Hearing Impairment Clinical Trial
Official title:
Clinically Implementing Online Hearing Support
Previous research has proposed employing telehealth in hearing healthcare to improve clinical
care and increase access to hearing services. Several studies have shown that hearing support
can be carried out without in-person meetings and lead to significant benefits for hearing
aid users. Interventions for persons with hearing impairment improve communication and
improve outcomes more than hearing aid use alone.
The first purpose of this study is needs-oriented and the second purpose is
research-oriented. The needs-oriented purpose of this project is to, via a national website
of health information and services for Sweden, provide needed online support to hearing aid
users. The research-oriented purpose of this project is to document the effectiveness of the
online support compared to traditional support that the Hearing Organization, provides
("standard care").
Aural rehabilitation The most common approach to hearing impairment is hearing aid fitting as
a part of aural rehabilitation (AR). In Sweden, approximately 50% of those who could benefit
from hearing aids are fitted with them, and nearly half of those use their hearing aids to a
considerable extent every day. Despite addressing the hearing impairment with hearing aids,
many hearing aid users experience substantial communication difficulties that can affect
their performance in daily life situations. This could cause patients to stop using their
hearing aids, which may negatively affect their interpersonal interactions and involvement in
community life.
Adjusting to hearing impairment involves more than just hearing aid fitting, although hearing
aid fitting is a step in the right direction. Additional steps within AR, such as learning
about the condition and providing perceptual training and counseling, need to be included in
order to minimize the negative effects of a hearing impairment on social interactions and
quality of life. These additional steps can effectively be included variously throughout the
AR (separately or in combination, and individually or in groups), they may increase hearing
aid use and satisfaction, and can be performed as an adjunct to or a supplement for hearing
aid fitting. However, even though combining these additional steps with hearing aid use has
proven to be beneficial, most hearing aid users are unaware of and are not offered any other
rehabilitation measures than hearing aid fitting. This deficiency could be due to clinicians
experiencing lack of time and difficulties scheduling interventions in addition to hearing
aid fitting. It could also be due to the presumably increased costs of adding extra support
to hearing aid fitting. These aspects could hinder audiologist's in general clinical practice
from providing holistic care. Thus, the overall availability of comprehensive AR is low.
Internet interventions Online interventions and healthcare information is cost-effective.
Online hearing healthcare has increased in recent years and is empowering for persons with
hearing impairment. Telehealth (i.e., telephone and internet) offers a more cost-effective
approach to hearing healthcare and increases the possibilities for the audiologist to reach
out to persons with hearing impairment. Previous research has proposed employing telehealth
in hearing healthcare to improve clinical care and increase access to hearing services.
Effective internet interventions have four important interactive design features: 1) social
context and support, 2) contacts with intervention, 3) tailoring, and 4) self-management.
Patient participation is central for self-management to be successful. For example, a person
with hearing impairment can apply knowledge obtained in communication training to reduce
hearing-related problems. The role of the audiologist in delivering social contact and
support, and contacts with the intervention, seems to be of particular importance in online
audiology interventions.
Purpose With this project we want to provide online support to hearing aid users. Further on,
we want to document the effectiveness of the online support compared to traditional support
that the Hearing Organization, VGR, provides ("standard care").
The needs-oriented purpose: The project is a part of a collaboration between 1177 Care-Guide
and region Vastra Gotaland (VGR). 1177 Care-Guide is a national website of health information
and services for Sweden. Every region customizes its 1177 Care-Guide. Regions use the 1177
Care-Guide platform to provide online services. The needs-oriented purpose of this project is
to, via 1177, provide needed online support to hearing aid users. The research-oriented
purpose of this project is to document the effectiveness of the online support compared to
traditional support that the Hearing Organization, VGR, provides ("standard care").
Traditional support ("standard care") in Sweden differs across and within counties, in
particular in terms of the number of visits and the content of comprehensive AR. The costs of
amplification for the person with hearing impairment may also vary across counties.
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