Barriers and facilitators to delivery of group audiological rehabilitation programs : a survey based on the COM-B model

OBJECTIVE : To canvas the views of Australia-based hearing healthcare clinicians regarding group audiological rehabilitation practices. DESIGN : A national cross-sectional self-report survey. Data were analysed using descriptive statistics and content analysis. STUDY SAMPLE : Sixty-two Australia-based hearing healthcare clinicians, with experience working in an adult rehabilitation setting. RESULTS : Clinicians appeared to positively view the provision of group audiological rehabilitation services, yet were limited in their ability to deliver these services due to organisational barriers. Although some organisational barriers were non-modifiable by the clinician (such as group AR services not prioritised within their workplace, a lack of support from colleagues/managers, lack of resources, and a lack of funding for the delivery of group AR services), others were within the clinicians’ ability to change (such as habit formation for recommending these services during clinical appointments). Participants expressed a desire for resources to assist them in delivering group AR, including downloadable lesson plans and information sheets for clients, clinician training videos and client educational videos. Clinicians called for increased diversity in program offerings, specifically relating to the emotional, relational and social impacts of hearing loss. CONCLUSIONS : These results provide a framework for the development of interventional studies to increase the utilisation of group audiological rehabilitation services.https://www.tandfonline.com/loi/iija202022-06-13hj2022Speech-Language Pathology and Audiolog

Binaural summation, binaural unmasking and fluctuating masker benefit in bimodal and bilateral adult cochlear implant users

OBJECTIVES : The number of bilateral adult cochlear implant (CI) users and bimodal CI users is expanding worldwide. The addition of a hearing aid (HA) in the contralateral non-implanted ear (bimodal) or a second CI (bilateral) can provide CI users with some of the benefits associated with listening with two ears. Our was to examine whether bilateral and bimodal CI users demonstrate binaural summation, binaural unmasking and a fluctuating masker benefit. METHODS : Direct audio input was used to present stimuli to 10 bilateral and 10 bimodal CochlearTM CI users. Speech recognition in noise (speech reception threshold, SRT) was assessed monaurally, diotically (identical signals in both devices) and dichotically (antiphasic speech) with different masking noises (steady-state and interrupted), using the digits-in-noise test. RESULTS : Bilateral CI users demonstrated a trend towards better SRTs with both CIs than with one CI. Bimodal CI users showed no difference between the bimodal SRT and the SRT for CI alone. No significant differences in SRT were found between the diotic and dichotic conditions for either group. Analyses of electrodograms created from bilateral stimuli demonstrated that substantial parts of the interaural speech cues were preserved in the Advanced Combination Encoder, an n-of-m channel selection speech coding strategy, used by the CI users. Speech recognition in noise was significantly better with interrupted noise than with steady-state masking noise for both bilateral and bimodal CI users. CONCLUSION : Bilateral CI users demonstrated a trend towards binaural summation, but bimodal CI users did not. No binaural unmasking was demonstrated for either group of CI users. A large fluctuating masker benefit was found in both bilateral and bimodal CI users.https://www.tandfonline.com/loi/ycii20hj2022Speech-Language Pathology and Audiolog

Barriers and facilitators to delivery of group audiological rehabilitation programs: a survey based on the COM-B model

OBJECTIVE : To canvas the views of Australia-based hearing healthcare clinicians regarding group audiological rehabilitation practices. DESIGN : A national cross-sectional self-report survey. Data were analysed using descriptive statistics and content analysis. STUDY SAMPLE : Sixty-two Australia-based hearing healthcare clinicians, with experience working in an adult rehabilitation setting. RESULTS : Clinicians appeared to positively view the provision of group audiological rehabilitation services, yet were limited in their ability to deliver these services due to organisational barriers. Although some organisational barriers were non-modifiable by the clinician (such as group AR services not prioritised within their workplace, a lack of support from colleagues/managers, lack of resources, and a lack of funding for the delivery of group AR services), others were within the clinicians’ ability to change (such as habit formation for recommending these services during clinical appointments). Participants expressed a desire for resources to assist them in delivering group AR, including downloadable lesson plans and information sheets for clients, clinician training videos and client educational videos. Clinicians called for increased diversity in program offerings, specifically relating to the emotional, relational and social impacts of hearing loss. CONCLUSIONS : These results provide a framework for the development of interventional studies to increase the utilisation of group audiological rehabilitation services.https://www.tandfonline.com/loi/iija202022-06-13hj2022Speech-Language Pathology and Audiolog

