Prevalence and characteristics of self-reported physical and mental disorders among adults with hearing loss in Denmark: a national survey

The effects of lockdown of work and activities for adults with multiple, complex needs including sensory impairments during the pandemic in 2020

Sheltered work and leisure activities were locked down in at the Signo centre in March 2020 because of the COVID-19 pandemic. The Signo centre is a Norwegian national centre for adults with multiple, complex needs, including severe sensory loss/impairments. Tension and uncertainty rapidly spread among relatives and workers. To explore the impacts of the pandemic on residents, 24 adults living in Signo Vivo answered a semi-structured interview together with their primary worker. Additionally, reports on staff injuries and PRN medication between April and Aug of 2020 were compared to the period before the lockdown. The reports from the interviews included fewer stressful events for the participants, more rest and sleep, more time spent in their own apartments, and more time with smaller groups of workers. The reports on staff injuries and PRN medication showed decreased occurrence.

Cochlear Implantation Improves Both Speech Perception and Patient-Reported Outcomes: A Prospective Follow-Up Study of Treatment Benefits among Adult Cochlear Implant Recipients

Cochlear implantation is considered the best treatment option for patients with severe-to-profound sensorineural hearing loss for whom conventional hearing aids are insufficient. We used a repeated measures longitudinal approach to evaluate speech recognition and patient-reported outcomes after cochlear implantation in an unbiased cohort of Danish adult patients in a prospective cohort study. We assessed 39 recipients before and two times after implantation using a battery of tests that included Dantale I, the Danish Hearing in Noise Test, the Nijmegen Cochlear Implant Questionnaire, and the Speech, Spatial, and Qualities of Hearing Scale. The study group improved significantly on all outcome measures following implantation. On average, Dantale I scores improved by 29 percentage points and Hearing in Noise Test scores improved by 22 percentage points. Most notably, the average Dantale score improved from 26 to 70% in the CI in quiet condition and from 12 to 42% in the cochlear implantation in noise condition when tested monaurally. Dantale demonstrated a significant positive correlation with Nijmegen Cochlear Implant Questionnaire and Speech, Spatial, and Qualities of Hearing Scale scores, while Hearing in Noise Test had no significant correlation with the patient-reported outcome measures. Patients improved significantly at 4 months and marginally improved further at 14 months, indicating that they were approaching a plateau. Our study’s use of audiometric and patient-reported outcome measures provides evidence of the treatment benefits of cochlear implantation in adults, which may help physicians advise patients on treatment decisions and align treatment benefit expectations, as well as serve as a foundation for the development of new cochlear implantation selection criteria.

[What Seems in Need of Psychiatric Care Does not Always Have to be. Hearing Loss as the Cause of a Suspected Psychopathological Diagnosis]

In the history of psychiatry and otology, there is evidence that mental and hearing disorders can be interdependent. For example, Emil Kraepelin in 1915 and a Leipzig serial study published in 1962 indicated that hearing-impaired people become psychologically conspicuous or mentally till more often than people whose hearing is not impaired.We outline the case of a patient who showed psychopathological abnormalities before and after giving birth to her daughter, especially in attention, cognitive conversion ability and social competence. After being diagnosed a bilateral moderate sensorineural hearing loss and being provided with hearing aids, no psychopathology was detectable. The case may be a pointer to the fact that hearing-impaired patients still fall through professional boundaries and are not provided with adequate care due to their lack of or limited ability to communicate.

Psychiatric Functioning, Resilience, and Recovery Among Deaf Consumers of Public Behavioral Health Services

Studies of deaf individuals generally indicate higher levels of mental illness and negative mental health outcomes compared to the general population (Anglemyer and Crespi in JAMA 2018: 3285153, 2018; Dammeyer and Chapman in JAMA 52: 807-813, 2017; Fellinger et al. in JAMA 379: 17-23, 2012; Hall et al. in JAMA 52: 761-776, 2017; as reported by Leigh and Pollard (M. Marschark and P. Spencer (eds) Oxford handbook of deaf studies, language and education, Oxford University Press, UK 2003); Landsberger et al. in JAMA 45, 42-51, 2014; Pollard in JAMA 39, 147-160, 1994). The purpose of this study is to understand the demographic variables, psychiatric symptoms, functioning, resilience, and recovery in a sample of 11,703 deaf adults. The de-identified dataset was provided by Beacon Health Options and Maryland Behavioral Health Administration and includes information about deaf adult consumers of public behavioral health services. Findings revealed that compared to hearing consumers in the dataset, deaf consumers were less likely to live in independent housing. They were more likely to live in structured community housing, such as group homes, or be homelessness. They had higher rates of arrests and incarcerations, higher proportion of unemployment, and higher rates of cigarette smoking. Deaf participants had lower rates of substance use. Deaf women in this sample reported significantly more difficulty in managing their psychiatric symptoms than deaf men. Deaf people of color had lower levels of psychiatric dysfunction, lower resilience, and greater recovery compared to white participants, which was inconsistent with other studies of people of color. Younger participants had significantly more difficulty with psychiatric symptoms and functioning than those in the older groups. Those who were 31-55 years old had higher resilience than those who were older than 56 years old. The author offers several recommendations for further research of the mental health of deaf populations, especially round race, age, and gender.

