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Aim: Best-practice in audiological rehabilitation takes a holistic client- and family-centred approach and considers hearing care in the context of personal well-being. Hearing loss not only impairs the ability to hear, but can also compromise the ability to communicate, thus negatively impacting both social and emotional well-being. Hearing care professionals play a key role in fostering their client's well-being. This paper aims to provide evidence-based recommendations to ensure inclusion of social-emotional well-being in audiologic rehabilitation clinical practice. Methods: A review of current research and expert opinion. Results: This guide proposes a 5-step plan which includes: identifying the client's social-emotional well-being; including family members in audiological rehabilitation; incorporating social-emotional needs and goals in an individualized management plan; relating identified hearing needs and goals to rehabilitation recommendations; and using counselling skills and techniques to explore and monitor social-emotional well-being. Each component of the 5-step plan is discussed and clinical considerations are presented. Conclusion: These comprehensive recommendations provide guidance to hearing care professionals looking to ensure clients' social-emotional well-being are considered throughout the rehabilitation journey. [ABSTRACT FROM AUTHOR]

To conduct the first phases in the development of a self-report measure of empowerment on the hearing health journey, specifically, item generation and content evaluation of the initial pool of items generated. A content expert panel survey and cognitive interviews were conducted. Descriptive statistics were obtained for the quantitative data, and the cognitive interviews were analysed using thematic analysis. Eleven researchers and clinicians participated in the content expert surveys. Sixteen experienced hearing aid users participated in the cognitive interviews, recruited from the USA and Australia. The items underwent five iterations based on feedback from the survey and interview data. This resulted in a set of 33 quality-tested potential survey items that were rated highly for relevance (mean = 3.96), clarity (mean = 3.70) and fit to dimensions of empowerment (mean = 3.92) (scale 0-4, where 4 was the maximum rating). Involving stakeholders in item generation and content evaluation increased relevance, clarity, fit to dimension, comprehensiveness, and acceptability of the items. This preliminary version of the 33-item measure underwent further psychometric refinement (Rasch analysis and traditional classical test theory testing) to validate it for clinical and research use (reported separately). [ABSTRACT FROM AUTHOR]

The first objective was to assess the feasibility of training on hearing aids and communication strategies by support workers in residential care via a cascade training model using two different training packages. The second was to identify key elements of these packages to inform the design of a multimedia training package. Quantitative and qualitative methodologies were used. A pre-post feasibility design assessed the questionnaire data from residential care support workers to measure knowledge and confidence at three stages during the training. Semi-structured interviews explored the support workers' experiences and adherence to cascading the training packages. Fourteen support workers employed by Sense (charity for deafblind people) were trained to become "Hearing Champions" and cascaded their learning to 117 support colleagues. Hearing Champions gained knowledge, skills and confidence, which were subsequently enhanced by sharing their learning with others. Despite individual and organisational barriers, they reported examples of improved practice and feelings of empowerment. It is feasible to deliver training to support workers in residential homes using the face-to-face "Hearing Champions" and multimedia C2Hear training methods by cascading training to their colleagues. Support workers expressed a preference for training that is portable, adaptable and interactive. [ABSTRACT FROM AUTHOR]

To examine patient and audiologist experiences and perspectives of using a patient-centred telecare tool, the Ida Institute's Why Improve My Hearing? (WIMH) Tool, before and during the initial hearing assessment appointment. A qualitative study comprising individual semi-structured interviews using a maximum variation sampling strategy. The data were analysed using an established thematic analysis technique. Fifteen participants, including ten patients (i.e. adults with hearing loss) and five audiologists, were recruited from Adult Audiology Services within the United Kingdom's publicly-funded National Health Service (NHS). Three themes described the impact of using the WIMH Tool. Theme 1 (i.e. enhanced preparation before the appointment): the Tool helps patients to better understand and accept their hearing difficulties in advance of their first appointment. Theme 2 (i.e. enriched discussion during the appointment): the tool can enhance patient-centred communication, as well as the efficiency of the appointment. Theme 3 (i.e. varied impact on outcomes following the appointment): the Tool can improve patient motivation, readiness, and involvement in decision-making, though it may have limited impact on additional outcomes, such as adherence. The WIMH Tool can be successfully implemented in audiological practice, resulting in benefits before and during the initial hearing assessment appointment. [ABSTRACT FROM AUTHOR]