The effect of hearing loss configuration on cochlear implantation uptake rates : an Australian experience

OBJECTIVE : Recent changes to cochlear implant (CI) candidacy criteria have led to the inclusion of candidates with greater levels of hearing in the contralateral and/or implanted ear. This study assessed the impact of various hearing loss configurations on CI uptake rates (those assessed as eligible for CI, who proceed to CI). DESIGN : Retrospective cohort study. STUDY SAMPLE : Post-lingually deaf adult CI candidates (n = 619) seen at a Western Australian cochlear implant clinic. RESULTS : An overall CI uptake rate of 44% was observed. Hearing loss configuration significantly impacted uptake rates. Uptake rates of 62% for symmetrical hearing loss, 48% for asymmetrical hearing loss (four-frequency average hearing loss (4FAHL) asymmetry ≤60 dB), 25% for highly asymmetrical hearing loss (4FAHL asymmetry >60 dB), 38% for hearing losses eligible for electric-acoustic stimulation, and 22% for individuals with single-sided hearing loss were observed. Hearing loss configuration and age were both significant factors in relation to CI uptake although the impact of age was limited. CONCLUSION : CI clinics who apply or are considering applying expanded CI candidacy criteria within their practice should be aware that candidates with greater levels of residual hearing in at least the contralateral ear are less likely to proceed to CI.https://www.tandfonline.com/loi/iija20hj2021Speech-Language Pathology and Audiolog

Remote technologies to enhance service delivery for adults : clinical research perspectives

There are many examples of remote technologies that are clinically effective and provide numerous benefits to adults with hearing loss. Despite this, the uptake of remote technologies for hearing healthcare has been both low and slow until the onset of the COVID-19 pandemic, which has been a key driver for change globally. The time is now right to take advantage of the many benefits that remote technologies offer, through clinical, consumer, or hybrid services and channels. These include greater access and choice, better interactivity and engagement, and tailoring of technologies to individual needs, leading to clients who are better informed, enabled, and empowered to self-manage their hearing loss. This article provides an overview of the clinical research evidence-base across a range of remote technologies along the hearing health journey. This includes qualitative, as well as quantitative, methods to ensure the end-users' voice is at the core of the research, thereby promoting person-centered principles. Most of these remote technologies are available and some are already in use, albeit not widespread. Finally, whenever new technologies or processes are implemented into services, be they clinical, hybrid, or consumer, careful consideration needs to be given to the required behavior change of the key people (e.g., clients and service providers) to facilitate and optimize implementation.https://www.thieme.com/books-main/audiology/product/2188-seminarsin-hearing2024-07-21hj2023Speech-Language Pathology and Audiolog

Remote technologies to enhance service delivery for adults: clinical research perspectives

There are many examples of remote technologies that are clinically-effective, and provide numerous benefits to adults with hearing loss. Despite this, the uptake of remote technologies for hearing healthcare has been both low and slow until the onset of the COVID-19 pandemic, which has been a key driver for change globally. The time is now right to take advantage of the many benefits that remote technologies offer, either through clinical, consumer or hybrid services and channels. These include greater access and choice, and better interactivity, engagement and tailoring of technologies to individual needs, leading to clients who are better informed, enabled and empowered to self-manage their hearing loss. This article provides an overview of the clinical research evidence-base across a range of remote technologies along the hearing health journey. This includes qualitative, as well as quantitative, methods to ensure the end-users’ voice is at the core of the research, thereby promoting person-centred principles. Most of these remote technologies are available and some are already in use, albeit not widespread. Finally, whenever new technologies or processes are implemented into services, be they clinical, hybrid or consumer, careful consideration needs to be given to the required behaviour change of the key people (e.g. clients and providers) to facilitate and optimise implementation.</p