1
|
Bussé AML, Qirjazi B, Mackey AR, Kik J, Goedegebure A, Hoeve HLJ, Toçi E, Roshi E, Carr G, Toll MS, Simonsz HJ. Implementation of Newborn Hearing Screening in Albania. Int J Neonatal Screen 2023; 9:ijns9020028. [PMID: 37218893 DOI: 10.3390/ijns9020028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/19/2023] [Accepted: 04/29/2023] [Indexed: 05/24/2023] Open
Abstract
Newborn hearing screening (NHS) was implemented in Albania in four maternity hospitals in 2018 and 2019. Implementation outcome, screening outcome, and screening quality measures were evaluated. Infants were first screened by midwives and nurses before discharge from the maternity hospital and returned for follow-up screening. Acceptability, appropriateness, feasibility, adoption, fidelity, coverage, attendance, and stepwise and final-referral rates were assessed by onsite observations, interviews, questionnaires, and a screening database. A post hoc analysis was performed to identify reasons for loss to follow up (LTFU) in a multivariate logistic regression. In total, 22,818 infants were born, of which 96.6% were screened. For the second screening step, 33.6% of infants were LTFU, 40.4% for the third, and 35.8% for diagnostic assessment. Twenty-two (0.1%) were diagnosed with hearing loss of ≥40 dB, six unilateral. NHS was appropriate and feasible: most infants are born in maternity hospitals, hence nurses and midwives could perform screening, and screening rooms and logistic support were supplied. Adoption among screeners was good. Referral rates decreased steadily, reflecting increasing skill. Occasionally, screening was repeated during a screening step, contrary to the protocol. NHS in Albania was implemented successfully, though LTFU was high. It is important to have effective data tracking and supervision throughout the screening.
Collapse
Affiliation(s)
- Andrea M L Bussé
- Department of Otorhinolaryngology, Erasmus University Medical Center, 3015 Rotterdam, The Netherlands
- Department of Ophthalmology, Erasmus University Medical Center, 3015 Rotterdam, The Netherlands
| | - Birkena Qirjazi
- Department of Ear, Nose and Throat Diseases-Ophthalmology, University of Medicine of Tirana, 1000 Tirana, Albania
| | | | - Jan Kik
- Department of Ophthalmology, Erasmus University Medical Center, 3015 Rotterdam, The Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology, Erasmus University Medical Center, 3015 Rotterdam, The Netherlands
| | - Hans L J Hoeve
- Department of Otorhinolaryngology, Erasmus University Medical Center, 3015 Rotterdam, The Netherlands
| | - Ervin Toçi
- Department of Public Health, University of Medicine of Tirana, 1000 Tirana, Albania
| | - Enver Roshi
- Department of Public Health, University of Medicine of Tirana, 1000 Tirana, Albania
| | - Gwen Carr
- Independent Consultant in Early Hearing Detection, Intervention and Family Centered Practice, Ribble Valley BB7 2RA, UK
| | - Martijn S Toll
- Department of Otorhinolaryngology, Erasmus University Medical Center, 3015 Rotterdam, The Netherlands
| | - Huibert J Simonsz
- Department of Ophthalmology, Erasmus University Medical Center, 3015 Rotterdam, The Netherlands
| |
Collapse
|
2
|
Verkleij ML, Heijnsdijk EAM, Bussé AML, Carr G, Goedegebure A, Mackey AR, Qirjazi B, Uhlén IM, Sloot F, Hoeve HLJ, de Koning HJ. Cost-Effectiveness of Neonatal Hearing Screening Programs: A Micro-Simulation Modeling Analysis. Ear Hear 2021; 42:909-916. [PMID: 33306547 PMCID: PMC8221716 DOI: 10.1097/aud.0000000000000981] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Supplemental Digital Content is available in the text. Early detection of neonatal hearing impairment moderates the negative effects on speech and language development. Universal neonatal hearing screening protocols vary in tests used, timing of testing and the number of stages of screening. This study estimated the cost-effectiveness of various protocols in the preparation of implementation of neonatal hearing screening in Albania.
