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Family Involvement

Family Involvement in Adult Audiology Appointments

Reynolds, Bailey; Yoho, SarahE. PhD; Muñoz, Karen EdD

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doi: 10.1097/01.HJ.0000654924.41430.bf
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The involvement of family and loved ones in health care appointments can be very beneficial, including providing patients with emotional and logistical support and sharing the burden of processing information.1-3 This may be particularly true for audiology appointments since the consequences of hearing loss can be profound. For audiologists to get a more holistic view of the challenges that patients face, it is important to actively involve family members in appointments since hearing loss often affects the entire family. Intervention plans for individuals can then be tailored to be more comprehensive,4,5 such as addressing communication barriers within the home environment for both sides of the communication pair. Audiology appointments can also be overwhelming to a new patient who just received a diagnosis along with substantial amounts of new information.

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Unfortunately, it appears that family involvement in adult audiology services may be limited.6 Despite awareness of its benefits, little research has been done on why this is the case. To increase the participation of family members, it is first necessary to understand the barriers to such participation, then educate audiology professionals on these barriers and how they can work with patients and their families to overcome them.

As a first step, we conducted a survey to gain insights into patients’ perspectives on involving family members in audiology appointments.

PATIENT PERSPECTIVES

A survey was completed by nearly 400 patients in a university audiology clinic.7 The survey asked questions concerning patients’ desire to have a family member present at audiology appointments and how their hearing loss affects their lives and those of their loved ones. Of note, nearly 50 percent of patients brought a companion when they came to the university audiology clinic for an appointment, during which they completed the survey. However, only 39 percent of respondents reported that they wanted family at appointments, and more than half said that they either did not want family to attend or were unsure. This is a relatively large proportion of participants who reported not wanting family at appointments. One possible reason is embarrassment or the stigma surrounding hearing loss. The study found a relationship between patients’ lack of desire to include family in appointments and negative feelings related to their hearing loss, including frequently feeling embarrassed or isolated. However, patient variables such as age, gender, duration of hearing loss, and education level did not predict whether a patient desired family at appointments.

It may be helpful to understand the reasoning and feelings of those who do or don't want family at appointments to overcome these barriers. Among those who want family at appointments, their motivations included:

  • for the family to gain a better understanding of hearing loss,
  • have assistance in retaining and remembering information provided during the appointment, and
  • have additional support.

For example, one respondent said that having family members at appointments would be helpful so they “understand what steps and procedures are being taken.” Another stated that her family members “may be able to express how my hearing loss is affecting them, and they would be able to get information on how to deal with their concerns.” On the other hand, patients who did not want family at appointments reported reasons such as having family members who were busy or lived in distant locations.

CLINICAL IMPLICATIONS

Ultimately, audiologists will need to find ways to overcome the barriers to family involvement. These barriers may include the stigma associated with hearing loss, which could be potentially mitigated through improved counseling. However, other barriers are more practical or logistical in nature, such as family living far away from the patient. Technology and the increased adoption of telepractice in audiology provide creative and simple solutions to address these logistical barriers.

Many patients may not realize the benefits of involving family in their hearing health care. Audiologists can educate patients and provide opportunities for involvement, which may be as simple as directly inviting patients to bring family members to appointments so that the concerns of both the patient and his or her family can be addressed or informing the patient of ways to include family members who live far away. Since our study found no relationship between patient characteristics (e.g., age or gender) and a patient's desire to have family at appointments, audiologists should have these conversations with all patients regardless of these factors.

The study described here is just a first step toward understanding patient attitudes on family involvement in audiology care. It is important to investigate audiology professionals’ understanding of and attitudes toward family involvement. Having an open and ongoing dialogue between patients and professionals could lead to a much deeper understanding of why family involvement is limited and what changes in practice can be implemented to increase participation. With the growing focus on patient- and family-centered care in audiology,3,4,8 increased awareness of this issue among professionals is timely and necessary.

REFERENCES

1. Gunn, K. L., Seers, K., Posner, N., & Coates, V. (2012). ‘Somebody there to watch over you’: the role of the family in everyday and emergency diabetes care. Health & social care in the community, 20(6), 591-598.doi: 10.1111/j.1365-2524.2012.01073.x
2. Piette, J.D. (2010). Moving beyond the notion of ‘self’ care. Chronic Illness, 6, 3-6.doi: 10.1177/1742395309359092
3. Singh, G., Hickson, L., English, K., Scherpiet, S., Lemke, U., Timmer, B., & Launer, S. (2016). Family-centered adult audiologic care: A Phonak position statement. Hearing Review, 23(4), 16.
4. Meyer, C., Scarinci, N., Ryan, B., & Hickson, L. (2015). “This Is a Partnership Between All of Us”: Audiologists' Perceptions of Family Member Involvement in Hearing Rehabilitation. American Journal of Audiology, 24(4), 536-548.doi: 10.1044/2015
5. American Speech Language Hearing Association, (2017). Hearing Aids for Adults. Practice Portal. Retrieved on November 24, 2017 from 7. Reynolds, B., Yoho, S. E., Muñoz, K., & Pitt, C. (2019). Family Involvement in Adult Hearing Evaluation Appointments: Patient Perspectives. American Journal of Audiology. https://doi.org/10.1044/2019_AJA-19-0013.
6. Ekberg, K., Meyer, C., Scarinci, N., Grenness, C., & Hickson, L. (2015). Family member involvement in audiology appointments with older people with hearing impairment. International Journal of Audiology, 54(2), 70-76.doi: 10.3109/14992027.2014.948218 http://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935381&section=Key_Issues.
7. Reynolds, B., Yoho, S. E., Muñoz, K., & Pitt, C. (2019). Family Involvement in Adult Hearing Evaluation Appointments: Patient Perspectives. American Journal of Audiology. https://doi.org/10.1044/2019_AJA-19-0013.
8. Boisvert, I., Clemesha, J., Lundmark, E., Crome, E., Barr, C., & McMahon, C. M. (2017). Decision-making in audiology: Balancing evidence-based practice and patient-centered care. Trends in Hearing, 21, 1-14.
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