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Functioning and disability in adults with hearing loss: the preparatory studies in the ICF Core sets for hearing loss project
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.ORCID iD: 0000-0002-2298-6806
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Hearing loss (HL) is a health condition that affects more than 360 million people worldwide. The findings from previous research point at the adverse relationship between adults with hearing loss and important aspects of everyday life such as social relations, communication and work-related tasks. However, the overall picture concerning the functional and disabling aspects of adults with HL re- mains incomplete. To identify the functional and disabling aspects, a conceptual and/or theoretical framework is required. The International Classification of Functioning, Disability and Health (ICF) offer a multidimensional framework based on bio-psycho-social assumptions about health. In previous research inves- tigations in which the ICF has been used, some utility problems in the linking (relating) of data to the classification have been highlighted.

The aims of the present thesis were to explore the areas of functioning and disability of relevance for adults with HL and to explore how audiological data can be linked to ICF. The aims were explored by applying the methodology of the ‘interdisciplinary evidence-based approach to functioning and disability in adults with HL’, acknowledging the merging of three perspectives designated the Researcher, the Patient and the Professional perspective. Four studies that focus on the three perspectives were conducted. All results were linked to the ICF classification. The results were merged into a model designated ‘the integrative model of functioning and disability in adults with HL’.

When the three perspectives were linked, the results revealed several aspects of relevance for the target group. Bodily (individual) dimensions, such as hear- ing, auditory perception, memory, attention, energy, and emotions, were acknowledged. Aspects of everyday life such as conversations, the usage of communication strategies, family relationships and work, were highlighted. Influential environmental factors, such as noise, assistive technical devices, the design of public buildings, social support and the attitudes of people in the envi- ronment, were also identified. In conclusion, interactions seemed to be vital as almost all identified aspects highlighted or were tied to this dimension of human functioning. Further, concerning the linking of the data it was acknowledged that the ICF and the research area of adult HL do not fully comply. Suggestions for improvements in future revisions of the ICF were highlighted and discussed.

Place, publisher, year, edition, pages
Örebro: Örebro university , 2015. , 139 p.
Series
Studies from The Swedish Institute for Disability Research, ISSN 1650-1128 ; 73
Keyword [en]
hearing loss, adults, ICF, classification, functioning, disability, linking
National Category
Other Health Sciences Otorhinolaryngology
Research subject
Disability Science
Identifiers
URN: urn:nbn:se:oru:diva-45274ISBN: 978-91-7529-086-7 (print)OAI: oai:DiVA.org:oru-45274DiVA: diva2:842369
Public defence
2015-09-11, Prismahuset, Hörsal 2, Örebro universitet, Fakultetsgatan 1, Örebro, 13:00 (English)
Opponent
Supervisors
Note

Funding agency: Oticon Foundation; Hörselforskningsfonden (Swedish HearingResearch Foundation); the Foundation for Audiological Research (FAR) Forskningskommitten, Region Örebro County

Available from: 2015-07-20 Created: 2015-07-20 Last updated: 2017-10-17Bibliographically approved
List of papers
1. The ICF Core Sets for hearing loss - researcher perspective. Part I: Systematic review of outcome measures identified in audiological research
Open this publication in new window or tab >>The ICF Core Sets for hearing loss - researcher perspective. Part I: Systematic review of outcome measures identified in audiological research
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2014 (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 53, no 2, 65-76 p.Article, review/survey (Refereed) Published
Abstract [en]

Objective: To review the literature in order to identify outcome measures used in research on adults with hearing loss (HL) as part of the ICF Core Sets development project, and to describe study and population characteristics of the reviewed studies.

Design: A systematic review methodology was applied using multiple databases. A comprehensive search was conducted and two search pools were created, pool I and pool II.

Study sample: The study population included adults (>= 18 years of age) with HL and oral language as the primary mode of communication.

Results: 122 studies were included. Outcome measures were distinguished by 'instrument type', and 10 types were identified. In total, 246 (pool I) and 122 (pool II) different measures were identified, and only approximately 20% were extracted twice or more. Most measures were related to speech recognition. Fifty-one different questionnaires were identified. Many studies used small sample sizes, and the sex of participants was not revealed in several studies.

Conclusion: The low prevalence of identified measures reflects a lack of consensus regarding the optimal outcome measures to use in audiology. Reflections and discussions are made in relation to small sample sizes and the lack of sex differentiation/descriptions within the included articles.

Place, publisher, year, edition, pages
London, UK: Informa Healthcare, 2014
Keyword
Hearing loss, audiology, ICF, ICF core sets, outcome assessment, systematic literature review
National Category
Other Health Sciences Otorhinolaryngology
Research subject
Disability Science
Identifiers
urn:nbn:se:oru:diva-33754 (URN)10.3109/14992027.2013.851799 (DOI)000329834600001 ()24313738 (PubMedID)2-s2.0-84892578224 (Scopus ID)
Note

Funding Agencies:

Oticon Foundation  

Stinger Foundation

Available from: 2014-02-14 Created: 2014-02-14 Last updated: 2017-12-06Bibliographically approved
2. The ICF Core Sets for hearing loss: researcher perspective, Part II: Linking outcome measures to the International Classification of Functioning, Disability and Health (ICF)
Open this publication in new window or tab >>The ICF Core Sets for hearing loss: researcher perspective, Part II: Linking outcome measures to the International Classification of Functioning, Disability and Health (ICF)
Show others...
2014 (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 53, no 2, 77-87 p.Article, review/survey (Refereed) Published
Abstract [en]

Objective: To link outcome measures used in audiological research to the ICF classification and thereby describe audiological research from the ICF perspective.

