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Climbing up the hearing rehabilitation ladder
Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Hearing impairment is a major public health problem, affecting communication and participation, and is associated with a range of health problems. Most individuals with perceived hearing impairment do not seek help, do not opt for rehabilitation (hearing aids), and do not use prescribed hearing aids adequately. Reducing the impact of hearing impairment and supporting healthy aging are important public health goals. Motivation, access to hearing health care, and poor societal awareness about hearing impairment, consequences, and rehabilitation options influence help-seeking. Offering online hearing screening has been proposed to improve hearing help-seeking, access to hearing health care, and to increase public knowledge about hearing and hearing impairment. Applying theories from health psychology (i.e. the Stages of change model) could help audiologists and other hearing health care professionals understand the psychological barriers that prevent people with hearing problems to seek help and take up rehabilitation. The overarching aim of this thesis was to investigate behaviors related to hearing rehabilitation (help-seeking, hearing aid uptake, and hearing aid use) in adults who fail an online hearing screening. A second aim was to explore the usefulness of the Stages of change model in predicting hearing rehabilitation related behavior in a self-selected online hearing screening sample. Studies I–IV show tentative support for offering online hearing screening and for supplementary interventions for increasing help-seeking and provide tentative support for Stages of change as a useful classification tool to indicate individual needs for further information and guidance. Future studies should contemplate integrating screening for multiple health-related factors associated with hearing impairment and to provide a clear and tailored pathway for each participant (e.g. referral to adequate health care or equivalent online intervention).

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2019. , p. 86
Series
Linköping Studies in Arts and Sciences, ISSN 0282-9800 ; 775Studies from the Swedish Institute for Disability Research, ISSN 1650-1128 ; 95
Keywords [en]
online hearing screening, Stages of change, Motivational interviewing
National Category
Other Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-159945DOI: 10.3384/diss.diva-159945ISBN: 9789175190112 (print)OAI: oai:DiVA.org:liu-159945DiVA, id: diva2:1346861
Public defence
2019-09-20, Key 1, Key-huset, Campus Valla, Linköping, 13:00 (English)
Opponent
Supervisors
Available from: 2019-08-29 Created: 2019-08-29 Last updated: 2019-09-09Bibliographically approved
List of papers
1. Stages of change in audiology: comparison of three self-assessment measures
Open this publication in new window or tab >>Stages of change in audiology: comparison of three self-assessment measures
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2017 (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 56, no 7, p. 516-520Article in journal (Refereed) Published
Abstract [en]

Objective: In a clinical setting, theories of health behaviour change could help audiologists and other hearing health care professionals understand the barriers that prevent people with hearing problems to seek audiological help. The transtheoretical (stages of change) model of health behaviour change is one of these theories. It describes a persons journey towards health behaviour change (e.g. seeking help or taking up rehabilitation) in separate stages: precontemplation, contemplation, preparation, action, and, finally, maintenance. A short self-assessment measure of stages of change may guide the clinician and facilitate first appointments. This article describes correlations between three stages of change measures of different lengths, one 24-item and two one-item. Design: Participants were recruited through an online hearing screening study. Adults who failed the speech-in-noise recognition screening test and who had never undergone a hearing aid fitting were invited to complete further questionnaires online, including the three stages of change measures. Study sample: In total, 224 adults completed the three measures. Results: A majority of the participants were categorised as being in one of the information- and help-seeking stage of change (contemplation or preparation). The three stages of change measures were significantly correlated. Conclusions Our results support further investigating the use of a one-item measure to determine stages of change in people with hearing impairment.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2017
Keywords
Hearing screening; motivation; stages of change
National Category
Other Health Sciences
Identifiers
urn:nbn:se:liu:diva-139671 (URN)10.1080/14992027.2017.1309466 (DOI)000404938300009 ()28420270 (PubMedID)
Note

Funding Agencies|Swedish Council for Working Life and Social Research [2009-0055]

Available from: 2017-08-16 Created: 2017-08-16 Last updated: 2019-08-29Bibliographically approved
2. Measuring motivation using the transtheoretical (stages of change) model: A follow-up study of people who failed an online hearing screening.
Open this publication in new window or tab >>Measuring motivation using the transtheoretical (stages of change) model: A follow-up study of people who failed an online hearing screening.
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2016 (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 55, no Suppl 3, p. S52-S58Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Acceptance and readiness to seek professional help have shown to be important factors for favourable audiological rehabilitation outcomes. Theories from health psychology such as the transtheoretical (stages-of-change) model could help understand behavioural change in people with hearing impairment. In recent studies, the University of Rhode Island change assessment (URICA) has been found to have good predictive validity.

DESIGN: In a previous study, 224 Swedish adults who had failed an online hearing screening completed URICA and two other measures of stages of change. This follow-up aimed to: (1) determine prevalence of help-seeking at a hearing clinic and hearing aid uptake, and (2) explore the predictive validity of the stages of change measures by a follow-up on the 224 participants who had failed a hearing screening 18 months previously.

STUDY SAMPLE: A total of 122 people (54%) completed the follow-up online questionnaire, including the three measures and questions regarding experience with hearing help-seeking and hearing aid uptake.

RESULTS: Since failing the online hearing screening, 61% of participants had sought help. A good predictive validity for a one-item measure of stages of change was reported.

CONCLUSIONS: The Staging algorithm was the stages of change measure with the best ability to predict help-seeking 18 months later.

Place, publisher, year, edition, pages
Taylor & Francis, 2016
National Category
Psychology
Identifiers
urn:nbn:se:liu:diva-130826 (URN)10.1080/14992027.2016.1182650 (DOI)000381035200007 ()27206679 (PubMedID)
Note

Funding agencies: Swedish Council for Working Life and Social Research [2009-0055]

Available from: 2016-08-26 Created: 2016-08-26 Last updated: 2019-08-29Bibliographically approved

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