Pilot evaluation of a protocol and a clinical tool developed to assess the audiological needs of adults with hearing loss.

OBJECTIVE: To evaluate the Québec Audiological Assessment Protocol for Younger and Older Adults (QAAP-YOA) and its accompanying clinical tool efficacy to assess the needs of individuals with hearing loss in a simulated context. This study is the Phase 2 in the development of the QAAP-YOA. DESIGN: Participants completed two needs assessments with simulated clients and wrote audiological reports, while applying the QAAP-YOA with and without the use of its clinical tool. Interviews were filmed, and reports collected. Both were scored by two independent evaluators. A qualitative analysis of reports was also conducted. STUDY SAMPLE: Eleven audiology students and four early-career audiologists (n = 15). RESULTS: The clinical tool did not influence the interview process since both experimental conditions had similar compliance rates to the protocol (p = 0.114). Compliance rates for assessment reports were higher with the clinical tool (p < 0.001). Participants' conclusions after applying the QAAP-YOA were consistent across participants. The information provided in the reports was more comprehensive and coherent with the client's needs when participants used the clinical tool. CONCLUSIONS: The QAAP-YOA can lead to a greater standardisation of needs assessments and to more comprehensive reports, which may lead to intervention programs more closely aligned with clients' needs.

Communication during the COVID-19 pandemic: the hearing-impaired perspective.

OBJECTIVE: To understand the communicational and psychosocial effects of COVID-19 protective measures in real-life everyday communication settings. DESIGN: An online survey consisting of close-set and open-ended questions aimed to describe the communication difficulties experienced in different communication activities (in-person and telecommunication) during the COVID-19 pandemic. STUDY SAMPLE: 172 individuals with hearing loss and 130 who reported not having a hearing loss completed the study. They were recruited through social media, private audiology clinics, hospitals and monthly newsletters sent by the non-profit organisation "Audition Quebec." RESULTS: Face masks were the most problematic protective measure for communication in 75-90% of participants. For all in-person communication activities, participants with hearing loss reported significantly more impact on communication than participants with normal hearing. They also exhibited more activity limitations and negative emotions associated with communication difficulties. CONCLUSION: These results suggest that, in times of pandemic, individuals with hearing loss are more likely to exhibit communication breakdowns in their everyday activities. This may lead to social isolation and have a deleterious effect on their mental health. When interacting with individuals with hearing loss, communication strategies to optimise speech understanding should be used.

Development of a protocol and a clinical tool to assess the audiological needs of younger and older adults with hearing loss.

OBJECTIVE: To develop a protocol and a clinical tool to assess the audiological needs of younger and older adults with hearing loss. DESIGN: A needs assessment protocol was developed based on recommendations of an expert panel, existing literature, the International Classification of Functioning, Disability and Health, client-centered care and goal setting. The protocol was reviewed by the expert panel. Semi-structured interviews were conducted with clinical audiologists to validate its content and explore its clinical applicability. A clinical tool was developed to make the administration of the protocol more uniform. STUDY SAMPLE: 15 experts and 14 clinical audiologists. RESULTS: Feedback received from the participants (experts and clinicians) supported the content validity of the needs assessment protocol and clinical tool. The topics covered within the protocol and tool include: Audiological needs (activity limitations, participation restrictions, environmental factors), Living conditions (social networks, living environment), Personal factors, Discussion with the client to define the intervention plan, and Recommendations. CONCLUSIONS: A protocol and a clinical tool were developed to help audiologists and clients undertake a comprehensive audiological needs assessment. The content validity of the protocol and tool were demonstrated. Their use can facilitate the delivery of a client-centered assessment using a uniform and comprehensive approach.

The Role and Relevance of Hearing Dogs from the Owner's Perspective: An Explorative Study among Adults with Hearing Loss.