Collapse
Affiliation(s)
- Mirjam L Verkleij
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Eveline A M Heijnsdijk
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Andrea M L Bussé
- Department of Otorhinolaryngology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Ophthalmology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Gwen Carr
- Independent Consultant in Early Hearing Detection, Intervention and Family Centered Practice, London, United Kingdom
| | - André Goedegebure
- Department of Otorhinolaryngology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Allison R Mackey
- Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Stockholm, Sweden
| | - Birkena Qirjazi
- Department of Ear, Nose and Throat Diseases-Ophthalmology, University of Tirana, Tirana, Albania
| | - Inger M Uhlén
- Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Stockholm, Sweden
| | - Frea Sloot
- Department of Ophthalmology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Hans L J Hoeve
- Department of Otorhinolaryngology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Harry J de Koning
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | |
Collapse
|
3
|
Kanji A, Naudé A. The Impact of Pass/Refer Criteria in the Use of Otoacoustic Emission Technology for Newborn Hearing Screening. Am J Audiol 2021; 30:416-422. [PMID: 34000205 DOI: 10.1044/2021_aja-20-00160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose The current study aimed to compare the specificity of transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) in isolation and in combination, with varying pass/refer criteria for DPOAE technology. Method A longitudinal, repeated-measures design was employed. The current study sample comprised 91 of the initial 325 participants who returned for the repeat screening and diagnostic audiological assessment within a risk-based newborn hearing screening program. Results TEOAE screening had the highest specificity in comparison to DPOAE screening at the initial and repeat screening, irrespective of differences in DPOAE pass/refer criteria. DPOAE screening had a slightly higher specificity, with a three out of six rather than the four out of six frequency pass criteria. Conclusions Pass/refer criteria alone do not influence referral rates and specificity. Instead, consideration of other factors in combination with these criteria is important. More research is required in terms of the sensitivity and specificity of OAE screening technology using repeated-measures and diagnostic audiological evaluation as the gold standard.
Collapse
Affiliation(s)
- Amisha Kanji
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Alida Naudé
- Centre for Augmentative and Alternative Communication, Faculty of Humanities, University of Pretoria, South Africa
| |
Collapse
|
4
|
Bussé AM, Qirjazi B, Goedegebure A, Toll M, Hoeve HL, Toçi E, Roshi E, Carr G, Simonsz HJ. Implementation of a neonatal hearing screening programme in three provinces in Albania. Int J Pediatr Otorhinolaryngol 2020; 134:110039. [PMID: 32304854 DOI: 10.1016/j.ijporl.2020.110039] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 03/13/2020] [Accepted: 04/03/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The EUSCREEN study compares the cost-effectiveness of paediatric hearing screening programmes and aims to develop a cost-effectiveness model for this purpose. Alongside and informed by the development of the model, neonatal hearing screening (NHS) is implemented in Albania. We report on the first year. METHODS An implementation plan was made addressing objectives, target population, screening protocol, screener training, screening devices, care pathways and follow up. NHS started January 1st, 2018 in four maternity hospitals: two in Tirana, one in Pogradec and one in Kukës, representing both urban and rural areas. OAE-OAE-aABR was used to screen well infants in maternity hospitals, whereas aABR-aABR was used in neonatal intensive care units and in mountainous Kukës for all infants. Screeners' uptake and attitudes towards screening and quality of screening were assessed by distributing questionnaires and visiting the maternity hospitals. The result of screening, diagnostics, follow up and entry into early intervention were registered in a database and monitored. RESULTS Screeners were keen to improve their skills in screening and considered NHS valuable for Albanian health care. The number of "fail" outcomes after the first screen was high initially but decreased to less than 10% after eight months. In 2018, 11,507 infants were born in the four participating maternity hospitals, 10,925 (94.9%) of whom were screened in the first step. For 486 infants the result of screening was not registered. For the first screen, ten parents declined, eight infants died and one infant was discharged before screening could be performed. In 1115 (10.2%) infants the test either could not be performed or the threshold was not reached; 361 (32,4%) of these did not attend the second screen. For the third screen 31 (34.4%) out of 90 did not attend. Reasons given were: parents declined (124), lived too far from screening location (95), their infant died (11), had other health issues (7), or was screened in private clinic (17), no reason given (138). CONCLUSIONS Implementation of NHS in Albania is feasible despite continuing challenges. Acceptance was high for the first screen. However, 32.4% of 1115 infants did not attend the second screen, after a "fail" outcome for the first test.