Factors contributing to successful employment outcomes for individuals who are hard-of-hearing

BACKGROUND: The State-Federal Vocational Rehabilitation (VR) Program provides rehabilitation services to people with disabilities with the intention of assisting them in securing competitive employment. The VR services offer substantial resources to help individuals who are hard-of-hearing to enhance their quality of life and employment opportunities. OBJECTIVE: The current study investigated the impact of demographic variables and the use of VR services on employment outcomes among hard-of-hearing consumers. Specific VR services that lead to successful employment among hard-of-hearing consumers were thoroughly examined. METHODS: Binary logistic regression, Chi-square, and Chi-square Automatic Interaction Detector analyses were used to analyze the data extracted from the 2014 fiscal year US. Department of Education Rehabilitation Service Administration Case Service Report (RSA-911). RESULTS: Logistic regression reveals that VR services such as diagnosis and treatment of impairments (p-value 0.000), counseling, and guidance (p-value 0.000), and rehabilitation technology (p-value 0.000) were influential factors in determining the successful employment outcome among the consumers. The relative importance of the factors based on the mean decrease in accuracy in CHAID identifies rehabilitation technology (0.264), diagnosis and treatment of impairments (0.090), job placement assistance (0.016), transportation (0.016), and secondary disability (0.010) to be among the most contributing factors. CONCLUSION: Overall, rehabilitation technology services were especially beneficial, particularly for minority consumers, in achieving a successful employment outcome.

Healthy aging in elderly cochlear implant recipients: a multinational observational study

Background

Given an increase in the aging population and its impact on healthcare systems, policy makers for provision of health and social services are aiming to keep older adults in good health for longer, in other words towards ‘healthy aging’. Our study objective is to show that rehabilitation with cochlear implant treatment in the elderly with hearing impairment improves the overall health-related quality of life and general well-being that translate into healthy aging.

Methods

The multicentre, prospective, repeated measures, single-subject, clinical observational study will accrue 100 elderly, first-time, unilateral CI recipients (≥ 60 years) and analyze changes on specific measurement tools over ca. 20 months from preimplant to postimplant. Evaluations will consist of details collected through case history and interview questionnaires by clinicians, data logging, self-report questionnaires completed by the recipients and a series of commonly used audiometric measures and geriatric assessment tools. The primary indicator of changes in overall quality of life will be the HUI-3.

Discussion

The protocol is designed to make use of measurement tools that have already been applied to the hearing-impaired population in order to compare effects of CI rehabilitation in adults immediately before their implantation, (pre-implant) and after gaining 1–1.5 years of experience (post-implant). The broad approach will lead to a greater understanding of how useful hearing impacts the quality of life in elderly individuals, and thus improves potentials for healthy aging. Outcomes will be described and analyzed in detail.

Trial registration

This research has been registered in ClinicalTrials.gov (http://www.clinicaltrials.gov/), 7 March 2017 under the n° NCT03072862.

Association between Participation in Annual Physical Examinations and Risk Factors for Noncommunicable Diseases in Adults with Disabilities: Evidence from Shanghai, China

The relationships between regular participation in annual physical examinations and the risk factors for noncommunicable diseases (NCDs) among adults with disabilities remains unclear. To address this gap, we used data from 130,899 individuals with disabilities in Shanghai (2014–2016) and evaluated four risk factors for NCDs: hypertension, hyperglycemia, hyperlipidemia, and being overweight. Overall, 4540 individuals participated in annual physical examinations across all three years and 11,388 missed examinations in 2015 (group without regular participation). Chi-squared tests and binary logistic regression were used to assess differences in patient characteristics and explore correlations between variables. Significant differences in age (χ² = 102.620, p < 0.01), place of residence (χ² = 94.308, p < 0.01), educational level (χ² = 59.884, p < 0.01), marital status (χ² = 16.414, p < 0.01) and disability type (χ² = 56.499, p < 0.01) and severity (χ² = 45.464, p < 0.01) were found between those who participated in regular physical examinations and those who did not. Regular participation was associated with reduced incidences of hypertension (odds ratio 0.799, 95% confidence interval (CI): 0.733–0.871) and hyperlipidemia (0.347, 95% CI: 0.307–0.392), but not with the incidence of diabetes (1.049, 95% CI: 0.944–1.166) or being overweight (0.907, 95% CI: 0.812–1.014). Hence, regular participation in annual physical examinations had different associations with risk factors for NCDs.