To examine the benefits of home-delivered auditory training for adult hearing aid users using live-voice conversations in the presence of a single-talker distractor (experimental group) or in quiet (active-control group). Randomised controlled trial. The experimental group held conversations with their nominated communication partner in the presence of a single-talker distractor set to a challenging level, 30 min/day, 5 days/week over 4 weeks. The active-control group held comparable conversations in quiet. Behavioural outcome measures of speech-in-noise perception, cognition and self-reported hearing difficulties were assessed pre- and post-training. Participant feedback was obtained. Thirty-nine hearing aid users (32 males, 7 females, mean age = 73.02 years, SD = 4.71 years) and their communication partners. The experimental group significantly improved and outperformed the active-control group for words-in-noise perception. Both groups achieved improvements in self-reported hearing difficulty while only the experimental group improved on dual-task. Subjectively, both groups found live-voice conversations beneficial and reported increased concentration and listening skills. Home-delivered live-voice auditory training with communication partners shows potential to improve outcomes for adult hearing aid users, regardless of the presence or absence of a competing speech distractor. Further research is required to assess mechanisms of benefit and distractor effects within carefully controlled experiments. [ABSTRACT FROM AUTHOR]

To develop a consensus among hearing healthcare professionals in the UK on connected hearing health technologies and service delivery models. A three-round, electronic Delphi review was developed using a participatory-design approach. This included ten open-ended questions (round one) that informed 69 Likert-scaled statements (rounds two and three). An expert panel of 34 hearing health professionals representing all geographic regions of the UK from either the publicly funded National Health Service (n = 22) or independent sector (n = 12). The majority of statements (61%) showed ≥80% consensus, highlighting that there was broad agreement amongst professionals on connected hearing health technologies. For example, there was consensus that adults who report communication difficulties and have no medical contraindications would be ideal candidates. Furthermore, it was unanimously agreed that connected technologies could result in delays in diagnosis of treatable medical conditions, as well as result in inadequate amplification. Overall, the expert panel concurred that connected technologies could serve as "gateway products" that lead to earlier hearing aid uptake. This Delphi review identified overarching areas of agreement that may serve as a blueprint for future implementation of connected hearing health technologies through either conventional or new service delivery models in the UK. [ABSTRACT FROM AUTHOR]

To canvas the views of Australia-based hearing healthcare clinicians regarding group audiological rehabilitation practices. A national cross-sectional self-report survey. Data were analysed using descriptive statistics and content analysis. Sixty-two Australia-based hearing healthcare clinicians, with experience working in an adult rehabilitation setting. Clinicians appeared to positively view the provision of group audiological rehabilitation services, yet were limited in their ability to deliver these services due to organisational barriers. Although some organisational barriers were non-modifiable by the clinician (such as group AR services not prioritised within their workplace, a lack of support from colleagues/managers, lack of resources, and a lack of funding for the delivery of group AR services), others were within the clinicians' ability to change (such as habit formation for recommending these services during clinical appointments). Participants expressed a desire for resources to assist them in delivering group AR, including downloadable lesson plans and information sheets for clients, clinician training videos and client educational videos. Clinicians called for increased diversity in program offerings, specifically relating to the emotional, relational and social impacts of hearing loss. These results provide a framework for the development of interventional studies to increase the utilisation of group audiological rehabilitation services. [ABSTRACT FROM AUTHOR]

Related to the hearing health journey, this study aimed to: (i) explore how empowerment manifests itself from individuals' first awareness of hearing loss through to hearing aid fitting and then to becoming an active hearing aid user, (ii) identify points when the different dimensions of empowerment are most relevant, and (iii) conceptualise empowerment. A semi-structured interview study was conducted, followed by a template analysis of the data. Adult hearing aid users from Sweden (n = 8) and Australia (n = 10) who had worn hearing aids for between 6 and 36 months. The themes that emerged from the transcripts were knowledge, skills and strategies, participation, self-efficacy, and control. This study conceptualises empowerment along the hearing health journey as the process through which individuals with hearing-related challenges acquire and use knowledge, skills, and strategies, and increase self-efficacy, participation, and the feeling of control of their hearing health care, hearing solutions, and everyday lives. There are not specific points along the hearing health journey where any dimension is uniquely relevant, instead, each dimension is a dynamic component at all stages. [ABSTRACT FROM AUTHOR]

