The Listening Shift: Evaluating a Communication-Strategies Training Program for Telepractice Nurses Experiencing Hearing Challenges

Workers who wish to remain employed should be supported in doing so, even if they are experiencing age-related disabilities, such as hearing loss. I aimed to better understand the strategies from which workers with hearing loss might benefit, and how they can be supported in adopting these strategies. To collect rich data, I recruited telepractice nurses who rely on listening to make critical decisions about triaging and health care recommendations. My first research question was: What strategies exist for making telephone speech more intelligible for health care providers and patients with hearing challenges? I performed a scoping review following the Joanna Briggs Institute’s protocol. I identified 11 types of strategies, many of which required cooperation from, and disclosure to, providers’ employers, co-workers, and clients. This led me to consider the public narrative workers associated themselves with when they disclosed. Thus, my second research question was: How do Canadian newspapers portray workers with hearing loss? Through a thematic analysis of newspapers articles on this topic, I found they are predominantly portrayed as striving cheerfully both towards functioning normally and towards differentiating themselves and their hearing loss as unique and positive. To further explore how a subset of adults with hearing loss strive to work with a hearing loss, I developed an online communication-strategies training program tailored to nurses with hearing challenges. I then used a multiple case study to answer the following research question: How do nurses with hearing challenges change in terms of their telephone performance and workplace wellbeing in response to participation in an online communication strategies training program? Results suggested that nurses engaged in a problem-solving process before adopting strategies, and that strategy adoption could positively contribute to their performance. Together, the findings from these studies suggest that strategies exist to enhance the performance of workers with hearing loss, but the process of adopting these strategies can be demanding. Organizations should take steps to proactively support their nurses, health-care providers, and potentially other workers with hearing loss in identifying communication strategies and adapting them to their unique context

The outcomes of bilateral cochlear implants in adult recipients

Although unilateral cochlear implants generally provide good speech understanding under quiet conditions, patients with unilateral cochlear implants frequently report difficulty in understanding speech in the presence of background noise and difficulty in localizing the source of sound. Since these two listening functions require binaural hearing in normal hearing individuals, there has been a growing interest in bilateral cochlear implants as intervention type for people with severe-to-profound bilateral hearing loss. This study investigated the outcomes of bilateral cochlear implants in all the adult recipients of the Pretoria Cochlear Implant Program. All the subjects with BCIs were asked to choose a significant other person to participate in the study. All the subjects (i.e. subjects with BCIs and their significant other people) were asked to participate in a semi-structured interview and to fill out a researcher-generated questionnaire. The subjects with BCIs also underwent audiometric testing. The majority of the subjects with BCIs were found to demonstrate improved ability to understand speech in the presence of background noise and, to some extent, in their ability to localize sound sources. As both quantitative and qualitative methods were used to determine the outcomes, it could be demonstrated that the majority of adult bilateral cochlear implant recipients gain from the auditory benefits in everyday listening situations. The majority of subjects and their significant other people conferred that their improved auditory skills allow them to be more participative in social, cultural, and other activities, which add to the quality of their lives.Dissertation (MCommunication Pathology)--University of Pretoria, 2009.Speech-Language Pathology and AudiologyUnrestricte

Keskusteluavustimen kehittäminen kuulovammaisia varten automaattista puheentunnistusta käyttäen

