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Bott A, Meyer C, Hickson L, Pachana NA. "It's Huge, in a Way." Conflicting Stakeholder Priorities for Managing Hearing Impairment for People Living with Dementia in Residential Aged Care Facilities. Clin Gerontol 2022; 45:844-858. [PMID: 32807024 DOI: 10.1080/07317115.2020.1805537] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aims of this study were to a) explore the impact of hearing impairment on people living with dementia in residential aged care facilities (RACFs) and b) investigate management of hearing impairment for this population. METHODS A descriptive qualitative approach, consisting of semi-structured interviews, was conducted with 23 participants across four stakeholder groups (audiologists, care staff, family members and individuals with dementia and hearing impairment living in RACFs). RESULTS Thematic analysis revealed an overarching theme of "different priorities for managing hearing impairment" that emerged from the data. Audiologists and care staff prioritized different practices for managing hearing impairment: audiologists emphasized hearing aids and care staff emphasized communication strategies. Care staff also identified that current management of hearing impairment was sub-optimal as they do not prioritize managing it. CONCLUSIONS Residents with dementia and hearing impairment living in RACFs are not receiving optimal hearing management. Further research is required to understand the factors that influence this. CLINICAL IMPLICATIONS Changes in practices of both care staff and audiologists are required to improve hearing impairment management for this population.
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Affiliation(s)
- Anthea Bott
- The HEARing Cooperative Research Centre, Melbourne, Australia.,School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Carly Meyer
- The HEARing Cooperative Research Centre, Melbourne, Australia.,School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Louise Hickson
- The HEARing Cooperative Research Centre, Melbourne, Australia.,School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, Brisbane, Australia
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Rajabloo S, Pakkhesal M, Naghavi Alhosseini A, Ghorbani Z, Rajabi A. Mothers view about oral health status, oral hygiene behaviors, and dental services utilization of their children with hearing impairment attending special schools. SPECIAL CARE IN DENTISTRY 2021; 42:149-154. [PMID: 34561867 DOI: 10.1111/scd.12648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/24/2021] [Accepted: 08/31/2021] [Indexed: 01/20/2023]
Abstract
AIM Parents are the principal decision-makers regarding their child's health. Awareness of mothers' view about their children's health, particularly with special health care needs (SHCN) (include hearing impaired children), is essential for health care providers. Therefore, the present study aimed to assess the mothers view about oral health status, oral hygiene practices, and dental services utilization of their children with hearing impairment attending special schools. METHODS A cross-sectional study was conducted between May and September 2020 among mothers of students with hearing impairment attending special schools. Also, the telephone structured interview was used to gathering mothers view. RESULTS 57.4% of the mothers rated their children's oral health status as excellent or good, 27.9% as moderate, and 14.7% as poor. About half of the mothers (49.2%) stated that their children used toothbrushes once daily, and 15% use dental floss. Also, 54% of the children visited the dentist before this survey's conduct. CONCLUSION The findings of the present study suggest that children with hearing impairment can also have good oral health status and behaviors. These results may be attributed to the fact that the study sample was taken from two special schools. Also, only the mothers' perception assessment of students' oral health status was done. Further studies are required to increase the strength of evidence.
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Affiliation(s)
- Soofia Rajabloo
- School of Dentistry, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mina Pakkhesal
- Community Oral Health Department, School of Dentistry, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Zahra Ghorbani
- Community Oral Health Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abdolhalim Rajabi
- Department of Health Management and Social Development Research Center, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
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Höbler F, McGilton KS, Wittich W, Dupuis K, Reed M, Dumassais S, Mick P, Pichora-Fuller MK. Hearing Screening for Residents in Long-Term Care Homes Who Live with Dementia: A Scoping Review. J Alzheimers Dis 2021; 84:1115-1138. [PMID: 34633326 PMCID: PMC8673512 DOI: 10.3233/jad-215087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Hearing loss is highly prevalent in older adults, particularly among those living with dementia and residing in long-term care homes (LTCHs). Sensory declines can have deleterious effects on functioning and contribute to frailty, but the hearing needs of residents are often unrecognized or unaddressed. OBJECTIVE To identify valid and reliable screening measures that are effective for the identification of hearing loss and are suitable for use by nursing staff providing care to residents with dementia in LTCHs. METHODS Electronic databases (Embase, Medline, PsycINFO, CENTRAL, and CINAHL) were searched using comprehensive search strategies, and a stepwise approach based on Arksey & O'Malley's scoping review and appraisal process was followed. RESULTS There were 193 scientific papers included in the review. Pure-tone audiometry was the most frequently reported measure to test hearing in older adults living with dementia. However, measures including self- or other-reports and questionnaires, review of medical records, otoscopy, and the whisper test were found to be most suitable for use by nurses working with older adults living with dementia in LTCHs. CONCLUSION Although frequently used, the suitability of pure-tone audiometry for use by nursing staff in LTCHs is limited, as standardized audiometry presents challenges for many residents, and specific training is needed to successfully adapt test administration procedures and interpret results. The whisper test was considered to be more suitable for use by staff in LTCH; however, it yields a limited characterization of hearing loss. There remains an urgent need to develop new approaches to screen hearing in LTCHs.
