Lecture 3: Hearing Impairment Flashcards
How to measure hearing loss?
Audiometry
- Unit of measure for sound intensity = decibel (dB)
- Unit of measure for tone of a sound = Hertz (Hz), in clycles per second
What are symptoms of high frequency hearing loss?
- Struggling to understanding the voices of women and children
- Not hearing birds chirping
- Words that start with s, h, f, of th are harder to hear
- When people talk, you feel like you hear but not understand
Causal factors of hearing loss (excl. adulthood and facors across lifespan)
Prenatal/ congenital (aangeboren)
- Genetics and intrauterine infections
Perinatal
- Lack of oxygen
- Prematurity
- Low birth weight
Childhood and adolecence
- Chronic otitis media
- Other infections
Causal factors of hearling loss adulthood and factors across lifespan
- Lifestyle (smoking, alcohol)
- NCDs (diabetes, hypertension)
- Genetics
- Ototoxic drugs and chemicals
- Infections
- Noise
- Older age
Primary prevention hearlingloss in NL
- Prenatal care
- Pretection against noise and ototoxic chemicals at work (Dutch working Conditions Legislation)
- Recreastional noise exposure (reduce noise, use of protection
Oorcheck
MP3-check “luister jij veilig?”
ILoveMyEars.nl
Prevention Programs in NL
The Netherlands Hearing Health Foundation
- Awareness, education, online tools, research, stakeholder collaboration
Oorcheck.nl (young adults)
- Prevention of hearingloss in the music sector
- Hearing module at TestJeLeefstijl.nu
NL + BE: “Ietsje minder is de max, help ze niet naar de tuut”
Prevention programs outside of NL
National Institude for Occupational Safety and Health (US)
- Hearing conservation program
- Buy quiet; quiet-by-design
- Incentives: Safe-in-sound Excellence in Hearing loss prevention Award
Dangerous decibels
- Non occupational noise
- youths and adults
Globally
- WHO-initiatives - evidence based advocacy (World hearing day, Make listening safe)
Secondary prevention (in NL)
- Neonatal screening (0-1week)
- Screening at primary school (5-10 years old)
- Self screening for adults
Tertiary prevention (impact in adults)
Communication
- Less social participation
Social participation
- Loneliness
- Depression
- Distress
- Cognitive impairment
- Work (sick leave, fatigue, lower income, finding/ keeping work)
Stigma/ shame
Physical health
- falls
= Reduced QoL
- Primary care (by)
- Secundary and tertiary care (by)
- Treatment and rehabilitation
1. Primary care
- GP
- Audiologist
2. Secundary and tertiary care
- Geriatric care
- Ear Nose Throat (ENT)
- Advanced Clinical Practitioner (ACP)
3. Treatment and rehabilitation
- Clinical treatment
- Communication advise
- Other hearing solutions
- Hearing aid
Rehabilitation for:
1. Profound hearing loss
2. Moderate to severe hearing loss
3. All types of hearing loss
4. Employed
- Hearing aid, cochlear implant
- Hearing aid and aditional hearing solutions
- Communication strategies
- Vocational rehabilitation
+ Lip reading, sign language, speech-to-tekst apps
Examples of communication strategies
- Tell friends and family
- Position yourself to hear others speak
- Turn off background noise
- Ask others to speak clearly, not louder
- Get the other persons attention before speaking
- Choose quiet settings
- Consider using an assertive listening device
Design of an intervention: implementation of an intake tool (3 phases)
- Understand behavior (COM-B model)
- Identify intervention options
- Identify content and implementation options (BCT-taxonomy)
What three parts does the behavior change wheel (BCW) consist of?
- Behavior (inner circle)
- Intervention (middle circle)
- Policy (outer circle)
What type of intervention is SUPR?
Tertiary prevention:
SUPR is an educational SUpport PRogramme for hearing aid users (HAUs) and their communication partners (CPs), offering care beyond hearing aid fitting.
SUPR
1. health problem?
2. Intervention?
3. Design?
4. Setting?
5. Study outcomes?
6. results?
7. Process evaluation?
1. Use and satisfaction with use of hearing aid
2. HoorSupport
- Practical Support Booklet and Online Educational videos
3. Randomized controlled trial
- SUPR versus care as usual
- Measurements at 0, 6, 12 and 18 months
4. Nationwide, 70 hearing aid dispensers (HAD)
5. Primary and secondary outcomes
- Primary = use of communication strategies
- Secondary = a.o. hearing aid use in hrs/ day
6. No results found
7. Process evaluation
- Limited number of participants watched the videos
- Only 50% of HAD encouraged their clients to watch the online videos,
- Forced cuts in personnel
- Suboptimal training
- Many policy changes
Summary tertiary prevention
= Services to deal with adverse effects of hearing loss
- Hearing aids
- Rehabilitation programs
SUPR
Summary secondary prevention
= Early identification to reduce negative effect of hearing loss
- screening tools
Summary primary prevention
= Reduction or elimination of hearing loss
- noise controls
- hearing protectors
What is the COM-B model and what are the main components?
The model can be used to better understand behavior, its main components are:
- Capability
- Motivation
- Oppertunity
- Behavior
- Behavior is influeced by Capability, Motivation and Oppertunity and visa versa
- Motivation is influenced by Capability and Oppertunity
