A cross-sectional survey of non-specialist Australian audio-vestibular clinical practice for traumatic brain injury and rehabilitation

Abstract

Objective: This study explored non-specialist audiological clinical practice in the context of traumatic brain injury (TBI), and whether such practices incorporated considerations of TBI-related complexities pertaining to identification, diagnosis and management of associated auditory and vestibular disturbances. Design: A cross-sectional online survey exploring clinical practice, TBI-related training and information provision was distributed to audiologists across Australia via Audiology Australia and social media. Fifty audiologists, 80% female and 20% male, participated in this study. Years of professional practice ranged from new graduate to more than 20 years of experience. Results: Clear gaps of accuracy in knowledge and practice across all survey domains relating to the identification, diagnosis and management of patients with auditory and/or vestibular deficits following TBI were evident. Further, of the surveyed audiologists working in auditory and vestibular settings, 91% and 86%, respectively, reported not receiving professional development for the diagnosis and management of post-traumatic audio-vestibular deficits. Conclusion: Inadequate resources, equipment availability and TBI-related training may have contributed to the gaps in service provision, influencing audiological management of patients with TBI. A tailored TBI approach to identification, diagnosis and management of post-traumatic auditory and vestibular disturbances is needed.

Clinical experiences, current approaches, opinions and awareness of healthcare professionals regarding the audio-vestibular consequences of individuals with traumatic brain injury: a cross-sectional online survey study

“…Finally, consistent with the studies in the literature, 15 22 several HCPs reported that patients with TBI with audio-vestibular complaints had the most vehicle-related collision aetiology. However, this was not universal and likely reflects the fact that audio-vestibular complaints are a common consequence of a wide variety of TBI aetiologies.…”

“…Furthermore, the inclusion of HCPs such as physiotherapists working in the field of balance may have influenced the results, in particular the confidence in vestibular assessments. Finally, we wanted to understand the experience of HCPs who specialise in TBI, therefore we did not include audiologists and/or ENT specialists in this survey and as such we do not know their experiences with this patient population, except for the findings from the Australia survey 15 which indicate similar experiences to our findings here. Future research should consider further investigation into the experiences of audiologists/ENT specialists in relation to this patient population, in particular the assessments that should be carried out.…”

“…Interestingly, a recent Australian study 15 also showed that audiologists lacked knowledge about the assessment and management of audio-vestibular impairments of patients with TBI in audiological services. While there can be variation in understanding of audio-vestibular consequences of TBI across clinical services and/or centres around the world, this study demonstrated a similar lack of awareness regarding the audio-vestibular consequences of patients with TBI in non-audiology HCPs.…”

“…A recent survey on audio-vestibular clinical practice within Australian audiology departments found gaps in audiologist knowledge and inadequate resources and practice regarding the identification, diagnosis and management of patients with auditory and/or vestibular deficits following TBI. 15 However, as yet, the clinical experiences, current approaches, opinions and awareness of HCPs who specialise in managing patients with TBI have not been fully investigated. It is therefore important to understand the experiences of these HCPs in particular to understand their awareness and knowledge of the audio-vestibular consequences of TBIs, in order to understand and identify areas that could be improved in existing practices.…”