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Affiliation(s)
- Fiona Höbler
- KITE – Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Katherine S. McGilton
- KITE – Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Walter Wittich
- École d’optométrie, Université de Montréal, Montréal, QC, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada
- Centre de réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l’Île-de-Montréal, Montréal, QC, Canada
| | - Kate Dupuis
- Sheridan Centre for Elder Research, Sheridan College, Oakville, ON, Canada
| | - Marilyn Reed
- Audiology, Baycrest Health Sciences, Toronto, ON, Canada
| | - Shirley Dumassais
- École d’optométrie, Université de Montréal, Montréal, QC, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada
| | - Paul Mick
- Department of Surgery, Faculty of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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Andrusjak W, Barbosa A, Mountain G. Identifying and Managing Hearing and Vision Loss in Older People in Care Homes: A Scoping Review of the Evidence. THE GERONTOLOGIST 2020; 60:e155-e168. [PMID: 31322168 DOI: 10.1093/geront/gnz087] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Poor identification of sensory impairments in care homes can be due to multiple factors. This scoping review identifies and synthesizes the literature into the detection of hearing and vision loss in the care home environment, and the management of these sensory losses once identified. RESEARCH DESIGN AND METHODS A scoping review methodology was used to identify primary research of any design published from 1985 to September 2018. Six electronic databases were searched, and articles were also sourced from reference lists, relevant charity organizations and published experts. RESULTS Six electronic databases and multiple gray literature sources identified 51 articles for inclusion. The evidence confirmed that lack of knowledge in care home staff, poor management of assistive aids, unsuitable environment, lack of connections with optometrists and audiologists, underuse of effective screening tools, and the added complexity of assisting those with dementia are all barriers to effective practice. Conversely, flexible training programs, availability of a variety of assistive aids, simple screening tools, and adaptions to the environment are effective facilitators. DISCUSSION AND IMPLICATION This review acknowledges that the barriers to identification and management of hearing and vision loss in care homes are multifaceted and that collaboration of multiple stakeholders is required to implement change and improve the residents' ear and eye care. Recommendations are offered to support more effective service provision tailored to meet the needs of people with sensory impairments living in care homes, and this could subsequently improve best practice.
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Affiliation(s)
- Wendy Andrusjak
- Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, UK
| | - Ana Barbosa
- Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, UK
| | - Gail Mountain
- Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, UK
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Giving permission to care for people with dementia in residential homes: learning from a realist synthesis of hearing-related communication. BMC Med 2019; 17:54. [PMID: 30827280 PMCID: PMC6398258 DOI: 10.1186/s12916-019-1286-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 02/11/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Managing hearing communication for residents living with hearing loss and dementia in long-term care settings is challenging. This paper explores how care can be effective in optimising hearing communication for residents living with dementia. We argue that the underlying notion of permission or authorisation allows care staff to do what they know will be effective in providing person-centred care that enhances hearing communication. The paper also indicates that this notion of permission can usefully be applied to other areas of care home practice. METHODS To address hearing-related communication in care homes, we conducted a realist synthesis (RS). As a theory-driven approach to reviewing literature, it also uses expert opinion to understand complex health situations. Using RS, we developed a theory surrounding the management of hearing-related communication in care homes. Applying formal processes to the literature search and data extraction, the analysis uncovered relevant mechanisms and contexts to help confirm, refute or refine our understanding of how hearing communication could be improved. RESULTS Forty-three papers were selected for the realist synthesis. The documents were analysed to construct five context-mechanism-outcome configurations (CMOCs). The CMOCs represent possible care interventions to optimise hearing-related communication in care homes for person living with dementia and hearing loss (PLWDHL). They include leadership promoting positive regard and empathy through person-centred care, communication training for staff, 'knowing the person' and relationship building for responsive awareness of residents' hearing needs, maintaining and monitoring hearing communication through care planning, and managing noise in the care home environment. CONCLUSIONS Leadership that provides appropriate training and resources is likely to enhance knowledge and skills, leading to staff feeling able and equipped to respond to the hearing-related communication needs of PLWDHL. Collaboration with local hearing services is likely to raise awareness of hearing loss among care home staff. Importantly, care staff require a sense of permission from leadership, to work with knowledge and autonomy in the interest of residents living with dementia and hearing loss.