Collapse
Affiliation(s)
- Andrea Ml Bussé
- Erasmus University Medical Center Rotterdam, Department of Ophthalmology, Rotterdam, the Netherlands; Erasmus University Medical Center Rotterdam, Department of Otorhinolaryngology, Rotterdam, the Netherlands.
| | - Birkena Qirjazi
- University of Medicine of Tirana, Department of Ear, Nose and Throat Diseases - Ophthalmology, Tirana, Albania
| | - André Goedegebure
- Erasmus University Medical Center Rotterdam, Department of Otorhinolaryngology, Rotterdam, the Netherlands
| | - Martijn Toll
- Erasmus University Medical Center Rotterdam, Department of Otorhinolaryngology, Rotterdam, the Netherlands
| | - Hans Lj Hoeve
- Erasmus University Medical Center Rotterdam, Department of Otorhinolaryngology, Rotterdam, the Netherlands
| | - Ervin Toçi
- University of Medicine of Tirana, Department of Public Health, Tirana, Albania
| | - Enver Roshi
- University of Medicine of Tirana, Department of Public Health, Tirana, Albania
| | - Gwen Carr
- Independent Consultant in Early Hearing Detection, Intervention and Family Centered Practice, London, United Kingdom
| | - Huibert J Simonsz
- Erasmus University Medical Center Rotterdam, Department of Ophthalmology, Rotterdam, the Netherlands
| |
Collapse
|
5
|
Vos B, Senterre C, Lagasse R, Tognola G, Levêque A. Organisation of newborn hearing screening programmes in the European Union: widely implemented, differently performed. Eur J Public Health 2016; 26:505-10. [DOI: 10.1093/eurpub/ckw020] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
6
|
Vos B, Lagasse R, Levêque A. Main outcomes of a newborn hearing screening program in Belgium over six years. Int J Pediatr Otorhinolaryngol 2014; 78:1496-502. [PMID: 25012194 DOI: 10.1016/j.ijporl.2014.06.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 06/10/2014] [Accepted: 06/14/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To present the outcomes of the newborn hearing screening program in Belgium (French-speaking area) since its implementation and to analyze its evolution between 2007 and 2012 in the neonatal population without reported risk factors for hearing loss. METHODS The study was descriptive and based on a retrospective analysis of six annual databases (2007-2012) from the newborn hearing screening program. The main outcomes were identified: prevalence of reported hearing impairment; coverage rates (first and second test, follow-up); proportions of conclusive screening tests; referral rate. Each outcome was presented for the six years and by year of birth. Chi-squares were used to study differences in the various outcomes according to time. RESULTS Over the six years, 264,508 newborns were considered as eligible for the screening. Hearing impairment was confirmed in 1.41‰ (n = 374) of them, with significant disparities from year to year, between 0.67‰ and 1.94‰. Analysis of the screening process showed that only 92.71% (n = 245,219) of the eligible newborns underwent a first hearing test. This coverage rate varied greatly over time: at the beginning, less than 90% of the newborns had a first test and it rose to almost 95%. After the two screening steps, 2.40% (n = 6340) of the newborns were referred to an ENT doctor; the referral rate slightly decreased during the first years of the program and then stabilized around 2.4%. Over the period, only 62.21% of the referred newborns had a follow-up; the follow-up rate was particularly low for the first year (44.91%) and then strongly increased (+19.52% in 2008) but never exceeded 70%. CONCLUSIONS Outcome measures for the newborn hearing screening program in Belgium are lower than the benchmarks released by the Joint Committee on Infant Hearing. Nevertheless, the evolution of the outcome measures since the implementation of the program has been positive, particularly during the first years. At some point, most of the outcome measures decreased or at least did not change any further. The motivation and commitment of the professionals have to be supported in a variety of ways to improve outcome measures and thus, the quality of the program.
Collapse
Affiliation(s)
- Bénédicte Vos
- Université libre de Bruxelles, School of Public Health, Research Center Health Policy and Systems - International Health, Route de Lennik 808, Brussels 1070, Belgium; Centre d'Epidémiologie Périnatale (CEpiP), Route de Lennik 808, Brussels 1070, Belgium.
| | - Raphaël Lagasse
- Université libre de Bruxelles, School of Public Health, Research Center Health Policy and Systems - International Health, Route de Lennik 808, Brussels 1070, Belgium.
| | - Alain Levêque
- Université libre de Bruxelles, School of Public Health, Research Center Health Policy and Systems - International Health, Route de Lennik 808, Brussels 1070, Belgium; Centre d'Epidémiologie Périnatale (CEpiP), Route de Lennik 808, Brussels 1070, Belgium; Université libre de Bruxelles, School of Public Health, Research Center Epidemiology, Biostatistic and Clinical Research, Route de Lennik 808, Brussels 1070, Belgium.
