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Original Research

Understanding the Hospital Experience of Older Adults with Hearing Impairment

Contrada, Emily

AJN The American Journal of Nursing: June 2018 - Volume 118 - Issue 6 - p 35,44
doi: 10.1097/01.NAJ.0000534822.11621.2c
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Understanding the Hospital Experience of Older Adults with Hearing Impairment

GENERAL PURPOSE:

To present the results of a study that assessed the hospital experience of older adults with hearing impairment in order to formulate suggestions for improving nursing care.

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LEARNING OBJECTIVES/OUTCOMES:

After completing this continuing education activity, you should be able to

  • summarize the findings from the review of the literature.
  • outline the methods and results of the authors’ study.
  • identify strategies to improve the hospital experience of the target population.
  1. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), what proportion of people ages 75 years and older have disabling hearing loss?
    1. one-third
    2. half
    3. two-thirds
  2. Pacala and Yueh reported that, among frail elderly patients with multiple comorbidities, hearing loss is a contributing factor to
    1. delirium.
    2. low literacy.
    3. failure to thrive.
  3. In a national survey, what percentage of hospice and palliative care providers could recall an encounter in which patients’ hearing deficits negatively affected communication?
    1. 42%
    2. 63%
    3. 88%
  4. Bridges and colleagues’ systematic review of qualitative studies of hospitalized older adults found that communication difficulties may contribute to feelings of
    1. powerlessness.
    2. depression.
    3. anger.
  5. Ekdahl and colleagues reported that many frail elderly patients perceive the hospital setting as an institution of power with which it is not possible to
    1. communicate.
    2. disagree.
    3. negotiate.
  6. According to the NIDCD, what percentage of people ages 70 years and older who would benefit from using hearing aids actually use them?
    1. fewer than 30%
    2. about 40%
    3. nearly 50%
  7. The authors noted that people often leave their hearing aids at home during a hospitalization, possibly because
    1. they forget to bring them.
    2. in the event of loss, they are costly to replace.
    3. they don't help much.
  8. Midha and Malik reported that hearing aids were often
    1. cumbersome.
    2. inconvenient.
    3. ineffective.
  9. In the authors’ study, which of the following was an exclusion criterion?
    1. being older than 65 years
    2. being unable to understand English
    3. having cognitive impairment that limited communication
  10. The study interviews followed the 4 phases outlined by Jovchelovitch and Bauer, one of which is
    1. concluding talk.
    2. outcome evaluation.
    3. follow-up communication.
  11. Some participants indicated that they avoided sharing hearing difficulties with staff because
    1. they knew any helpful measures wouldn't last.
    2. they did not want to inconvenience staff.
    3. such interactions often triggered anger.
  12. The authors noted that participants evaluated certain cues when deciding whether to disclose hearing loss to staff; these included which of the following?
    1. facial expressions
    2. presence of family
    3. environmental noise
  13. Participants reported several barriers to understanding conversations, including
    1. the poor quality of hospital-provided personal sound amplifiers.
    2. staff speaking to them at eye level.
    3. staff speaking too loudly.
  14. Study participants offered several recommendations for improving communication, including that staff
    1. share information about patients’ hearing deficits at shift handoffs.
    2. convey information only through printed handouts.
    3. speak as loudly as possible.
  15. Several participants reported that they had not told staff about specific barriers to hearing, such as
    1. people speaking from behind them.
    2. multiple people speaking at once.
    3. people looking down at a computer when speaking.
  16. The authors noted that participants didn't expect staff members to accommodate their hearing impairment, and consequently
    1. pretended to hear everything staff said.
    2. requested a personal sound amplifier.
    3. withdrew from participating in their care.
  17. In the finger rub test, a positive result is when the patient fails to hear the sound 2 out of
    1. 3 times.
    2. 4 times.
    3. 5 times.
  18. Which of the following strategies should nurses use when communicating with patients who have hearing loss?
    1. Leave the door to the room open.
    2. Use a higher pitch when speaking.
    3. Rephrase rather than repeat information.
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