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Höbler F, Argueta-Warden X, Rodríguez-Monforte M, Escrig-Pinol A, Wittich W, McGilton KS. Exploring the sensory screening experiences of nurses working in long-term care homes with residents who have dementia: a qualitative study. BMC Geriatr 2018; 18:235. [PMID: 30286718 PMCID: PMC6172849 DOI: 10.1186/s12877-018-0917-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 09/12/2018] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The prevalence of vision and hearing loss is higher amongst older individuals with dementia, as well as higher in long-term care settings than in the wider community. However, the incidence of sensory impairment is underreported and often goes untreated. In this study, we aimed to understand nurses' current experiences of screening and caring for long-term care residents who have dementia and sensory impairment. METHODS As part of a larger study on the sensory screening of long-term care residents with dementia, an environmental scan was conducted with front-line healthcare providers. We report here on the findings from the content analysis of individual, semi-structured interviews with nurses working in two long-term care homes in Southern Ontario, Canada. Twenty regulated nurses, including designated resident assessment coordinators, working full- or part-time with individuals who have dementia, participated across the two sites. All interviews were transcribed, and their contents reviewed and coded for themes by means of inductive thematic analysis. RESULTS Following a systematic and recursive approach, three analysts identified several themes relating to: 1) the sensory screening process, 2) communication strategies, and 3) quality of life, sensory loss, and dementia. Participants reported on the strengths and limitations of screening procedures, what improvements should be made, which informal strategies are effective, and the continued professional development that is needed. CONCLUSIONS Nurses demonstrated insight into the facilitators and barriers to effective screening and care of residents with dementia and sensory impairments, and expressed the need for further education, more suitable screening tools, and formalised accountability within the screening process for vision and hearing loss in these long-term care residents.
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Affiliation(s)
- Fiona Höbler
- Toronto Rehabilitation Institute-University Health Network, 130 Dunn Ave, Toronto, M6K 2R7 Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON Canada
| | - Xochil Argueta-Warden
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 130 Dunn Ave, Toronto, M6K 2R7 Canada
| | | | - Astrid Escrig-Pinol
- Toronto Rehabilitation Institute-University Health Network, 130 Dunn Ave, Toronto, M6K 2R7 Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
| | - Walter Wittich
- School of Optometry, Université de Montréal, 3744, rue Jean-Brillant, 260-7, Montréal, Québec, H3T 1P1 Canada
- CRIR/Centre de réadaptation MAB-Mackay du CIUSSS du Centre-Ouest-de-l’Île-de-Montréal, Montréal, Québec, Canada
- CRIR/Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, Québec, Canada
| | - Katherine S. McGilton
- Toronto Rehabilitation Institute-University Health Network, 130 Dunn Ave, Toronto, M6K 2R7 Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 130 Dunn Ave, Toronto, M6K 2R7 Canada
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Schwartz SR, Magit AE, Rosenfeld RM, Ballachanda BB, Hackell JM, Krouse HJ, Lawlor CM, Lin K, Parham K, Stutz DR, Walsh S, Woodson EA, Yanagisawa K, Cunningham ER. Clinical Practice Guideline (Update): Earwax (Cerumen Impaction). Otolaryngol Head Neck Surg 2017; 156:S1-S29. [DOI: 10.1177/0194599816671491] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective This update of the 2008 American Academy of Otolaryngology—Head and Neck Surgery Foundation cerumen impaction clinical practice guideline provides evidence-based recommendations on managing cerumen impaction. Cerumen impaction is defined as an accumulation of cerumen that causes symptoms, prevents assessment of the ear, or both. Changes from the prior guideline include a consumer added to the development group; new evidence (3 guidelines, 5 systematic reviews, and 6 randomized