Week Two Flashcards
What are the findings Saunders (2015) found related to help seeking for hearing loss?
80% of adults don’t seek help for their hearing loss for the first 5-10 years after noticing symptoms
20% don’t seek help at all
Saunders (2015) reported on some reasons why people do seek help for their hearing difficulties. What are they?
- They notice hearing related difficulties
- They feel they have poor hearing
- They don’t have good coping skills for their hearing difficulties
- They are prompted to do so by others
- They do not expect that wearing hearing aids will be negatively viewed by others
- They have support from others.
What is the goal of the Health Belief Model (HBM)?
To describe and predict how people will behave in relation to their health
What are the different domains in the Health Belief Model (HBM)?
- Self Efficacy: Your belief in your ability to do something (e.g., use hearing aids)
- Perceived Threat: A belief that your health or well being is threatened (e.g., communication difficulties)
- Perceived Susceptibility: Your knowledge of the risks of developing the health condition (e.g., family history of hearing loss)
- Perceived Severity: Your perception of how serious you think the health condition is (not how severe your symptoms are)
- Cues to action: Things in your environment that prompt you to take action regarding your health (seeing an advert, whānau, friends). Can reduce or enhance perceived threat (e.g., neighbor who says hearing aids didn’t work).
- Perceived benefits-perceived barriers: pros and cons to taking action regarding your health.
- Increased likelihood of engaging in health behaviour: where we want people to be
Knoetze et al., (2023) completed a systematic review investigating the influences of various factors on health seeking behaviors. What are some of these factors?
Top three factors that influence health seeking behaviors:
- Communication difficulties
- Self-reported hearing difficulties and beliefs
- Hearing sensitivity
- Health, cognition and mental health
- Social pressure, stigma and social activities
Knoetze et al., (2023) completed a systematic review investigating the influences of various factors on hearing aid uptake. What are some of these factors?
Top three factors:
- Communication difficulties
- Self-reported hearing difficulties and beliefs
- Hearing sensitivity
What is hearing aid uptake?
Obtaining hearing aids. This does not imply the hearing aids are worn.
Franks and Timmer (2024) investigated the influences of various factors on why people stop wearing hearing aids. What are some of these factors?
Top three factors (past h/a users):
- Hearing aids didn’t feel comfortable (48%)
- Didn’t like wearing hearing aids (48%)
- Hearing aids didn’t help (41%)
Top three factors (family members):
- Didn’t feel comfortable (60%)
- Didn’t like wearing hearing aids (50%)
- Couldn’t manage the hearing aids (32%)
Biggest differences:
- Hearing aids didn’t help (family 12.5, h/a user 41.38)
- H/a didn’t work properly (family 7.5%, user 24%)
- couldn’t afford the batterise and repairs (family 0%, user 13%).
What is motivational interviewing (MI)?
A counseling technique designed to help people understand their underlying motivation to make health-related changes.
It helps people to understand what is stopping them from making healthy choices.
Useful for people experiencing ambivalence. Not suitable for people who are highly motivated.
What are the three tools that can help motivational interviewing be applied to rehabilitative audiology?
- The Line
- The Box
- Circle
Describe the process of using The Line tool.
Uses two questions and a Likert scale to help explore a client’s motivation and self-efficacy.
First question: “How important is it for you to improve your hearing right now?”
Second question: “How much do you believe in your ability to use…?”
If the client rates themselves highly in both questions, they probably don’t need motivational interviewing. If they rate low, you can move on to The Box.
Describe the process of using The box tool.
The goal of The Box is to further explore motivation and ambivalence.
It asks the client to write their answer to the following prompts:
- What are the advantages of continuing as they are now
- What are the disadvantages of continuing as they are now.
If people are still not sure how to proceed, introduce the following prompts:
1. What are the disadvantages of taking action now
2. What are the advantages of taking action now
What is The Circle tool?
It is a tool based on the Trans-theoretical Model, sometimes known as the Stages of Change.
The underlying concept is that people go through different stages as they change their health behaviors and need different things from their clinicians at each stage.
Describe the different stages in The Circle tool and appropriate clinician support in each.
Pre-contemplation
- People are starting to think about making a change.
- Clinicians don’t usually see people at this stage
Contemplation
- People are actively thinking about making a change
- Part of the attitude process
- Clinicians often see people at this stage because they have been pushed into it by others. Be careful about pushing forward with the rehabilitation plan as they may not be ready yet for change.
Preparation
- Part of the attitude process
- Seeking advise from others at this stage (internet, family, friends). May not yet be ready to see an audiologist.
- Clinicians need to be careful about pushing forward with the rehabilitation plan as they may not be ready yet for change.
Action
- The stage where people are ready to take action about their hearing.
- Part of the behavioral stage
- Clinicians need to provide encouragement to increase self-efficacy (in addition to information and advise).
Maintenance
- People need to maintain their use of their rehabilitation strategy.
- Clinicians need to provide ongoing support through regular check-ups and appointments.
Relapse
- Many people may stop to wear their hearing aids or using their rehabilitative strategies.
- May not interact with a clinician at this stage (embarrassment, lost to follow-up)
- Many may need to complete the stages of change again to re-enter the action stage.
- Clinicians should not just jump back into the action stage for people who are in relapse.
Permanent exit
- Ideally people enter this stage after maintenance
- Hallmark of effective rehabilitation
- The client has all the tools needed to carry on with whatever rehabilitation option they have chosen.
clinician should still put them on a follow-up schedule.
To help identify which stage of the trans theoretical model/The Circle a client is at you can ask a client to select a sentence that best describes them right now.
The answers relate to the different stages. What stage does the response “I don’t have a problem with my hearing” relate to?
Pre-contemplation
To help identify which stage of the trans theoretical model/The Circle a client is at you can ask a client to select a sentence that best describes them right now.
The answers relate to the different stages. What stage does the response “I might need hearing aids” relate to?
Contemplation
To help identify which stage of the trans theoretical model/The Circle a client is at you can ask a client to select a sentence that best describes them right now.
The answers relate to the different stages. What stage does the response “I need hearing aids” relate to?
Preparation
To help identify which stage of the trans theoretical model/The Circle a client is at you can ask a client to select a sentence that best describes them right now.
The answers relate to the different stages. What stage does the response “I am getting hearing aids” relate to?
Action
To help identify which stage of the trans theoretical model/The Circle a client is at you can ask a client to select a sentence that best describes them right now.
The answers relate to the different stages. What stage does the response “I am using my hearing aids” relate to?
Maintenance
To help identify which stage of the trans theoretical model/The Circle a client is at you can ask a client to select a sentence that best describes them right now.
The answers relate to the different stages. What stage does the response “I don’t like using my hearing aids” relate to?
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