Hindhede, Anette Lykke

English

This dissertation investigates Danish hearing health care and the rehabilitation of working-age people with onset hearing impairment. The focus is on the structure and function of Danish hearing health care and its impact on the hearing impaired, in terms of their experiences of the impairment and their conduct in relation to the rehabilitation service offered. The dissertation is based on a report from the Danish National Centre for Social Research (SFI) on the effect of reduced hearing on labour-market attachment and working life, which raises the ostensible issues that there is a large group who seem reluctant to acknowledge their hearing impairment, and that many hearing- impaired persons do not continue to use hearing aids after the fitting, and that those who do use them continue to report communication difficulties in everyday life. By considering audiological rehabilitation from different qualitative sociological perspectives, the dissertation brings new insights into the continuing paucity of sociological literature around hearing disability, and into the construction of hearing disability and hearing disabled identities in clinical settings.In the dissertation, I present five articles that explore the research question in different ways. The articles are based on empirical data constructed by means of text analyses, observations, and interviews at two public hearing clinics in Denmark.In the first article, co-authored with Agnete Parving, we trace the history of those forms of rationality that comprise the present situation in hearing clinics. The article briefly describes the history of Danish audiology during the last 60 years, starting from the 1950s when audiology became a public service. The formation of the field of audiology is framed according to Bourdieu’s conception of fields, which means that there are medical, technological, and rehabilitative subfields with different agents, roots, and interests.In the second article, I explore the patients’ reasons for attending the hearing clinic, as up to 40 % of hearing-impaired people do not use their hearing aid as prescribed. The article describes how the reason for people seeking help at the clinic is often due to significant others who assist them in defining their ‘need’. The theoretical basis of the article is theories of normality and meanings of normality, and is based on interviews with patients. In the third article, drawing on Foucault’s theories on power/knowledge and Goffman’s theory of interaction rituals, the article analyses 41 video-recorded encounters between audiologists and first- time users of hearing aids in two public hearing clinics in Denmark. The article identifies a ritualised pattern in the interactions, which helps explain how only some of the patients’ experiences are allowed to be brought to the audiological encounter.In the fourth article, I explore how governmental rationalities and techniques for mobilising the elective consumer translate into audiological practice by ‘studying though’ policy. The article investigates the way in which neoliberalism can claim empirical validity and concludes that, on the conceptual level, a change has occurred from having been viewed earlier as passive clients of welfare to now being mobilised as active consumers. In present-day hearing clinics a co-presence of multilevel ways of governance has transpired and few of the hearing-impaired patients feel able to embrace the new consumer ethos.In the fifth article, I explore how working-age people confront and handle the medical diagnosis of the onset of hearing impairment, and what it means for their sense of identity. Based on interviews with hearing-impaired people, the article describes how, in order to overcome potential stigmatisation, ‘passing’ as normal becomes predominant for the impaired. Wearing a hearing aid works against the contemporary attempt to create socially ideal bodily presentations of the self, as the hearing aid is considered to be a symbolic extension of the body’s lack of functionality.This dissertation investigates Danish hearing health care and the rehabilitation of working-age people with onset hearing impairment. The focus is on the structure and function of Danish hearing health care and its impact on the hearing impaired, in terms of their experiences of the impairment and their conduct in relation to the rehabilitation service offered. The dissertation is based on a report from the Danish National Centre for Social Research (SFI) on the effect of reduced hearing on labour-market attachment and working life, which raises the ostensible issues that there is a large group who seem reluctant to acknowledge their hearing impairment, and that many hearing-impaired persons do not continue to use hearing aids after the fitting, and that those who do use them continue to report communication difficulties in everyday life. By considering audiological rehabilitation from different qualitative sociological perspectives, the dissertation brings new insights into the continuing paucity of sociological literature around hearing disability, and into the construction of hearing disability and hearing disabled identities in clinical settings.In the dissertation, I present five articles that explore the research question in different ways. The articles are based on empirical data constructed by means of text analyses, observations, and interviews at two public hearing clinics in Denmark

Audiological rehabilitation in sociological perspectives:Ph.D. dissertation

https://vbn.aau.dk/ws/files/293272820/Samlet_afhandling_Anette_Lykke_Hindhede_091218.pdf

Audiological rehabilitation in sociological perspectives:Ph.D. dissertation

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