controlled trials); enhanced information on patient education and counseling; a new algorithm to clarify action statement relationships; expanded action statement profiles to explicitly state quality improvement opportunities, confidence in the evidence, intentional vagueness, and differences of opinion; an enhanced external review process to include public comment and journal peer review; and 3 new key action statements on managing cerumen impaction that focus on primary prevention, contraindicated intervention, and referral and coordination of care. Purpose The primary purpose of this guideline is to help clinicians identify patients with cerumen impaction who may benefit from intervention and to promote evidence-based management. Another purpose of the guideline is to highlight needs and management options in special populations or in patients who have modifying factors. The guideline is intended for all clinicians who are likely to diagnose and manage patients with cerumen impaction, and it applies to any setting in which cerumen impaction would be identified, monitored, or managed. The guideline does not apply to patients with cerumen impaction associated with the following conditions: dermatologic diseases of the ear canal; recurrent otitis externa; keratosis obturans; prior radiation therapy affecting the ear; previous tympanoplasty/myringoplasty, canal wall down mastoidectomy, or other surgery affecting the ear canal. Key Action Statements The panel made a strong recommendation that clinicians should treat, or refer to a clinician who can treat, cerumen impaction, defined as an accumulation of cerumen that is associated with symptoms, prevents needed assessment of the ear, or both. The panel made the following recommendations: (1) Clinicians should explain proper ear hygiene to prevent cerumen impaction when patients have an accumulation of cerumen. (2) Clinicians should diagnose cerumen impaction when an accumulation of cerumen, as seen on otoscopy, is associated with symptoms, prevents needed assessment of the ear, or both. (3) Clinicians should assess the patient with cerumen impaction by history and/or physical examination for factors that modify management, such as ≥1 of the following: anticoagulant therapy, immunocompromised state, diabetes mellitus, prior radiation therapy to the head and neck, ear canal stenosis, exostoses, and nonintact tympanic membrane. (4) Clinicians should not routinely treat cerumen in patients who are asymptomatic and whose ears can be adequately examined. (5) Clinicians should identify patients with obstructing cerumen in the ear canal who may not be able to express symptoms (young children and cognitively impaired children and adults), and they should promptly evaluate the need for intervention. (6) Clinicians should perform otoscopy to detect the presence of cerumen in patients with hearing aids during a health care encounter. (7) Clinicians should treat, or refer to a clinician who can treat, the patient with cerumen impaction with an appropriate intervention, which may include ≥1 of the following: cerumenolytic agents, irrigation, or manual removal requiring instrumentation. (8) Clinicians should recommend against ear candling for treating or preventing cerumen impaction. (9) Clinicians should assess patients at the conclusion of in-office treatment of cerumen impaction and document the resolution of impaction. If the impaction is not resolved, the clinician should use additional treatment. If full or partial symptoms persist despite resolution of impaction, the clinician should evaluate the patient for alternative diagnoses. (10) Finally, if initial management is unsuccessful, clinicians should refer patients with persistent cerumen impaction to clinicians who have specialized equipment and training to clean and evaluate ear canals and tympanic membranes. The panel offered the following as options: (1) Clinicians may use cerumenolytic agents (including water or saline solution) in the management of cerumen impaction. (2) Clinicians may use irrigation in the management of cerumen impaction. (3) Clinicians may use manual removal requiring instrumentation in the management of cerumen impaction. (4) Last, clinicians may educate/counsel patients with cerumen impaction or excessive cerumen regarding control measures.