Childhood Sensorineural Hearing Loss and Educational Attainment in Adulthood: Results From the HUNT Study

OBJECTIVES

Although the educational achievement gap between people without hearing loss and people with hearing loss is well-documented, few studies are based on large, nonclinical samples. The present study aims to investigate the educational attainment among Norwegian adults diagnosed with sensorineural hearing loss as children, compared with a matched control group of people without hearing loss.

DESIGN

A prospective cohort design was applied. Between 1954 and 1986, the children in the first, fourth, and/or seventh grade in all primary schools in Nord-Trøndelag County participated in the School Hearing Investigation in Nord-Trøndelag, in which they underwent audiometric screening. Those with positive results had their hearing further tested by means of pure tone audiometry at 0.25, 0.5, 1, 2, 4, and 8 kHz with air- and bone-conduction thresholds, as well as a full examination by an ear, nose, and throat (ENT) specialist. In the present study, 216 persons were classified with moderate-severe hearing loss (41 to 100 dB HL), 293 with mild hearing loss (26 to 40 dB HL), and 240 with slight hearing loss (16 to 25 dB HL). Age-matched controls were recruited from the Norwegian Health Study, which was conducted in the same county. A total of 48,606 people participated in the present study. Data on educational attainment up to 2014 was provided by Statistics Norway. Control variables comprised sex, age, mothers', and fathers' education. The relation between childhood sensorineural hearing loss and educational attainment was tested by means of multinomial logistic regression models; first for the total sample (born between 1941 and 1979), and then for two different birth cohorts born between 1941 and 1959 and between 1960 and 1979.

RESULTS

Percentwise, the educational attainment level in general has increased, both among people without hearing loss and people with hearing loss, and especially for women. However, 27.5% of people without hearing loss obtained higher education, whereas the corresponding numbers for those with mild or moderate-severe hearing loss were 18.8%, and 21.3%, respectively. The results from the regression analyses showed that in the total sample, compared with having primary education, people with moderate-severe or mild hearing loss were about half as likely to achieve higher education as people without hearing loss (odds ratio (OR) = 0.63 and 0.49, respectively). An interaction term between sensorineural hearing loss and sex was specified but it was not significant. In the older cohort, we found a significant association between mild hearing loss and higher education (OR = 0.40), and between moderate-severe hearing loss and secondary education (OR = 0.65). In the younger cohort, there was a significant association between mild hearing loss and higher education (OR = 0.56) and between slight hearing loss and secondary education (OR = 0.61).

CONCLUSIONS

The results from this study indicate that the achievement gap between people without hearing loss and those with hearing loss remains. Future studies should try to pinpoint what might be hindering people with slight, mild, moderate, or severe hearing loss in pursuing higher education. Parents, health personnel, institutions for higher education, and policy makers alike should take this into consideration when making plans and policies.

Work and Employment Characteristics of Deaf and Hard-of-Hearing Adults

Studies have reported a higher level of unemployment among deaf and hard-of-hearing (DHH) adults compared to adults without hearing loss. However, little is known about factors explaining success in the labor market. This study presents the analysis of two data sets. The first was drawn from a survey of 804 DHH adults in Denmark. The second was a survey completed by 190 DHH adults with post-secondary qualification in the United States. In the Danish sample, among the spoken language users, higher ages, higher level of educational attainment, and no additional disabilities were associated with having a job. Among the sign language users, higher ages, higher level of educational attainment, earlier ages at hearing loss diagnosis, and not using cochlear implants were associated with having a job. In the US sample, male gender and better sign language skills were associated with having a job.

Deaf Child and Adolescent Consumers of Public Behavioral Health Services

This study describes the demographic profiles of 1,164 deaf children and adolescents who are consumers of the public behavioral health services in the state of Maryland. Up until recent years, data about deaf adults, children, and youth were unavailable. Over the past couple years, items to the Outcomes Measurement System (OMS) Interview included questions such as "primary language" and boxes to indicate if the participant was "deaf." The data presented in this paper are extracted from the state database of all consumers of public behavioral health services from January 1, 2016 to January 1, 2018. The sample included 1,166 deaf children and adolescents. The results include a demographic profile of deaf children on the OMS items, including the likelihood of being diagnosed with specific disorders. The results of this sample were also compared to the aggregate results on hearing children and adolescents. Results indicate that deaf youth are homeless at lower rates than their hearing counterparts. They are employed less and less likely to be arrested than their hearing counterparts. Reports of smoking, psychosocial functioning, school performance, and substance use were similar to hearing children and adolescents.