Development of a protocol and a clinical tool to assess the audiological needs of younger and older adults with hearing loss

Pilot evaluation of a protocol and a clinical tool developed to assess the audiological needs of adults with hearing loss

OBJECTIVE

To evaluate the Québec Audiological Assessment Protocol for Younger and Older Adults (QAAP-YOA) and its accompanying clinical tool efficacy to assess the needs of individuals with hearing loss in a simulated context. This study is the Phase 2 in the development of the QAAP-YOA.

DESIGN

Participants completed two needs assessments with simulated clients and wrote audiological reports, while applying the QAAP-YOA with and without the use of its clinical tool. Interviews were filmed, and reports collected. Both were scored by two independent evaluators. A qualitative analysis of reports was also conducted.

STUDY SAMPLE

Eleven audiology students and four early-career audiologists (n = 15).

RESULTS

The clinical tool did not influence the interview process since both experimental conditions had similar compliance rates to the protocol (p = 0.114). Compliance rates for assessment reports were higher with the clinical tool (p < 0.001). Participants' conclusions after applying the QAAP-YOA were consistent across participants. The information provided in the reports was more comprehensive and coherent with the client's needs when participants used the clinical tool.

CONCLUSIONS

The QAAP-YOA can lead to a greater standardisation of needs assessments and to more comprehensive reports, which may lead to intervention programs more closely aligned with clients' needs.

Guidance on Providing Patient-Centered Care

This article explores the clinical applications of Audiology Practice Standards Organization (APSO) Standards 2 and 13, both of which keep us fully focused on the patient-as-person. The topics within Standard 2 include audiologists' interpersonal communication skills, specifically clarity (ensuring patient comprehension) and empathy (understanding the patient's experiences). Standard 2 also addresses the topic of health literacy, which has been recently expanded to consider not only the degree to which individuals are able to find, understand, and use information and services to inform health-related decisions but also how organizations equitably support those necessary skills. The characteristics and benefits of services provided in patient- and family-centered care contexts are also described. Standard 13 addresses audiologists' support toward overall successful adjustment as defined by the patient, including both technical and personal adjustment to amplification, nontechnical communication issues, and rehabilitation support using readily available technologies. A new assessment protocol that includes goal setting and intervention is described, as well as a patient-centered intervention strategy involving discussion of personally meaningful photographs. Both standards provide a necessary balance to our technology-reliant profession.

APSO Standards: Implementing Hearing Aid Needs Assessments and Measuring Related Outcomes

The proportion of individuals who pose to benefit from the use of hearing aids is much smaller than those who adopt them. Likewise, many adults who try hearing devices abandon using them after a short period of time. Most factors related to hearing aid use are unrelated to a patient's hearing loss severity. Hearing loss treatment requires more than the provision of hearing aids as a sole intervention. Adoption rates could be improved through the implementation of evidence-based clinical protocols which maximize patients' success. Recently, the Audiology Practice Standards Organization (APSO) released evidence-based, formal standards of practice addressing hearing aid selection, fitting, and rehabilitation for adult and geriatric patients. Notably, the standards acknowledge the importance of an amplification needs assessment, including hearing aid outcomes measurement. In this brief narrative, we describe Standards 3 and 14 ( Needs Assessment and Hearing Aid Outcomes Measurement ) and offer an example of the clinical implementation of a comprehensive needs assessment and hearing aid outcomes measurement currently being used in a multisite, longitudinal clinical trial.