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Affiliation(s)
- Seth R. Schwartz
- Department of Otolaryngology, Virginia Mason Medical Center, Seattle, Washington, USA
| | - Anthony E. Magit
- Division of Otolaryngology, Rady Children’s Hospital–San Diego, San Diego, California, USA
| | - Richard M. Rosenfeld
- Department of Otolaryngology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | | | | | - Helene J. Krouse
- College of Nursing, Wayne State University, Detroit, Michigan, USA
| | - Claire M. Lawlor
- Department of Otolaryngology, Tulane University, New Orleans, Louisiana, USA
| | - Kenneth Lin
- Georgetown University School of Medicine, Washington, DC, USA
| | - Kourosh Parham
- Division of Otolaryngology, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - David R. Stutz
- University of Michigan Health System, East Ann Arbor Health Care Center, Ann Arbor, Michigan, USA
| | - Sandy Walsh
- Consumers United for Evidence-Based Healthcare, Davis, California, USA
| | | | - Ken Yanagisawa
- Yale New Haven Hospital and Southern New England Ear, Nose, Throat & Facial Plastic Surgery Group, LLP, New Haven, Connecticut, USA
| | - Eugene R. Cunningham
- American Academy of Otolaryngology—Head and Neck Surgery Foundation, Alexandria, Virginia, USA
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Review of the effect of music interventions on symptoms of anxiety and depression in older adults with mild dementia. Int Psychogeriatr 2015; 27:1661-70. [PMID: 25921299 DOI: 10.1017/s1041610215000393] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Treatment of anxiety and depression, the most common psychiatric symptoms in older adults with mild dementia, requires innovative approaches due to the high cost and significant side effects associated with traditional pharmacological interventions. Alternative non-pharmacological therapies, such as music, when used in conjunction with pharmacological treatment, have the potential to alleviate symptoms of anxiety and depression in older adults diagnosed with mild dementia. The purpose of this review was to examine the evidence of music's efficacy in improving symptoms of anxiety and depression in older adults with mild dementia. METHODS Four databases (Medline, CINAHL, PsychInfo, PubMed) were searched using the terms "music," "music therapy," "music intervention," "singing," "dementia," "anxiety," and/or "depression," identifying ten studies that met the inclusion and exclusion criteria. RESULTS The poor methodological rigor of the studies precluded reaching consensus on the efficacy of a music intervention in alleviating symptoms of anxiety and depression in older adults with mild dementia. CONCLUSIONS There was inconclusive evidence as to whether music interventions are effective in alleviating symptoms of anxiety and depression in older adults with mild dementia due to the poor methodological rigor. However, with improved designs guided by a deeper understanding of how music engages the aging brain, music may emerge as an important adjunct therapy to improving the lives of older adults with mild dementia.
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Linssen AM, Joore MA, Theunissen EJJM, Anteunis LJC. The effects and costs of a hearing screening and rehabilitation program in residential care homes for the elderly in the Netherlands1. Am J Audiol 2014; 22:186-9. [PMID: 23800817 DOI: 10.1044/1059-0889(2013/12-0058)] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE This study describes the effects and costs of hearing screening and rehabilitation in residential care homes for the elderly. It was hypothesized that offering an in-house hearing screening and rehabilitation program would be an effective strategy to increase hearing aid ownership among the residents. METHOD All 705 residents of 8 residential care homes in the Netherlands were invited to participate in a hearing screening (pure-tone audiometry) and rehabilitation (hearing aids) program. Resident participation was analyzed, and the costs were calculated. RESULTS A total of 243 residents (34%) participated in the screening, 222 (91%) of whom had hearing loss. Ninety-one (41%) of the screening participants with hearing loss started rehabilitation, which was successful for 50 (55%) of them. Hearing aid ownership among the residents with hearing loss increased from 28% at the start of the program to 33% at the end. The costs were €1,896 (US $2,480) per successfully rehabilitated resident. Hearing aid trials and hearing aids together accounted for 83% of the total costs. CONCLUSION The effectiveness of the program was limited, as hearing aid ownership increased only slightly. Cost reduction measures should focus on decreasing the number of unsuccessful hearing aid trials.