| |
Collapse
|
7
|
Alvarenga KDF, Araújo ES, Melo TMD, Martinez MAN, Bevilacqua MC. Questionnaire for monitoring auditory and language development in the first year. Codas 2014; 25:16-21. [PMID: 24408165 DOI: 10.1590/s2317-17822013000100004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 04/09/2012] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To validate a monitoring questionnaire about hearing and language development applied by community health agents in the first year of life. METHODS Seventy six community health agents, previously trained on infant hearing health, administered a questionnaire to the families of 304 children with ages from 0 to 1 year. The questionnaire contains questions regarding hearing and language development and, for all age groups, the question "Does your child hear well?" was presented. The validity of the questionnaire was assessed by analyzing false positive and false negative rates of the identified children. A double-blind study was conducted so that all children assessed by the questionnaire were submitted to hearing evaluation performed by audiologists. RESULTS Four children (1.32%) were diagnosed with sensorineural hearing loss (two unilateral), and 69 (22.7%) with conductive hearing loss. The monitoring questionnaire showed specificity of 96% and sensitivity of 67%, with a false-negative rate of 33% for not identifying the unilateral hearing loss, and a false-positive rate of 4%. CONCLUSION The questionnaire used has shown to be feasible and relevant to actions of the community health agents of the Family Health Strategy program, with high specificity and moderate sensitivity. The use of the validated instrument should be considered to complement Newborn Hearing Screening Programs, in order to identify late onset or acquired hearing loss.
Collapse
|
8
|
Kanji A, Kara R. Pediatric Physicians' Referral of Children Aged 0-3 Years for Audiological Evaluation in the Public Health Care Sector. Audiol Res 2013; 3:e7. [PMID: 26557345 PMCID: PMC4627124 DOI: 10.4081/audiores.2013.e7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 09/08/2013] [Accepted: 10/16/2013] [Indexed: 11/23/2022] Open
Abstract
The current study aimed to determine the current practice of pediatric physicians in the referral of children (0-3 years) for further audiological evaluation in the South African public health care sector. Sixty three pediatric physicians comprising of pediatricians, neonatologists, medical officers, registrars and interns from three academic hospitals completed a self- administered questionnaire. Most participants reported referrals to an audiologist when hearing loss was suspected. An average of eight risk factors for hearing loss listed on the Health Professionals Council of South Africa (HPCSA) 2007 position statement were identified by participants, indicating the need for referral. Generally, participants reported that referral/s occurred easily within the respective hospitals. Results highlight that pediatric physicians are aware of the role that audiologists play in the diagnosis and management of hearing loss, are involved in the referral of children that are at risk for hearing loss, and have awareness of some of the known risk factors associated with hearing loss. Further education regarding other risk factors is required in order to increase referral/s, and ensure appropriate referral of children at risk for hearing loss.
Collapse
Affiliation(s)
- Amisha Kanji
- University of the Witwatersrand, Johannesburg , South Africa
| | - Razeena Kara
- University of the Witwatersrand, Johannesburg , South Africa
| |
Collapse
|
9
|
Maia RM, Silva MAMD, Tavares PMB. Saúde auditiva dos recém-nascidos: atuação da fonoaudiologia na Estratégia Saúde da Família. REVISTA CEFAC 2011. [DOI: 10.1590/s1516-18462011005000114] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: analisar o acompanhamento dos recém-nascidos quanto à promoção da saúde auditiva após a inserção da fonoaudiologia na Estratégia Saúde da Família. MÉTODO: estudo retrospectivo e documental com abordagem quantitativa com 88 recém-nascidos que realizaram o teste da orelhinha, no período de fevereiro a maio de 2010, a partir dos relatórios mensais de devolutiva do Serviço de Atenção a Saúde Auditiva do município, consolidados mensais e prontuários de um Centro de Saúde da Família em Sobral-Ce. RESULTADOS: dos recém-nascidos avaliados, 35 (39,77%) falharam no teste, entre estes, 7 (20%) apresentam indicador de risco para deficiência auditiva e 28 (80%) não apresentavam nenhum risco. Verificou-se também divergências entre os dados do Serviço de Atenção a Saúde Auditiva e os prontuários do Centro de Saúde da Família quanto a classificação dos indicadores de risco para a perda auditiva. Observou-se ainda que, o número de encaminhamentos para o teste da orelhinha aumentou 8,33%. Em relação ao reteste, 1 (7,69%) criança retornou nos meses de março a agosto de 2009 e entre os meses de setembro/2009 a fevereiro/2010 após a atuação da fonoaudiologia no CSF do Sumaré 17 (65,38%) crianças realizaram o reteste. CONCLUSÃO: os dados sugerem a importância da presença do fonoaudiólogo na atenção primária, sendo fundamental no acompanhamento e monitoramento do diagnóstico precoce das alterações auditivas.
