Patient-centred hearing care in Malaysia: what do audiologists prefer and to what extent is it implemented in practice?

Ali, Akmaliza; Meyer, Carly; Hickson, Louise

doi:10.1080/2050571x.2017.1385167

Cited by 9 publications

(6 citation statements)

References 30 publications

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“…Patients often cited a lack of confidence and low health literacy in making health care decisions for themselves; thus, they would rather comply with professional expertise, a finding similar to other Malaysian studies 52,53 . In fact, this finding may be a reflection of Malaysian norms as several other Malaysian studies had demonstrated that patients prefer a passive role in decision making, even though health care providers are increasingly aware of the importance of shared decision making with patients 55,56 . Similar to our findings, studies have also suggested that the fear of not deciding the best choice caused patients to put the full decision‐making responsibility to their health care providers 57 .…”

Section: Discussionsupporting

confidence: 87%

Patient‐centred care in the context of pharmacy consultations: A qualitative study with patients and pharmacists in Malaysia

Shah

Loong

et al. 2020

Evaluation Clinical Practice

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Rationale, aims and objectives: Patient-centred care (PCC) has been increasingly recognized as the standard in current health care, especially when it comes to health communication between patients and health care professionals. The evidence suggests that PCC could potentially improve medication-related outcomes such as medication adherence, disease self-management, and patient-provider relationships. Pharmacists are strategically positioned in the health care system to provide medication management to patients. However, there is a paucity of research regarding PCC in pharmacist-patient consultations. This study aimed to explore the views and experiences of pharmacists and patients on the important aspects of a PCC consultation. Methods: A semistructured interview study was conducted among 17 patients and 18 pharmacists in three tertiary hospitals in Malaysia. All interviews were audiotaped and transcribed verbatim. Themes were developed using a constant comparison approach and thematic analysis. Results: Five main themes emerged from the data, namely, achieving mutual understanding, recognizing individuality, communication style, information giving, and medication decision making. For both pharmacists and patients, a PCC consultation should promote mutual understanding and non-judgmental discussions. Communication was an important element to bridge the gap between patients' and pharmacists' expectations. Patients emphasized the importance of emotional aspects of the consultation, while pharmacists emphasized the importance of evidence-based information to support patient engagement and information needs. Conclusions: Comparison of pharmacists' and patients' views provided insight towards important aspects of PCC in pharmacist-patient consultations. It was suggested that PCC is not a one-sided approach but rather a patient-provider collaboration to optimize the consultation. Further research can be done to improve the integration of PCC in the local health care context, including pharmacist consultations.

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Section: Discussionsupporting

confidence: 87%

Patient‐centred care in the context of pharmacy consultations: A qualitative study with patients and pharmacists in Malaysia

Shah

Loong

et al. 2020

Evaluation Clinical Practice

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“…This finding is consistent with data from semi-structured interviews exploring the nature of audiological management provided to adult patients in Malaysia (Ali, Meyer et al, 2017). Ali and colleagues found that although the audiologists reported providing options to their patients and allowing patients to make choices, the options given were mainly related to device management (e.g.…”

Section: Discussionsupporting

confidence: 76%

“…In Malaysia, an investigation of the attitudes of audiologists and their adult patients towards PCC found both groups had a preference for patient-centred audiological management Ali, Meyer, & Hickson, 2017), a similar result to the Australian findings. A qualitative investigation on the extent of PCC behaviours incorporated in audiological appointments reported by audiologists in Malaysia showed that audiologists prescribed a biomedically-focused management for their patients (Ali, Meyer et al, 2017).…”

Section: Introductionsupporting

confidence: 72%

Evaluation of audiological rehabilitation services for adults with hearing impairment in Malaysia