Understanding and participating in conversations has been reported as one of the biggest challenges hearing impaired people face in their daily lives. These communication problems have been shown to have wide-ranging negative consequences, affecting their quality of life and the opportunities available to them in education and employment. A conversational assistance application was investigated to alleviate these problems. The application uses automatic speech recognition technology to provide real-time speech-to-text transcriptions to the user, with the goal of helping deaf and hard of hearing persons in conversational situations. To validate the method and investigate its usefulness, a prototype application was developed for testing purposes using open-source software. A user test was designed and performed with test participants representing the target user group. The results indicate that the Conversation Assistant method is valid, meaning it can help the hearing impaired to follow and participate in conversational situations. Speech recognition accuracy, especially in noisy environments, was identified as the primary target for further development for increased usefulness of the application. Conversely, recognition speed was deemed to be sufficient and already surpass the transcription speed of human transcribers.Keskustelupuheen ymmärtäminen ja keskusteluihin osallistuminen on raportoitu yhdeksi suurimmista haasteista, joita kuulovammaiset kohtaavat jokapäiväisessä elämässään. Näillä viestintäongelmilla on osoitettu olevan laaja-alaisia negatiivisia vaikutuksia, jotka heijastuvat elämänlaatuun ja heikentävät kuulovammaisten yhdenvertaisia osallistumismahdollisuuksia opiskeluun ja työelämään. Työssä kehitettiin ja arvioitiin apusovellusta keskustelupuheen ymmärtämisen ja keskusteluihin osallistumisen helpottamiseksi. Sovellus käyttää automaattista puheentunnistusta reaaliaikaiseen puheen tekstittämiseen kuuroja ja huonokuuloisia varten. Menetelmän toimivuuden vahvistamiseksi ja sen hyödyllisyyden tutkimiseksi siitä kehitettiin prototyyppisovellus käyttäjätestausta varten avointa lähdekoodia hyödyntäen. Testaamista varten suunniteltiin ja toteutettiin käyttäjäkoe sovelluksen kohderyhmää edustavilla koekäyttäjillä. Saadut tulokset viittaavat siihen, että työssä esitetty Keskusteluavustin on toimiva ja hyödyllinen apuväline huonokuuloisille ja kuuroille. Puheentunnistustarkkuus erityisesti meluisissa olosuhteissa osoittautui ensisijaiseksi kehityskohteeksi apusovelluksen hyödyllisyyden lisäämiseksi. Puheentunnistuksen nopeus arvioitiin puolestaan jo riittävän nopeaksi, ylittäen selkeästi kirjoitustulkkien kirjoitusnopeuden

APPLICATION OF THE EXPECTANCY-DISCONFIRMATION MODEL IN THE PREDICTION OF HEARING AID USER SATISFACTION

The relationship between expectations and satisfaction, across a variety of products and services, has been documented in consumer and health care literature. The expectancy-disconfirmation model of satisfaction has grown out of this work. This model proposes that the size of difference between a consumer's expectation and perception of a product or experience (disconfirmation) is predictive of the resulting satisfaction. This model has been empirically tested and shown to predict satisfaction in health care settings such as vision correction, hospital stays, and pharmacy purchases as well as in consumer services and purchases. Results from a study of the expectancy-disconfirmation model suggest that disconfirmation might be a strong predictor of satisfaction in Chinese first-time hearing aid users. This topic is relevant to hearing health care and health care in general, at the conceptual and the clinical level. Patient satisfaction leads to increased patient compliance with the procedures or interventions offered, leading to better treatment outcomes. Patient satisfaction has an important influence on utilization patterns and on patients’ responses to the care given. Many treatment outcomes, particularly those associated with hearing aid use, are dependent on a high level of patient compliance. As clinicians seek to attain optimal treatment outcomes, which should include improved quality of life; it is legitimate to pursue patient satisfaction as a prerequisite goal. One component of this study was to develop a reliable hearing aid disconfirmation measurement instrument that could be used to investigate the relationship between disconfirmation and satisfaction in first time purchasers of hearing instruments in the United States. Further research questions addressed more specific aspects of that relationship. Results indicated that disconfirmation is a strong predictor of satisfaction in first time hearing aid users. The perception of hearing aid performance and the disconfirmation contribute heavily to satisfaction, and seem to carry similar weighting. The use of self-report measures in hearing aid outcomes appears to be immune to the bias posed by socially desirable responding. This study provides the first empirical evidence that the expectancy-disconfirmation model of satisfaction can be applied to the study of satisfaction in first time hearing aid purchasers in the United States