recorder, which were transcribed, and analyzed using the Codes for Human Analysis of Transcripts and Child Language Analysis computer programs. Mean length of turn and frequency of utterances related to explicit discussion or description of symptoms or the patient's interpretation of symptoms was determined. STUDY SAMPLE: six audiologist-patient interactions were recorded and transcribed. A single audiologist was used for this pilot investigation. Results suggest that during the initial audiological consultations related to hearing difficulties the audiologist produced more utterances related to explicit description of the symptoms, whereas when during the sessions about complex disorder and hearing aid consultation the audiologist produced more utterances related to the patient's interpretation of the symptoms. Also, a more equitable distribution of words and utterances per turn are observed during the initial consultation about hearing difficulties when compared to complex disorders and hearing aid consultation sessions where the audiologist was dominant within the interaction. This preliminary study reveals unique insights to audiologist's communication behavior during audiology consultation session. Efforts are needed to educate and promote appropriate communication between audiologists' and patients, which could result in increased patient satisfaction.

Speech-language pathologists' preferences for patient-centeredness.

PURPOSE: Preferences for patient-centeredness is an important indicator in healthcare service delivery. However, it remains largely unexplored in the field of communication science and disorders. This study investigated speech-language pathologists' (SLPs) preferences for patient-centeredness METHOD: The study involved a cross-sectional survey design. SLPs (n = 102) fully completed the modified Patient-Practitioner Orientation Scale (PPOS; Krupat et al, 2000) and also provided demographic details. Data were analyzed using descriptive statistics, correlation, and linear regression methods. RESULTS: Mean PPOS scores indicated that SLPs value patient-centeredness. There was a strong positive correlation among sharing and caring subscales with the full-scale. Results from the linear regression modeling suggested no relationship between demographic factors and preferences for patient-centeredness. CONCLUSIONS: SLPs value patient-centeredness, although there may be regional and cultural variations. Qualitative investigations may help uncover dimensions of patient-centeredness that were not captured in the PPOS scale. In addition, further research should explore congruence in preferences for patient-centeredness among SLPs and patients.

Applications of direct-to-consumer hearing devices for adults with hearing loss: a review.

BACKGROUND: This systematic literature review is aimed at investigating applications of direct-to-consumer hearing devices for adults with hearing loss. This review discusses three categories of direct-to-consumer hearing devices: 1) personal sound amplification products (PSAPs), 2) direct-mail hearing aids, and 3) over-the-counter (OTC) hearing aids. METHOD: A literature review was conducted using EBSCOhost and included the databases CINAHL, MEDLINE, and PsycINFO. After applying prior agreed inclusion and exclusion criteria, 13 reports were included in the review. RESULTS: Included studies fell into three domains: 1) electroacoustic characteristics, 2) consumer surveys, and 3) outcome evaluations. Electroacoustic characteristics of these devices vary significantly with some meeting the stringent acoustic criteria used for hearing aids, while others producing dangerous output levels (ie, over 120-dB sound pressure level). Low-end (or low-cost) devices were typically poor in acoustic quality and did not meet gain levels necessary for most adult and elderly hearing loss patterns (eg, presbycusis), especially in high frequencies. Despite direct-mail hearing aids and PSAPs being associated with lower satisfaction when compared to hearing aids purchased through hearing health care professionals, consumer surveys suggest that 5%-19% of people with hearing loss purchase hearing aids through direct-mail or online. Studies on outcome evaluation suggest positive outcomes of OTC devices in the elderly population. Of note, OTC outcomes appear better when a hearing health care professional supports these users. CONCLUSION: While some direct-to-consumer hearing devices have the capability to produce adverse effects due to production of dangerously high sound levels and internal noise, the existing literature suggests that there are potential benefits of these devices. Research of direct-to-consumer hearing devices is limited, and current published studies are of weak quality. Much effort is needed to understand the benefits and limitations of such devices on people with hearing loss.

Preference to Patient-Centeredness in Undergraduate Audiology Students in Portugal.

BACKGROUND: In health care, the model of patient-centered care is growing; and improved outcomes have been linked to patient-centeredness. Practicing audiologists have been found to strongly prefer a patient-centered approach as years in practice increase. It is unknown whether patient-centeredness begins during education and training. PURPOSE: The current study was aimed at understanding the preference to patient-centeredness in undergraduate audiology students in Portugal. RESEARCH DESIGN: The study used a cross-sectional survey design. STUDY SAMPLE: One hundred and thirty-seven undergraduate audiology students completed patient-practitioner orientation scale (PPOS) and provided some demographic details. DATA COLLECTION AND ANALYSIS: The data were analyzed using one-way analysis of variance and one-sample t tests. RESULTS: A significant difference was found for sharing subscale (p ≤ 0.001), caring subscale (p = 0.033), and the PPOS full scale (p ≤ 0.001) among different undergraduate groups. Further, post hoc tests showed that the difference between year 1 and with years 2, 3, and 4 were significant for sharing subscale and PPOS full scale, but not for caring subscale. No significant differences were observed among the years 2, 3, and 4 for sharing subscale, caring subscale, and for PPOS full scale. When compared audiologists' preferences from a previous study on audiologists with students' preferences in the current study, significant difference for both subscales and full scale was found between year 1 students and audiologists (p ≤ 0.001), with higher preference to patient-centeredness was reported by qualified audiologists. Also, significant difference was found between audiologists and overall undergraduate group for caring subscale (p = 0.001). CONCLUSIONS: The current study suggests that audiology education influences preference to patient-centeredness. Within a year of undergraduate coursework, students tend to develop high preference to patient-centeredness, which stays stable during four years of undergraduate studies. These results provide useful insights to audiology education and training, particularly in the context of audiological rehabilitation.

Preferences to Patient-Centeredness in Pre-Service Speech and Hearing Sciences Students: A Cross-Sectional Study.

BACKGROUND AND OBJECTIVES: Patient-centeredness is a critical approach to rehabilitation in allied health professions and is an imperative component of evidence-based practice. However, it is unknown if patient-centeredness is valued by students enrolled in allied health. This study was aimed at determining preferences to patient-centeredness in pre-service speech and hearing students in the field of speech and hearing sciences. SUBJECTS AND METHODS: Pre-service speech and hearing students (n=93) completed the Patient-Practitioner Orientation Scale (PPOS) and were grouped according to low, medium, or high exposure to curriculum content. RESULTS: Across exposure levels, students exhibited high preference to patient centeredness with a mean PPOS score of 4.13 (standard deviation-0.5). A pairedsample t-test revealed a significant difference (p≤0.0001) between the caring and sharing subscales of the PPOS with lower mean scores on the caring subscale. No significant differences were noted across levels of exposure for sharing subscale, caring subscale, or PPOS full-scale. CONCLUSIONS: Results suggest a need for curriculum enhancement focused on improved caring and empathy.