Ali¹

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The effects of hearing impairment on adult patients and their families have been extensively reported (e.g. communication difficulties, emotional distress and social engagement restrictions, and decreased quality of life). Therefore, audiologists have a responsibility to help patients and their families manage activity limitations and participant restrictions that arise from hearing impairment in the context of the International Classification of Functioning, Disability and Health (ICF). This approach is very much in line with the principles of patient-centred care (PCC) that have been extensively promoted as best practice for the healthcare management of older adults. Despite reports of the benefits of PCC for adult patients in Western countries, including adherence to management plans and reduced recovery time, it is not known whether this approach is incorporated into audiological services for adult patients in Malaysia.The aims of this thesis were to investigate (i) the nature of audiological rehabilitation services for adults with hearing impairment in Malaysia, and (ii) the extent of patient-centredness exhibited by audiologists in Malaysia. To address these aims, a mixed methods approach was used. The quantitative measures were utilised to explore the current practice of audiologists in managing adult patients and to identify the preferences for PCC in audiological management from the perspectives of audiologists and adult patients, while the qualitative measures provided an in-depth view of the implementation of PCC in audiological management. The types of methods utilised were online and paper based surveys, individual semi-structured in-depth interviews, and video observation.Chapter 1 describes Malaysia briefly, with a focus on the field of audiology and the services offered. The ICF framework, which structures this thesis, and the PCC approach, which is the focus of this thesis, is presented in this chapter. Chapter 2 describes the audiological management for adults with hearing impairment and their significant others in the context of the ICF, as recommended by established audiology professional associations. Chapter 2 also includes background on PCC in more detail.Chapter 3 explored the nature of audiological services for adults with hearing impairment in Malaysia, with an emphasis on whether current services addressed patients' overall functioning described in the ICF. In general, the audiologists in Malaysia addressed the hearing impairment and its associated activity limitations and participation restrictions in their ii management of adult patients. However, gaps were identified with there being a strong emphasis on addressing impairment-level impacts. Inadequate infrastructure, resources and facilities in the workplace may have contributed to the gaps in service provision and influenced the current practice of audiological management for patients in Malaysia.Chapter 4 identified the preferences of adult patients for PCC and the level of PCC they received from audiologists. Although the...

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“…55 It is diametrically opposed to a paternalistic, clinician-led style of practice, in which the patient is largely a passive recipient of treatment. Surveys conducted in Australia, 56 Portugal, 57 India, 57 Iran, 57 and Malaysia 58 have revealed that while audiologists express an overall preference for, and theoretical understanding of, patient-centered care, they do not necessarily practice in accordance with this belief. For example, participants in Kelly et al's patient focus groups frequently described clinical encounters in which the audiologist implicitly assumed that they would take up hearing aids, rather than explicitly soliciting their views.…”

Section: How Is Adult Hearing Rehabilitation Currently Delivered?mentioning

confidence: 99%

The Chronic Care Model and Chronic Condition Self-Management: An Introduction for Audiologists

et al. 2019

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Hearing health care is biomedically focused, device-centered, and clinician-led. There is emerging evidence that these characteristics—all of which are hallmarks of a health care system designed to address acute, rather than chronic, conditions—may contribute to low rates of help-seeking and hearing rehabilitation uptake among adults with hearing loss. In this review, we introduce audiologists to the Chronic Care Model, an organizational framework that describes best-practice clinical care for chronic conditions, and suggest that it may be a viable model for hearing health care to adopt. We further introduce the concept of chronic condition self-management, a key component of chronic care that refers to the knowledge and skills patients use to manage the effects of a chronic condition on all aspects of daily life. Drawing on the chronic condition evidence base, we demonstrate a link between the provision of effective self-management support and improved clinical outcomes and discuss validated methods with which clinicians can support the acquisition and application of self-management skills in their patients. We examine the extent to which elements of chronic condition self-management have been integrated into clinical practice in audiology and suggest directions for further research in this area.

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Patient-centred hearing care in Malaysia: what do audiologists prefer and to what extent is it implemented in practice?

Cited by 9 publications

References 30 publications

Patient‐centred care in the context of pharmacy consultations: A qualitative study with patients and pharmacists in Malaysia

Patient‐centred care in the context of pharmacy consultations: A qualitative study with patients and pharmacists in Malaysia

Evaluation of audiological rehabilitation services for adults with hearing impairment in Malaysia

The Chronic Care Model and Chronic Condition Self-Management: An Introduction for Audiologists

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