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Affiliation(s)
- A. M. Linssen
- Maastricht University Medical Centre, Maastricht, The Netherlands
| | - M. A. Joore
- Maastricht University Medical Centre, Maastricht, The Netherlands
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Reyes-Alcázar V, Cambil Martín J, Herrera-Usagre M. [Recommendations on the safety of patients for socio-health centers: systematic review]. Med Clin (Barc) 2013; 141:397-405. [PMID: 23597954 DOI: 10.1016/j.medcli.2013.02.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2013] [Revised: 02/07/2013] [Accepted: 02/14/2013] [Indexed: 10/27/2022]
Abstract
We did a systematic review to find recommendations on patient safety oriented toward improving the quality of care in nursing homes, residential facilities, housing for the elderly and long-term care facilities, among others. One hundred and thirty-four articles were selected in MEDLINE, EMBASE and CINAHL up to October 2012. Of these, 17 met inclusion criteria and 5 studies were added in the secondary search for further detailed analysis. Few studies with high or very high level of scientific evidence on the scale SIGN were identified. Analyzed studies focused primarily on nursing staff. Most of the recommendations are oriented toward medication-related issues, staff training, pressure ulcers or falls, adherence to guidelines and protocols and topics referred to organizational culture.
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Paglialonga A, Grandori F, Tognola G. Using the Speech Understanding in Noise (SUN) Test for Adult Hearing Screening1. Am J Audiol 2013; 22:171-4. [DOI: 10.1044/1059-0889(2012/12-0055)] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose
To develop a novel speech-in-noise test for adult hearing screening—the Speech Understanding in Noise (SUN) test. The goal was to design a fast, automated, easy-to-use test to identify difficulties in speech communication.
Method
The SUN test consists of a short list of intervocalic consonants in noise presented in a forced-choice paradigm by means of a touch screen. The SUN test was developed and evaluated in an overall population of >6,000 participants. The test is available in various languages (i.e., English, French, German, and Italian) and continues to be developed in others (e.g., Spanish, Portuguese, and Mandarin).
Results
Test time was <1 min/ear. Test–retest reliability was very good. The test showed good agreement with conventional clinical measures (e.g., pure-tone testing, speech-in-noise testing, and self-reported hearing handicap). The test's sensitivity and specificity to identify disabling hearing impairment were 84% and 75%, respectively. The same results were obtained in low and high ambient noise.
Conclusion
The SUN test is fast, repeatable, easy to use, self-explanatory, specific to the impairment, and robust to ambient noise. It may be a viable approach for adult hearing screening in clinical as well as nonclinical settings.
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Affiliation(s)
- Alessia Paglialonga
- CNR, Italian National Research Council, Institute of Biomedical Engineering, Milan, Italy
| | - Ferdinando Grandori
- CNR, Italian National Research Council, Institute of Biomedical Engineering, Milan, Italy
| | - Gabriella Tognola
- CNR, Italian National Research Council, Institute of Biomedical Engineering, Milan, Italy
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Pryce H, Gooberman-Hill R. Foundations of an intervention package to improve communication in residential care settings: A mixed methods study. HEARING BALANCE AND COMMUNICATION 2013. [DOI: 10.3109/21695717.2012.756224] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Jupiter T. Cognition and Screening for Hearing Loss in Nursing Home Residents. J Am Med Dir Assoc 2012; 13:744-7. [DOI: 10.1016/j.jamda.2012.07.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 07/12/2012] [Indexed: 10/28/2022]
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Kovach CR, Simpson MR, Joosse L, Logan BR, Noonan PE, Reynolds SA, Woods DL, Raff H. Comparison of the effectiveness of two protocols for treating nursing home residents with advanced dementia. Res Gerontol Nurs 2012; 5:251-63. [PMID: 22998656 DOI: 10.3928/19404921-20120906-01] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Accepted: 01/16/2012] [Indexed: 11/20/2022]
Abstract
The Serial Trial Intervention (STI) is a decision support tool to address the problem of underassessment and undertreatment of pain and other unmet needs of people with dementia. This study compared the effectiveness of the 5-step and 9-step versions of the STI using a two-group repeated measures quasi-experimental design with randomization of 12 matched nursing homes. The sample consisted of 125 residents with moderate to severe dementia. Both the 5- and 9-step STIs significantly decreased discomfort and agitation from pre- to posttest (effect sizes = 0.45 to 0.90). The 9-step version was more effective for comorbid burden and increased cortisol slope (effect sizes = 0.50 and 0.49). Process variables were all statistically significantly improved using the 9-step STI. Nurse time was not different between the two groups. The clinical decision support rules embedded in the STI, particularly the 9-step version, helped nurses change practice and improved resident outcomes.
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Affiliation(s)
- Christine R Kovach
- Self-Management Science Center, University of Wisconsin, Milwaukee, WI, USA.
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