Evaluation of the psychometric properties of the Social Isolation Measure (SIM) in adults with hearing loss

This study aimed to evaluate the psychometric properties of a brief, hearing-specific outcome measure: the Social Isolation Measure (SIM). In Phase 1, adults with hearing loss were invited to complete an online survey that contained the SIM, a hearing-specific participation questionnaire, a generic activity and participation questionnaire, and a generic loneliness questionnaire. In Phase 2, the participants were asked to complete the SIM for a second time 2-3 weeks following Phase 1. One hundred and sixteen adults with hearing loss completed Phase 1. Ninety-five participants also completed Phase 2. Twenty-nine participants were excluded from the Phase 2 data analysis because they reported that their hearing had changed since Phase 1 or because they completed Phase 2 outside of the 2-3 week interval following Phase 1. In support of its construct validity, the SIM had a strong correlation with the hearing-specific questionnaire and moderate correlations with the generic questionnaires. The findings also supported the internal consistency, interpretability, and test-retest reliability of the SIM. In conclusion, the SIM was found to have strong psychometric properties. It could serve as a brief measure of perceived social isolation in research or clinical practice

The development of a self-report outcome measure to assess social participation restrictions in adults with hearing loss

Hearing loss is a widespread condition that can substantially affect not only auditory functioning but also social functioning. Therefore, it is essential to demonstrate that auditory rehabilitation can improve social participation in individuals with hearing loss. However, currently, there is a lack of agreed-upon, gold-standard, hearing-specific outcome measures. Consequently, the primary aim of this research was to develop a high quality measure of hearing-related social participation restrictions for use in research and practice. To achieve this aim, four consecutive studies were carried out using best practice questionnaire design techniques. Study 1 generated content for the Social Participation Restrictions Questionnaire (SPaRQ) through semi-structured interviews with 25 adults with hearing loss and nine hearing healthcare professionals. Study 2 evaluated the content of the measure through a subject matter expert panel with 20 hearing healthcare professionals and cognitive interviews with 14 adults with hearing loss. Study 3 assessed the psychometric properties of the SPaRQ by applying Rasch analysis to data collected from 279 adults with hearing loss. Finally, Study 4 further assessed the psychometric properties of the SPaRQ by applying traditional psychometric analysis to data collected from a further 102 adults with hearing loss. This research led to the development of a 19-item questionnaire that measured two key elements: social behaviours (e.g. difficulties with social interactions) and social perceptions (e.g. feelings of isolation). There was strong evidence to support the measurement properties of SPaRQ, including construct validity, person separation reliability, and internal consistency. Furthermore, the response scale was statistically justified and respondent burden was minimal. Future research should examine additional measurement properties, such as responsiveness and cross-cultural validity. Also, the best practice techniques used in this research should be applied to other new and existing hearing-specific questionnaires to ensure that they meet the requisite standards for use in clinical trials and clinical practice

Applying theories of health behaviour and change to hearing health research: time for a new approach

Objective: In recent years, there has been an increase in the application of behavioural models, such as social cognition models, to the promotion of hearing health. Despite this, there exists a well-developed body of literature that suggests such models may fail to consistently explain reliable amounts of variability in human behaviours. Design: This paper provides a summary of this research across selected models of health-related behaviour, outlining the current state of the evidence. Results: Recent work in the field of behaviour change is presented together with commentary on the design and reporting of behaviour change interventions. Conclusions: We propose that attempts to use unreliable models to explain and predict hearing health behaviours should now be replaced by work which integrates the latest in behaviour change science, such as the Behaviour Change Wheel and Theoretical Domains Framework

How do we know that our patients have benefitted from our ENT/Audiological interventions?: presented at the Annual Meeting of ADANO 2016 in Berlin

This short review article gives an introduction to some of the fundamental concepts and challenges facing measurement in hearing healthcare practice and research. The impact of hearing loss almost always extends beyond the sensory impairment itself, even when the measured degree of audiometric loss is mild. Yet, going beyond audibility, into the realm of measuring impact, takes us into a much more complex and less well-defined space. How does one therefore best measure the therapeutic benefit for evaluating efficacy or for clinical practice audit? Three case studies illustrate approaches to overcome such challenges. Each example highlights the importance of thinking critically about what it is one is seeking trying to measure, rather than selecting a questionnaire instrument based simply on its popularity or accessibility. We conclude by highlighting the important role that clinicians can play in collecting clinical data about their preferred instruments so that we have some evidence to inform decisions about good practice (content validity etc). We would also strongly support open data sharing as we believe that this is one of the best ways to make the most rapid progress the field

