“Keep it simple! The impact of audiologists’ language on clients’ decisions to obtain hearing aids” And “How patient-centred are initial audiological rehabilitation consultations? An investigation of audiologist-patient communication”

Contact Name: Carly Meyer and Caitlin Grenness

Carly Meyer

Carly Meyer (PhD, BSpchPath) is a speech pathologist who currently holds a HEARing CRC Postdoctoral Fellowship. She is also affiliated with the Communication Disability Centre at The University of Queensland. Carly’s research focuses on the holistic management of children and adults with a communication disorder, and is driven by the World Health Organisation’s International Classification of Functioning, Disability and Health. Specifically, Carly’s research interests are associated with: (1) improving outcomes for older adults with hearing impairment through the development of novel treatment approaches, (2) the implementation of patient- and family-centred care in audiology practice, (3) the holistic management of people living in the community with dementia and concomitant hearing loss, and (4) the evaluation of functional outcomes following intervention for communication disorders.

Caitlin Grenness

Caitlin Grenness, PhD is an audiologist, lecturer and research officer at the University of Melbourne and HEARing Cooperative Research Centre in Australia and is affiliated with the Communication Disability Centre at the University of Queensland. Caitlin has taught the adult audiological rehabilitation courses in the Clinical Audiology program since 2010 and serves as a director on the Board of Audiology Australia. Caitlin’s body of research examines patient-centred care in adult audiological rehabilitation; barriers and facilitators to clinician behaviour change, and the impact of service-delivery models on audiologic outcomes. She is passionate about empowering clinicians to provide high quality audiological care.

Keep it simple! The impact of audiologists’ language on clients’ decisions to obtain hearing aids.

Older adults with hearing loss want to be involved in their rehabilitation decisions. To facilitate shared decision making between the client and clinician, it is important that the clinician’s language be easily understood by the client. This is particularly important for older adults with hearing loss, wherein a proportion of clients present with low health literacy. Accordingly, the aims of this study were to: profile the complexity of language spoken by audiologists during hearing assessment appointments; and explore associations between audiologists’ language and clients’ decisions to obtain hearing aids.  Sixty-two initial assessment appointments with adult clients over the age of 55 years were filmed. Each appointment was transcribed, and the diagnosis and management planning phase of appointments was isolated for analysis. Audiologists’ language complexity was profiled using Microsoft Word grammar summary statistics (e.g., Flesch-Kincaid Reading Grade Level) and inspected for the presence of 39 jargon terms (e.g., directional microphone). A binomial, multivariate logistic regression model was applied to the data to determine if the decision to obtain hearing aids was associated with audiologists’ language complexity. Preliminary results indicate that clients were significantly less likely to obtain hearing aids if their audiologist used more complex language.

How patient-centred are initial audiological rehabilitation consultations? An investigation of audiologist-patient communication

Patient-centred communication in health consultations leads to improved patient satisfaction, treatment adherence and self-management. Despite advocacy for patient-centred care within audiology, little research explores the presence of behaviours indicative of such an approach. This study aimed to: 1) observe the nature of patient-centred communication between audiologist and adult patient/companion throughout initial audiology consultations; 2) identify audiologist, patient or consultation-related factors that may influence patient-centred communication dynamics in initial audiology consultations; and, 3) answer the question “do older adults receive patient-centred audiologic rehabilitation?” Sixty-two initial audiological rehabilitation consultations with patients over 55 years were filmed and verbal communication was analysed using the Roter Interaction Analysis System (RIAS). Linear Mixed Modelling was used to examine associations between communication dynamics and audiologist, patient or consultation factors. Results revealed a paucity of patient-centred communication behaviours. For example, audiologist-led unilateral information exchange that focused on hearing aids was observed; patients’/companions’ opinions were rarely elicited; in the presence of a companion, audiologists asked significantly fewer lifestyle-related questions; and, minimal audiologist-patient emotional engagement was observed. Results have implications for at least four areas of clinical practice: 1) attending to psychosocial concerns; 2) shift in focus from biomedical to biopsychosocial; 3) sharing control; 4) involvement of family members.

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