Design: Through a peer-reviewed or a joint linking procedure, link outcome measures to the ICF classification system using standardized ICF linking rules. Additional linking rules were developed in combination with the established rules to overcome difficulties when connecting audiological data to ICF. Absolute and relative frequencies of ICF categories were reported.

Study sample: The identified outcome measures from the previous study (Part I) constituted the empirical material. Results: In total, 285 ICF categories were identified. The most prevalent categories were related to listening, hearing functions, auditory perceptions, emotions and the physical environment, such as noise and hearing aids. Categories related to communication showed lower relative frequencies, as did categories related to the social and attitudinal environment.

Conclusions: Based on the linked outcome measures, communication as a research topic is subordinated to other research topics. The same conclusion can be drawn for research targeting the social and attitudinal environment of adults with HL. Difficulties in the linking procedure were highlighted and discussed, and suggestions for future revisions of the ICF from the audiological perspective were described.

Place, publisher, year, edition, pages
Informa Healthcare, 2014
Keyword
Hearing loss, audiology, ICF, linking, ICF core sets
National Category
Other Health Sciences Otorhinolaryngology
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-33755 (URN)10.3109/14992027.2013.858279 (DOI)000329834600002 ()24329490 (PubMedID)2-s2.0-84892619855 (Scopus ID)
Note

Funding Agencies:

Oticon Foundation  

Stinger Foundation

Available from: 2014-02-14 Created: 2014-02-14 Last updated: 2017-12-06Bibliographically approved
3. The ICF core sets for hearing loss project: International expert survey on functioning and disability of adults with hearing loss using the International classification of functioning, disability, and health (ICF)
Open this publication in new window or tab >>The ICF core sets for hearing loss project: International expert survey on functioning and disability of adults with hearing loss using the International classification of functioning, disability, and health (ICF)
Show others...
2014 (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 53, no 8, 497-506 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To identify relevant aspects of functioning, disability, and contextual factors for adults with hearing loss (HL) from hearing health professional perspective summarized using the ICF classification as reference tool.

Design: Internet-based cross-sectional survey using open-ended questions. Responses were analysed using a simplified content analysis approach to link concept to ICF categories according to linking rules.

Study sample: Hearing health professionals (experts) recruited through e-mail distribution lists of professional organizations and personal networks of ICF core set for hearing loss steering committee members. Stratified sampling according to profession and world region enhanced the international and professional representation.

Results: Sixty-three experts constituted the stratified sample used in the analysis. A total of 1726 meaningful concepts were identified in this study, resulting in 209 distinctive ICF categories, with 106 mentioned by 5% or more of respondents. Most categories in the activities & participation component related to communication, while the most frequent environmental factors related to the physical environment such as hearing aids or noise. Mental functions, such as confidence or emotional functions were also frequently highlighted.

Conclusions: More than half (53.3%) of the entire ICF classification categories were included in the expert survey results. This emphasizes the importance of a multidimensional tool, such as the ICF, for assessing persons with hearing loss.

Place, publisher, year, edition, pages
Informa Healthcare, 2014
Keyword
Hearing loss; audiology; ICF; ICF core sets; hearing health professionals; expert survey
National Category
Other Health Sciences Otorhinolaryngology
Research subject
Disability Science
Identifiers
urn:nbn:se:oru:diva-34834 (URN)10.3109/14992027.2014.900196 (DOI)000339630500001 ()24754459 (PubMedID)2-s2.0-84904126425 (Scopus ID)
Note

Funding Agencies:

Oticon Foundation

Hörselforskningsfonden (Swedish hearing research foundation)

Available from: 2014-04-24 Created: 2014-04-24 Last updated: 2017-12-05Bibliographically approved
4. The ICF core sets for hearing loss project: Functioning and disability from the patient perspective
Open this publication in new window or tab >>The ICF core sets for hearing loss project: Functioning and disability from the patient perspective
Show others...
2014 (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 53, no 11, 777-786 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To explore areas of functioning, disability, and environmental factors of adults with hearing loss (HL) by using the ICF classification as a tool to determine and document each element. Design: A qualitative study applying mainly focus-group methodology was applied.

Study sample: Thirty-six Dutch and South African adults (18 years of age) with HL (20–95 dB HL) who used oral communication as first communication. Summative content analysis was performed on the transcripts by linkage to appropriate ICF categories.

Results: 143 ICF categories were identified, most of which belonged to the Activities & Participation (d) component, closely followed by the Environmental factors component. Participants specifically mentioned categories related to oral communication and interaction. Assistive technology (such as hearing aids), noise, and support by and attitudes of others in the environment of the participants were considered highly influential for functioning and disability.

Conclusions: The present study illustrates the complex and encompassing nature of aspects involved in functioning and disability of adults with HL. Findings highlight the necessity of using a multidimensional tool, such as the ICF, to map functioning and disability with hearing loss, allowing consideration and evaluation of aspects that are both internal and external.

Place, publisher, year, edition, pages
London, UK: Informa Healthcare, 2014
Keyword
ICF, ICF core sets, focus groups, qualitative study, patient perspective
National Category
Other Health Sciences Otorhinolaryngology
Research subject
Disability Science
Identifiers
urn:nbn:se:oru:diva-39251 (URN)10.3109/14992027.2014.938370 (DOI)000343928200001 ()25311099 (PubMedID)2-s2.0-84911460995 (Scopus ID)
Note

Funding Agency:

Oticon Foundation  

Available from: 2014-12-02 Created: 2014-12-02 Last updated: 2017-12-05Bibliographically approved

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