How do we know that our patients have benefitted from our ENT/Audiological interventions?: presented at the Annual Meeting of ADANO 2016 in Berlin

This short review article gives an introduction to some of the fundamental concepts and challenges facing measurement in hearing healthcare practice and research. The impact of hearing loss almost always extends beyond the sensory impairment itself, even when the measured degree of audiometric loss is mild. Yet, going beyond audibility, into the realm of measuring impact, takes us into a much more complex and less well-defined space. How does one therefore best measure the therapeutic benefit for evaluating efficacy or for clinical practice audit? Three case studies illustrate approaches to overcome such challenges. Each example highlights the importance of thinking critically about what it is one is seeking trying to measure, rather than selecting a questionnaire instrument based simply on its popularity or accessibility. We conclude by highlighting the important role that clinicians can play in collecting clinical data about their preferred instruments so that we have some evidence to inform decisions about good practice (content validity etc). We would also strongly support open data sharing as we believe that this is one of the best ways to make the most rapid progress the field

Patient perceptions of cognitive screening in adult audiology services: A qualitative exploration

Introduction: Both hearing loss and dementia are extremely pervasive, especially amongst older adults. As hearing loss and dementia have common symptoms, misdiagnosis can be common, and failure to address hearing loss for people with dementia could accelerate cognitive decline. The timely detection of cognitive impairment is clinically important, however the use of cognitive assessments in adult audiology services is a hotly debated topic. Although the early detection of cognitive impairment may improve patient care and quality of life, patients attending audiology services for hearing assessment might not expect to be asked questions about their cognition. The aim of this study was to qualitatively explore patient and public perspectives and preferences on the use of cognitive screening within adult audiology services. Methods: Quantitative and qualitative data were gathered from an online survey and a workshop. Descriptive statistics were applied to quantitative data and an inductive thematic analysis was performed on free-text responses. Results: In total, 90 respondents completed the online survey. Overall, cognitive screening in audiology was reported to be acceptable to participants (92%). A reflexive thematic analysis of the qualitative data reported four themes: i) knowledge of cognitive impairment and screening, ii) implementation of cognitive screening, iii) impact of screening on patient and iv) contributions to future care and research. A workshop was held with five participants to discuss and reflect on the findings in more detail. Discussion: Participants found cognitive screening to be acceptable within adult audiology services providing audiologists had suitable training, and sufficient explanation and justification were provided. However, implications such as additional time and staff resource and supplementary training for audiologists would be required to address participants concerns

Understanding the psychosocial experiences of adults with mild-moderate hearing loss: an application of Leventhal’s self-regulatory model

Objective: This study explored the psychosocial experiences of adults with hearing loss using the self-regulatory model as a theoretical framework. The primary components of the model, namely cognitive representations, emotional representations, and coping responses, were examined. Design: Individual semi-structured interviews were conducted. The data were analysed using an established thematic analysis procedure. Study sample: Twenty-five adults with mild-moderate hearing loss from the UK and nine hearing healthcare professionals from the UK, USA, and Canada were recruited via maximum variation sampling. Results: Cognitive representations: Most participants described their hearing loss as having negative connotations and consequences, although they were not particularly concerned about the progression or controllability/curability of the condition. Opinions differed regarding the benefits of understanding the causes of one’s hearing loss in detail. Emotional representations: negative emotions dominated, although some experienced positive emotions or muted emotions. Coping responses: engaged coping (e.g. hearing aids, communication tactics) and disengaged coping (e.g. withdrawal from situations, withdrawal within situations): both had perceived advantages and disadvantages. Conclusions: This novel application of the self-regulatory model demonstrates that it can be used to capture the key psychosocial experiences (i.e. perceptions, emotions, and coping responses) of adults with mild-moderate hearing loss within a single, unifying framework