Collapse
|
10
|
Khoza-Shangase K, Joubert K. The influence of epidural anesthesia on new-born hearing screening: A pilot study. J Pharm Bioallied Sci 2011; 3:135-41. [PMID: 21430964 PMCID: PMC3053511 DOI: 10.4103/0975-7406.76493] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Revised: 09/07/2010] [Accepted: 12/09/2010] [Indexed: 11/16/2022] Open
Abstract
Objective: The main aim was to establish if epidural anesthesia had an influence on new-born hearing screening results in newborns born via elective Cesarean section in healthy pregnancies. Specific objectives included determining screening results in a group of newborns born to mothers who had undergone epidural anesthesia during Cesarean section childbirth (experimental group); and comparing the findings with those of a group of newborns born to mothers who had undergone natural delivery without epidural anesthesia (comparison group); while establishing if the time of screening following delivery had any effect on the overall screening results. Materials and Methods: The above objectives were achieved through the use of a prospective quasi-experimental repeated measures design with a comparison group, where 40 newborns (20 in the experimental and 20 in the comparison group) were screened at three different times through transient otoacoustic emissions (TEOAEs) and automated auditory brainstem response (AABR) measures. All participants were screened while resting quietly in open bassinets in an empty new-born nursery. For both test measures, the results were recorded as either pass or refer. Data were analyzed through both descriptive and inferential statistics. Results: Findings indicated that hearing screening earlier than four hours after birth, for both the experimental and comparison groups yielded more false positive findings than testing conducted after 24 hours. An index of suspicion in relation to the influence of epidural anesthesia on Automated Auditory Brainstem Response (AABR), when conducted less than four hours after birth, was raised, as statistically significant findings (P<0.05) were obtained. Conclusions: The findings have implications for timing of screening where universal newborn hearing screening is being implemented.
Collapse
Affiliation(s)
- Katijah Khoza-Shangase
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | | |
Collapse
|
11
|
Schade G. Early detection of hearing loss. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2010; 7:Doc05. [PMID: 22073092 PMCID: PMC3199831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The universal newborn hearing screening (UNHS) is currently spreading in Germany, as well, even though there can be no talk of a comprehensive establishment. The introduction of UNHS in several federal states such as Hamburg, Hessen, and Schleswig-Holstein can be ascribed to the personal commitment of individual pediatric audiologists. Apart from the procurement of the screening equipment and the training of the staff responsible for the examination of the newborns, the tracking, i.e. the follow-up on children with conspicuous test results, is of utmost importance. This involves significant administration effort and work and is subject to data protection laws that can differ substantially between the various federal states. Among audiologists, there is consensus that within the first three months of a child's life, a hearing loss must be diagnosed and that between the age of 3 and 6 months, the supply of a hearing aid must have been initiated. For this purpose, screening steps 1 (usually a TEOAE measurement) and 2 (AABR testing) need to be conducted in the maternity hospital. The follow-up of step 1 then comprises the repetition of the TEOAE- and AABR measurement for conspicuous children by a specialized physician. The follow-up of step 2 comprises the confirmatory diagnostics in a pediatric audiological center. This always implies BERA diagnostics during spontaneous sleep or under sedation. The subsequent early supply of a hearing aid should generally be conducted by a (pediatric) acoustician specialized on children.
Collapse
Affiliation(s)
- Götz Schade
- Univ. HNO-Klinik Bonn, Deutschland,*To whom correspondence should be addressed: Götz Schade, Univ. HNO-Klinik Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Deutschland, Tel.: +49(0)228 28715563, E-mail:
| |
Collapse
|
12
|
Tronco CS, Paula CCD, Padoin SMDM, Langendorf TF. Análise da produção científica acerca da atenção ao recém-nascido de baixo peso em UTI. Rev Gaucha Enferm 2010; 31:575-83. [DOI: 10.1590/s1983-14472010000300024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
O objetivo deste estudo foi analisar a natureza e tendência dos artigos na temática saúde do recém nascido de baixo peso. Trata-se de uma revisão integrativa desenvolvida em agosto de 2009, a partir dos descritores: "recém-nascido de baixo peso" or "recém-nascido de muito baixo peso" and "unidades de terapia intensiva neonatal", no recorte temporal 1990-2008. A amostra de 608 resumos foi submetida à análise de conteúdo temática. Nos resultados, os estudos de natureza clínico-epidemiológica contemplam os fatores de risco do baixo peso e morbimortalidade neonatal e os de tendência assistencial contribuem com as rotinas e cuidados prestados. Evidenciam-se os avanços na atenção a saúde do recém-nascido, a complexidade clínica e as implicações para sua assistência. Destaca-se a lacuna de pesquisas que aponte a subjetividade, o apoio e a inclusão das famílias nos cuidados e no enfrentamento dessa situação.
Collapse
|