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

Abstract

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.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.A literature review was conducted.The review included eight empirical studies.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.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).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.

How do patients decide on interventions for single sided deafness? A qualitative investigation of patient views

“…The understanding of patient's needs beyond the traditional objective focus of the bio-medical model is often lacking in clinical encounters (Walseth and Schei 2011;Meyer, Hickson, Lovelock, et al 2014). This lack of holistic engagement has been reported previously, whereby audiologists dominate clinical conversations and often do not fully engage with patient concerns and preferences to facilitate shared decision-making (Dillon and Pryce 2020;Manchaiah et al 2019).…”

“…Previous studies indicate that audiologists have a powerful position as an expert within consultations, in keeping with the biomedical model (Southall, Gagn e, and Jennings 2010;Pryce, Hall, and Marks et al 2018). Audiologists dominate clinical conversations and often do not fully engage with patient concerns and preferences to facilitate shared decision-making, especially as technical and complex language is a barrier to patient understanding (Manchaiah et al 2019). This previous research supports the findings from this study, demonstrating that participants with SSD need good access to information, as this influences their decision-making, alongside reduction of barriers to understanding through simple language.…”

The experience of speech–language therapists and audiologists when delivering bad news: A qualitative analysis

“…The authors observed a substantial amount of mitigative, vague and exaggerated language in these interactions and stress the need for training in such situations (Watermeyer et al 2020). In the same vein, a literature review of studies focusing on communication between audiologists and patients shows that audiologists did not take advantage of the opportunity to develop patient-centred communication and shared decision-making with clients (Manchaiah et al 2019).…”

“…In the same vein, a literature review of studies focusing on communication between audiologists and patients shows that audiologists did not take advantage of the opportunity to develop patient‐centred communication and shared decision‐making with clients (Manchaiah et al . 2019).…”

Audiologic Assessment

“…Throughout the process of obtaining a case history, clinicians can build significant rapport with their patients and begin to determine the specific hearing needs of their patients. 1 In addition, this initial interaction can foster trust between the clinician and the patient. This can enhance patient care and result in improved outcomes because the patient's thoughts and opinions are valued, and the patient sees engagement from the clinician, which increases their feeling of being valued.…”