Rehabilitation Flashcards
Rehabilitation definition
Helping individual restore high test level of function, independence and quality of life.
Physical sensory, mental loss during to injury or disease.
Person-centered care definition
Approach where patients are encouraged to actively participate in their own healthcare.
Decibels of disabling HL in adults & children
40 in adults
30 in children
Most cause of HL globally
Medication
Most effective solution to HL
Prevention
Disability
Impairment that can be cognitive, developmental, intellectual, mental, physical, sensory or a combination of these.
Affects persons life activities and may be present from birth or occur during life.
ICF aim
To provide a scientific basis for understanding and studying of health and health related states, outcomes and determinants.
ICF categories
Health condition
Bodily structures and functions (impairment): plan needs to be based on what the person can do, assess functionality before planning.
Activity (limitations) and participation (restrictions): plan needs to target restricted activities, what the person participates in.
Environmental factors and personal factors: patient centered and contextual
Age related HL audiological findings
Presbycusis
Sloping high frequency loss
Progressive/gradual bilateral symmetrical SNHL
Effects of Age related HL
Cognitive decline
Risk for falls
Risk for dementia
Reduced participation
Negative social effects of HL
Reduced social activity- isolation and withdrawal
Problems communicating with spouse, friends and relatives
Problems communicating at work- lack of concentration
Negative psychological effects of HL
Embarrassment, guilt, shame and anger
Anxiety and suspicion- sadness or depression
Self criticism- low self esteem/ confidence
Stages of grief post diagnosis
Denial Anger Bargaining Depression Acceptance
Counseling approaches
Psychodynamic counseling
Client-centered counseling
Psychodynamic approaches
The conscious: things we are aware of e.g. feelings
The subconscious: things below conscious awareness, easy to access
Unconscious: area in the mind where memories have been suppressed and are difficult to access
Client centered counseling
Empathetic, warm, genuine
Behavioral approach
Humanistic approach
Self assessment scales
Hearing Handicap inventory for adults
Hearing Handicap inventory for elderly
Quality of life
Perceived quality of an individuals daily life
Emotional, social, physical aspects of persons life.
Observe life satisfaction
Generic QOL
Multidimensional construct with 4 key domains: Family, health, function Psychological and spiritual Social Economic
Measure for generic QOL
Quality of life Index
Health related QOL
Assessment of how individuals wellbeing may be affected overtime by disease, disability or disorder.
First dimension of PCC
Health is not considered simply by the absence of illness or injury.
Second dimension of PCC
Values the being of the patient rather than a body with a condition and encourages clinician to see person within the patient.
Third dimension of PCC
Shared power and responsibility between client and clinician.
Forth dimension of PCC
Therapeutic alliance where clinician and patient are supported in research in order to achieve best health outcomes.
Fifth dimension of PCC
Clinician is viewed as a person rather than a mere expert without human characteristics.
CORE:
Assessment procedures:
Communication status
Overall participation variables
Related personal factors
Environmental factors
CARE
Management procedures:
Counseling and psychosocial aspects
Audibility and amplification aspects
Remediation and communication acuity
Environmental coordination/ participation improvement
Boothroyd rehabilitation framework
Counseling: informational/ psychosocial
Sensory management technology: hearing aids, cochlear implants, frequency modulation.
Communication intervention (receptive &a expressive communication training): auditory training, communication partner training, speechreading training.
Communication training
Training to help remediate and improve impacted communication function as a result of hearing loss.
Compensation strategies
Maximizes use of residual hearing
Communication training approaches
Analytic
Synthetic
Pragmatic
Eclectic
Analytic
Bottom-up
Focuses on elements of speech
Vowel and consonant recognition on phoneme level
Breaks speech into smaller components
If you can reliably tell apart elements of speech, you can comprehend larger units.
Synthetic
Top-down
Uses prior knowledge of language to fill in acoustic gaps
Sentence level and more challenging tasks
Comprehending sentence meaning without attending to specific acoustic elements.
Stimulus often presented in presence of noise to stimulate real life listening situation.
Pragmatic
Involves listening controlling communication variables
Use of repair strategies, adjust distance between listener and speaker.
Eclectic
Combines strategies from other approaches.
Benefits of communication training
Improved audibility in quiet environments improved communication function
reduced perception of Handicap
Limitations of communication training
Adherence Structure Cost Context Perceived benefit
Types of communication training
Auditory training therapy Speech perception training Conversation therapy Assertiveness training Compensation & repair strategies
Auditory training therapy
Helps individual with hearing loss use residual hearing maximally.
Emphasizes development of listening skills to improve recognition and interpretation of sounds despite limited hearing abilities.
Candidacy: change in hearing status and recently received CI or HA, HL due to trauma or drugs, long term HA users.
Can be self directed or consultation based.
Speech perception training
Focus is to improve speech recognition and intelligibility in people with HL.
Emphasizes specific aspects elements of speech use and understanding such as discrimination, pronunciation, intonation, consonant vs vowel.
Conversation therapy
Creates a realistic and generalizable to real
Life communication environment
Assertiveness training
Helps people stand up for themselves to empower themselves.
Seeks to create an appropriate balance between passivity and aggression.
Compensation & repair strategies
Informational counseling to help make the everyday adjustments and adaptations to overcome communication adjustments.
