How Can eHealth Meet the Hearing and Communication Needs of Adults With Hearing Impairment and their Significant Others? A Group Concept Mapping Study

Abstract

Objectives: To seek the perspectives of key stakeholders regarding: (1) how eHealth could help meet the hearing and communication needs of adults with hearing impairment and their significant others; and (2) how helpful each aspect of eHealth would be to key stakeholders personally. Design: Group concept mapping, a mixed-methods participatory research method, was used to seek the perspectives of key stakeholders: adults with hearing impairment (n = 39), significant others (n = 28), and hearing care professionals (n = 56). All participants completed a short online survey before completing one or more of the following activities: brainstorming, sorting, and rating. Brainstorming required participants to generate ideas in response to the focus prompt, “One way I would like to use information and communication technologies to address the hearing and communication needs of adults with hearing loss and their family and friends is to….” The sorting task required participants to sort all statements into groups that made sense to them. Finally, the rating task required participants to rate each of the statements according to “How helpful would this idea be to you?” using a 5-point Likert scale. Hierarchical cluster analysis was applied to the “sorting” data to develop a cluster map using the Concept Systems software. The “rating” data were subsequently analyzed at a cluster level and an individual-item level using descriptive statistics. Differences in cluster ratings between stakeholder groups were examined using Kruskal-Wallis tests. Results: Overall, 123 statements were generated by participants in response to the focus prompt and were included in subsequent analyses. Based on the “sorting” data and hierarchical cluster analysis, a seven-cluster map was deemed to be the best representation of the data. Three key themes emerged from the data, including using eHealth to (1) Educate and Involve Others; (2) Support Aural Rehabilitation; and (3) Educate About and Demonstrate the Impacts of Hearing Impairment and Benefits of Hearing Rehabilitation. Overall median rating scores for each cluster ranged from 3.97 (educate and involve significant others) to 3.44 (empower adults with hearing impairment to manage their hearing impairment from home). Conclusions: These research findings demonstrate the broad range of clinical applications of eHealth that have the capacity to support the implementation of patient- and family-centered hearing care, with self-directed educational tools and resources typically being rated as most helpful. Therefore, eHealth appears to be a viable option for enabling a more biopsychosocial approach to hearing healthcare and educating and involving significant others in the hearing rehabilitation process without adding more pressure on clinical time. More research is needed to inform the subsequent development of eHealth interventions, and it is recommended that health behavior change theory be adhered to for such interventions.

Is Teleaudiology Achieving Person-Centered Care: A Review

“…Data were extracted from seven studies: five research studies [ 31 , 32 , 33 , 34 , 35 ], one review [ 36 ] and one case study [ 37 ]. The identified studies ranged from 2010 to April 2022, with one per year from 2019 to 2022, when the COVID-19 pandemic began, forcing many audiology clinicians to adopt or consider accepting teleaudiology as part of their potential clinic service offerings [ 32 ].…”

“…Meyer et al provided the greatest detail regarding the tasks for which teleaudiology could be used, and this information was collected from people with hearing impairment and their significant others, and as such this paper may be the most representative of actual teleaudiology use [ 34 ]. There was evidence of all degrees of autonomy being used across the papers [ 31 , 32 , 33 , 34 , 35 , 36 , 37 ], which provided a balance in how much control the person with hearing impairment can be given, but the phases of intervention in which teleaudiology were used were heavily concentrated in the rehabilitation [ 32 , 33 , 34 , 35 , 36 , 37 ] and general phases [ 33 , 34 , 35 , 36 ] ( Table 4 ).…”

“…Autonomy, defined as “the feeling self-directed” p.8., is the first guiding principle suggested by Yardley et al for person-centered application of digital health in behavior-change-dependent intervention [ 26 ]. Analysis revealed ten instances of self-directed use of teleaudiology, referred to here as self-led use, across five studies [ 33 , 34 , 35 , 36 ]. According to the descriptions used by Eikelboom et al in reporting on teleaudiology practices, the degree of autonomy was better represented as a spectrum ranging from self-led to clinician-led [ 29 ].…”

“…According to the descriptions used by Eikelboom et al in reporting on teleaudiology practices, the degree of autonomy was better represented as a spectrum ranging from self-led to clinician-led [ 29 ]. Despite self-assessment or self-fit or programming of hearing aids being well established in audiological care [ 5 ], there was only one mention of autonomy for the immediate intervention tasks described, and it focused on describing what those with hearing impairment and their support network would like [ 35 ]. Taken together, this highlights a gap between methods that have been rigorously validated for common use [ 29 ], and yet still evade being common practice [ 32 ].…”

“…However, it is worth noting that some autonomy for the person and their family was still clearly noted by Behl et al [ 37 ]. More than half of the studies described the provision of information in a self-led format [ 33 , 34 , 35 , 36 ].…”