Clinicians' and Managers' Views and Experiences of Audiology and Speech-Language Pathology Service Provision for Culturally and Linguistically Diverse Families of Young Children With Hearing Loss

PURPOSE

This study aimed to gather the views and experiences of clinicians and managers on early intervention audiology and speech-language pathology services for culturally and linguistically diverse (CALD) families of children with hearing loss.

METHOD

This qualitative descriptive study involved 27 semistructured interviews with audiologists, speech-language pathologists, and managers working with CALD families of young children with hearing loss. Purposeful sampling was used to recruit participants from three hearing centers working with these families. Interviews were analyzed using thematic analysis.

RESULTS

Analysis of the data resulted in five themes: (a) There were perceived added complexities for CALD families in accessing and being involved in services and receiving information; (b) there were perceived family-provider relationship complexities, cultural differences, and service delivery challenges in working with CALD families; (c) clinicians and managers used various strategies for service provision of CALD families; (d) involving interpreters benefited service provision but was challenging at times; and (e) looking to the future and recommendations for clinical practice.

CONCLUSIONS

Current practices reflect some principles of family-centered care for CALD families of young children with hearing loss. Families and services may benefit from more support regarding family-provider partnerships, information materials and child assessments, working with interpreters, and center support for time and resources.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.20044427.

Appropriateness of deep vein thrombosis (DVT) prophylaxis use among medical inpatients: a DVT risk alert tool (DRAT) study

INTRODUCTION

Increasing incidence of Venous Thromboembolism (VTE) has complicated treatment courses for hospitalised patients. Despite recommendation to support deep vein thrombosis (DVT) risk assessment and appropriate use of prophylaxis in medical inpatients, it is either neglected or prescribed unnecessarily by the clinicians. This study aimed to assess and compare the appropriateness of DVT prophylaxis prescribing between usual care versus a pharmacist-driven DVT Risk Alert Tool (DRAT) intervention among hospitalised medical patients.

METHODS

A prospective pre- and post-intervention study was conducted among medical inpatients in a Malaysian secondary care hospital. DVT and bleeding risks were stratified using validated Padua Risk Assessment Model (RAM) and International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) Bleeding Risk Assessment Model. Pharmacist-driven DRAT was developed and implemented post-interventional phase. DVT prophylaxis use was determined and its appropriateness was compared between pre and post study using multivariate logistic regression with IBM SPSS software version 21.0.

RESULTS

Overall, 286 patients (n=142 pre-intervention versus n=144 post-intervention) were conveniently recruited. The prevalence of DVT prophylaxis use was 10.8%. Appropriate thromboprophylaxis prescribing increased from 64.8% to 68.1% post-DRAT implementation. Of note, among high DVT risk patients, DRAT intervention was observed to be a significant predictor of appropriate thromboprophylaxis use (14.3% versus 31.3%; adjusted odds ratio=2.80; 95% CI 1.01 to 7.80; p<0.05).

CONCLUSION

The appropriateness of DVT prophylaxis use was suboptimal but doubled after implementation of DRAT intervention. Thus, an integrated risk stratification checklist is an effective approach for the improvement of rational DVT prophylaxis use.

Perspectives of adults with cochlear implants on current CI services and daily life

This paper reports on a survey and interviews carried out with adults who have gone through the cochlear implantation pathway. It explores their experiences of current services, the assessment process for implantation, and the impact on their daily lives, including views and experiences on communication, independence and confidence. It also explores, in today's financially challenging climate, their awareness of current funding issues and the value of their implant to them.

SoundSpace Online: The Development of an Online Resource About Hearing Loss

PURPOSE

The Internet has been a growing source of health information on hearing loss, but the information provided often varies in quality, readability, and usability. Additionally, the information is provided across a wide range of domains, making access challenging to those who need it. This research forum article describes the development of a new website, SoundSpace Online (Ng, Archbold, Mayer, & Mulla, 2014), which aims to tackle these issues and bring together information and resource s f or all those concerned with hearing loss.

METHOD

The SoundSpace Online website’s current developmental state was reached through the following methods: (a) discussions with a group of individuals that included experts in e-learning, education, research, and hearing loss; (b) interviews with different target groups (e.g., users, families, and professionals); and (c) collaboration with contributors.

RESULT

The website is structured to become a g o-to resource on various topics related to hearing loss, providing accurate, comprehensive, and functional information and resources at varying levels of complexity for the intended users.

CONCLUSION

The literature and the range of interest have illustrated the need for an up-to-date website providing information and resources on hearing loss. Challenges include monitoring and keeping the website up to date; in this article, a plan of action is discussed. The website is currently in development, with plans for a launch in the near future.

Three-dimensional analysis of the palmar plate and collateral ligaments at the proximal interphalangeal joint

The purpose of this study was to analyze the palmar plate complex at the proximal interphalangeal joint using a three-dimensional (3D) technique, which makes it easier to understand the dimensions of structures and their relationship to the adjacent components. This method allows individual elements to be removed virtually, facilitating clearer observation of each component. Sixteen cadaveric specimens were dissected and reconstructed in a 3D virtual environment. The palmar plate is made up of a distal, fibrous portion and a proximal, membranous portion, which anchors distally on the base of the middle phalanx and is continuous with the bilateral check-rein ligaments proximally. The accessory collateral ligaments and the A3 pulley suspend the palmar plate laterally.

Perception of spectrally degraded reflexives and pronouns by children

Speech perception skills in cochlear-implant users are often measured with simple speech materials. In children, it is crucial to fully characterize linguistic development, and this requires linguistically more meaningful materials. The authors propose using the comprehension of reflexives and pronouns, as these specific skills are acquired at different ages. According to the literature, normal-hearing children show adult-like comprehension of reflexives at age 5, while their comprehension of pronouns only reaches adult-like levels around age 10. To provide normative data, a group of younger children (5 to 8 yrs old), older children (10 and 11 yrs old), and adults were tested under conditions without or with spectral degradation, which simulated cochlear-implant speech transmission with four and eight channels. The results without degradation confirmed the different ages of acquisition of reflexives and pronouns. Adding spectral degradation reduced overall performance; however, it did not change the general pattern observed with non-degraded speech. This finding confirms that these linguistic milestones can also be measured with cochlear-implanted children, despite the reduced quality of sound transmission. Thus, the results of the study have implications for clinical practice, as they could contribute to setting realistic expectations and therapeutic goals for children who receive a cochlear implant.