This study aimed to explore perceptions and experiences about how owning a hearing dog can influence the functioning and the autonomy of people with hearing loss. Three adults participated in a semi-structured interview. The interviews were video recorded, transcribed, and coded. A procedure combining qualitative content analysis and interpretative phenomenological analysis was used. The study shows how specific aspects of hearing dogs are associated with increased autonomy and sense of security among owners. The attentive dog-owner pairing, the outstanding training and the companion role of the hearing dog are the main elements supporting the high satisfaction related by all the participants. In regard of the location context (Quebec, Canada), ongoing challenges for owners are reflected in the lack of visibility of this rehabilitation means and its poor recognition from the society, resulting in the constant burden to explain the dog's work to others. For adults with hearing loss, the hearing dog is a relevant way of offering both the benefits of functional assistance and the psychosocial support of a pet. The association between owning a hearing dog and improved overall well-being suggests that this form of rehabilitation should be considered as a pertinent option by hearing health professionals.

Perceptions of Adults With Hearing Loss About the Communication Difficulties Generated by the COVID-19 Preventive Measures: A Qualitative Study.

PURPOSE: The COVID-19 pandemic led to the implementation of preventive measures that exacerbated communication difficulties for individuals with hearing loss. This study aims to explore the perception of adults with hearing loss about the communication difficulties caused by the preventive measures and about their experiences with communication 1 year after the adoption of these preventive measures. METHOD: Individual semistructured interviews were conducted via videoconference with six adults who have hearing loss from the province of Québec, Canada. Data were examined using qualitative content analysis. RESULTS: The study found that face masks and in-person work (i.e., in opposition to remote work) were important barriers to communication because of hindered lipreading and competing noise in many workplaces. In contrast, preventive measures that allowed visual information transmission (e.g., transparent face masks, fixed plastic partitions) were considered favorable for communication. Communication partners were perceived as playing an important role in communication success with preventive measures: Familiar communication partners improved communication, whereas those with poor attitude or strategies hindered communication. Participants found that videoconferences could provide satisfactory communication but were sometimes hindered by issues such as bad audiovisual quality or too many participants. CONCLUSIONS: This study identified reduced access to speech reading and lack of general awareness about hearing issues as key barriers to communication during the pandemic. The decreased communication capabilities were perceived to be most problematic at work and during health appointments, and tended to cause frustration, anxiety, self-esteem issues, and social isolation. Suggestions are outlined for current and future public health measures to better consider the experience of people with hearing loss.

Impacts and Identification of Hearing Aid Refurbishing Programs for People with Hearing Loss: A Scoping Review.

This article consists of a scoping review completed to describe the impacts of refurbished hearing aids (HAs) for people with hearing loss, and to identify existing HA refurbishing programs around the world. In this review, JBI methodological guidance for scoping reviews was followed. All types of sources of evidence were considered. Thirty-six sources of evidence were included, 11 articles and 25 web pages. Results suggest that refurbished HAs may improve communication and social participation for individuals with hearing loss and provide monetary savings to them and to governmental agencies. Twenty-five HA refurbishing programs were identified, all based in developed countries and distributing refurbished HAs mostly locally, but also in developing countries. Issues related to refurbished HAs were highlighted, such as potential cross-contamination, quick obsolescence, and repairing problems. Some facilitators for the success of this intervention are to offer accessible and affordable follow-up services, repairs, and batteries, and to ensure awareness and participation of hearing healthcare professionals and citizens with hearing loss. In conclusion, the use of refurbished HAs appears to be a valuable option for low-income people with hearing loss, but it should be included in a more global intervention program to ensure its sustainability.

Communication With Older Adults in Times of a Pandemic: Practical Suggestions for the Health Care Professionals.