To explore the perceived benefit and likely implementation of approaches used by audiologists to address their adult clients' psychosocial needs related to hearing loss. Adults with hearing loss and audiologists completed separate, but related, surveys to rate their perceived benefit and also their likely use of 66 clinical approaches (divided over seven themes) that aim to address psychosocial needs related to hearing loss. A sample of 52 Australian adults with hearing loss, and an international sample of 19 audiologists. Overall, participants rated all of the approaches highly on both benefit and likelihood of use; the highest ranked theme was Providing Emotional Support. Cohort comparisons showed that audiologists ranked the approaches significantly higher than did adults with hearing loss. Overall, participants ranked the themes higher on benefit than on the likelihood to use scales. Adults with hearing loss and audiologists recognise the importance of approaches that address the psychosocial impacts of hearing loss in audiological rehabilitation. However, both groups placed slightly greater value on the internal-based approaches (the clients own emotional response, empowerment, and responsibility), and slightly less emphasis on the external-based approaches (being supported by communication partners, support groups or other health professionals). [ABSTRACT FROM AUTHOR]

To (i) assess the delivery, accessibility, usability, acceptability, and adherence, and (ii) identify suitable outcome measures, for a mobile-enhanced multimedia educational programme (m2Hear) in first-time hearing aid users. A prospective, single-centre feasibility study. First-time hearing aid users (n = 59), recruited at their initial hearing assessment. Evaluations were made at 1-week and at 10–12 weeks post-hearing aid fitting. m2Hear was most commonly accessed via tablets (42.3%). Usability was high for the System Usability Scale (88.5%), and the uMARS, particularly for the Information (M = 4.7), Functionality (M = 4.5) and Aesthetics (M = 4.2) subscales (maximum score = 5). Participant feedback was positive, with a high percent agreeing that m2Hear aided understanding of hearing aids (98%), held their interest (86%), improved confidence to use hearing aids and communicate (84%), and provided additional information to audiologist's advice (82%). Learnings about practical hearing aid handling/maintenance skills and how to communicate with others were reportedly used equally in participant's everyday lives. m2Hear was convenient to use, clear, concise and comprehensive. Outcome measures of social participation resulted in large effect sizes (Cohen's d > 1.6). A theoretically-driven, personalised and co-designed educational m-health intervention is feasible and beneficial for use in the self-management of hearing loss and hearing aids. [ABSTRACT FROM AUTHOR]

To identify the approaches taken by audiologists to address their adult clients' psychosocial needs related to hearing loss. A participatory mixed methods design. Participants generated statements describing the ways in which the psychosocial needs of their adult clients with hearing loss are addressed, and then grouped the statements into themes. Data were obtained using face-to-face and online structured questions. Concept mapping techniques were used to identify key concepts and to map each of the concepts relative to each other. An international sample of 65 audiologists. Ninety-three statements were generated and grouped into seven conceptual clusters: Client Empowerment; Use of Strategies and Training to Personalise the Rehabilitation Program; Facilitating Peer and Other Professional Support; Providing Emotional Support; Improving Social Engagement with Technology; Including Communication Partners; and Promoting Client Responsibility. Audiologists employ a wide range of approaches in their attempt to address the psychosocial needs associated with hearing loss experienced by their adult clients. The approaches described were mostly informal and provided in a non-standardised way. The majority of approaches described were not evidence-based, despite the availability of several options that are evidence-based, thus highlighting the implementation gap between research and clinical practice. [ABSTRACT FROM AUTHOR]

Objectives: This study examined the effect of a multimedia educational programme for first-time hearing aid users (C2Hear reusable learning objects, RLOs), delivered at the hearing assessment on (1) self-efficacy for hearing aids (primary outcome), and (2) readiness for hearing rehabilitation and hearing aid knowledge (secondary outcomes). Design: A single-centre, prospective, pre-post, randomised controlled trial with two arms. The intervention group (n = 24) received RLOs, and the waitlist control group (n = 23) received a printed booklet on hearing aids. Outcomes were measured at the hearing assessment and hearing aid fitting appointments. Study sample: Fifty-six adult first-time hearing aid users attending a publicly funded audiology service. Results: The RLO group showed significantly greater improvement in self-efficacy and knowledge of hearing aids than the control group. A borderline effect of readiness for hearing rehabilitation was also found. Potential links between hearing aid self-efficacy and knowledge were identified. Conclusions: Early delivery of the RLOs results in greater hearing aid self-efficacy and knowledge at the hearing aid fitting appointment, with indications that RLOs increase readiness for hearing rehabilitation. As knowledge, self-efficacy and readiness are cornerstones of self-management, the C2Hear RLOs can prime first-time hearing aid users to better self-manage their hearing aids before they receive them. [ABSTRACT FROM AUTHOR]