In order to limit the spread of the coronavirus, several protective measures have been put in place in the community, in private and public residences and in health care centers. Some measures have a negative impact on communication. They include physical distancing, the use of face masks and shields as well as the increased use of telephone and videoconferencing for distance communication. The effects of COVID-19 are particularly harsh on older adults. Consequently, older adults, especially those with hearing loss, are particularly at risk of experiencing communication breakdowns and increased social isolation. Health care professionals should learn about and be encouraged to use communication strategies to maintain good interactions with their patients. This article proposes practical suggestions to health professionals who interact with older adults, especially those who have difficulty understanding speech. The goal of this article is to inform on the prevalence of hearing loss, the hearing difficulties experienced by older adults, the manifestations of hearing problems, the effects of pandemic protection measures on communication and the strategies that can be used to optimize professional-patient communication during a pandemic.

Impact of COVID-19 on people with physical disabilities: A rapid review.

BACKGROUND: The COVID-19 pandemic caused drastic changes in the lives of the general population. People with physical disabilities, who commonly encounter daily challenges such as barriers to community mobility, reduced access to healthcare services and higher risk of suffering from depression, may face additional challenges in the context of the pandemic. OBJECTIVE: This study aims to review the impact of the COVID-19 pandemic, and associated isolation and protective measures, among people with physical disabilities. METHODS: A rapid review of the published literature was conducted on August 10, 2020 through a search in six online databases to synthesize results from original studies regarding the impact of the COVID-19 pandemic on people with physical disabilities. The International Classification of Functioning, Disability and Health was used to describe the population and the personal and environmental factors with a unified and standard health language. RESULTS: Eleven records were extracted from 1621 individual papers retrieved from the search strategy. Various impacts on daily functioning such as a decrease in access to healthcare have been noted during the pandemic. Changes in social and lifestyle habits, mood changes and decreased levels of physical activity were also noted. CONCLUSIONS: Our results highlighted the lack of early research about the impacts of COVID-19 experienced by people with physical disabilities. Future studies should focus on specific consequences and needs of this vulnerable population to ensure their inclusion in public health recommendations and consideration by policy makers.

Message transmission efficiency through five telecommunication technologies for signing deaf users.

This cross-sectional research design compares the efficiency of videoconferencing in distance communication for signing deaf persons with that of teletypewriter (TTY)-based telecommunication for the deaf. The efficiency of message transmission was evaluated among 30 signing deaf persons (18 to 65 years) under the six following experimental conditions: (a) Omnitor Allan eC software, (b) Polycom ViaVideo II software, (c) Microsoft Windows Live Messenger software, (d) the D-Link videophone, (e) TTY (written French), and (f) face to face (reference standard). Three timed intelligibility tests and a satisfaction assessment were carried out for each of the experimental conditions. Results showed that videoconferencing technologies offer a better efficacy/time ratio for communication than does TTY. Communication using videoconferencing technologies was very similar to face-to-face communication; this was also true for technologies that are not designed specifically for the deaf population. Equivalent satisfaction levels were observed between TTY and videoconferencing technologies. Microsoft Windows Live Messenger was less preferred due to image fluidity issues.

Comparison of eSRTs and comfort levels in users of Digisonic SP cochlear implants.

OBJECTIVE: This project proposes to assess the relation between the electrical stapedius reflex threshold (eSRT) and comfort levels in users of the Digisonic SP cochlear implant. METHODS: Cross-sectional study, where eSRTs are compared to the comfort current levels at 2 weeks and at 1-year post-fitting in a group of 11 adults getting a significant improvement in open set speech recognition from a Digisonic SP cochlear implant. RESULTS: The linear relation between eSRTs and comfort levels results in Pearson correlation coefficients of 0.65 (P < 0.01; at 2 weeks) to 0.60 (P < 0.05; at 1 year). The comfort levels can be predicted from the eSRTs for the Digisonic SP device from the model equation C level = 19.12 + 0.41*eSRT within a clinically acceptable margin of error. DISCUSSION: Reflex thresholds could be obtained in most participants, and in most channels of the Digisonic implant. The equation model appears as a quite reliable predictor of comfort levels for users of this device.