College of Health Sciences Discipline of Audiology. counselling adults with hearing aids: Practice & Perceptions of Audiologists in South Africa

Transcription

1 College of Health Sciences Discipline of Audiology counselling adults with hearing aids: Practice & Perceptions of Audiologists in South Africa & Neethie (L) Joseph

2 Introduction Study purpose: Advancements in technology Client acceptant and use of amplification remains low What is counselling in the Audiology profession? Types of counselling? Current challenges faced by audiologist in SA

3 Types of counselling Informational counselling: Relates to answering questions regarding hearing and hearing loss, explanation of test results, anatomy of the ear, amplification use and communication strategies. Rational acceptance counselling: Addresses emotional and psycho-social reactions to hearing loss, gaining a deeper understanding of hearing loss which leads to acceptance of hearing loss. Adjustment counselling: Focuses on the permanency of hearing loss and concrete means to managing communication difficulties. (English 2008, Tye-Murray 2004)

4 Methodology The research question posed: What are audiologists practices and views regarding counselling adult clients who require hearing aids? Aim: The main aim of the study was to determine audiologists practices and views regarding counselling adult clients who require hearing aids in South Africa. Objectives: 1. To describe the nature of counselling offered by audiologists to adult clients who require hearing aids 2. To describe their views on the skills needed to counsel adult clients who require hearing aids and challenges faced

5 Methodology Research design: quantitative descriptive research design, data collected by means of a selfadministered semi-structured electronic questionnaire survey.

6 Frequency Frequency Description of participants Total amount of 1119 participants where contacted to partake in the study 152 completed responses Participants Educational Background (n=150) 82 (55%) (31%) Age of Participants (n=150) (22%) (29%) Bachelor's degree in Audiology 14 (9%) Master's degree in Audiology Bachelor's degree in Speech Therapy & Audiology Educational Background 11 (7%) Master's degree in Speech Therapy & Audiology (17%) (13%) (7%) (3%) (4%) (3%) (1%) Age

7 Frequency Results Nature of counselling: When is counselling offered to clients? Informational Counseling (n=151) Rational Acceptance Counseling (n=150) Adjustment Counseling (n=149) Before audiological assessment Immediately after audiological assessment Immediately after hearing aid evaluation During hearing aid fitting and orientation During aural rehabilitation All of the previous options N/A Points of contact with the client

8 Time (minutes) Results Nature of counselling: Average amount of time spent counselling N/A >60 (11%) (1%) (1%) (13%) (12%) (2%) Average amount of time spent on informational counseling (n=148) (3%) (11%) (2%) (5%) (2%) (5%) Average amount of time spent on rational acceptance counseling (n=149) (30%) (29%) (29%) Average amount of time spent on adjustment counseling (n=147) 0-15 (43%) (49%) (50%) 0% 20% 40% 60% 80% 100% Frequency

9 Results Skills and challenges faced counselling: Current challenges faced by audiologists in South Africa: Client specific (53%) Audiologist specific (10%) Hearing aids specific (27%) Do not take responsibility for Clients want cheaper hearing hearing loss Language barrier aids which are not the best fit Unrealistic expectations Lack of skills, knowledge to Adherence to hearing aids, not Uninformed public due to counsel wanting to wear hearing aids all marketing restrictions of Lack of clinical experience in day profession counselling Misconceptions of hearing aids Poor socioeconomic status Time constraints for adequate Cost, cosmetic appeal Lack of understanding aural rehabilitation Family pressure to get hearing Takes a lot of time to reach a Poor follow-up aids break through with client

10 Discussion Hearing loss cannot only be viewed as a loss of sense but rather a part of a whole person with other contributing factors. Representation of younger audiologists in South Africa 65% of participants had 0-10 years of working experience 60% of participants were employed in the private sector which indicates that majority of the professionals are services the minority of the populations (Swanepoel, 2006). Further insights needed on the public system and medical reimbursement systems Skill training -Post graduation needed techniques, IDA tools, roleplay, workshops, online UK 20 hour workshop over six weeks (English & Archbold, 2014)

11 Conclusion Counselling should be incorporated throughout the interaction with clients and not only at isolated intervals More time spent on informational counselling More time spent counselling client only rather than client together with significant other Majority spent up to 15 min counselling the client counselling was offered mostly after audiological evaluation and after hearing aid fitting Audiologists rated their informational and adjustment counselling skills high Although still highlighted the need for further skill development Moderate to great need in rational and adjustment counselling More focus on counselling within the curricula of audiology training is needed Offering of courses to qualified professionals to increase their knowledge and skills in the area of counselling Need for supervision of clinical training of audiology students in order to develop skills

12 References English, M.K. (2008). counselling issues in audiologic rehabilitation. Contemporary Issues in Communication Science and Disorders, 35, Flahive, M.J., White, S.C. (1981). Audiologists and counselling. Journal of the Academy of Rehabilitative Audiology XIV, Health Professionals Council of South Africa (HPCSA). (2012), Regulations defining the scope of the professions of Speech Therapy and Audiology. Act 56 of 1974 Ratanjee, H.N. (2015). counselling of adults who need amplification: Practices of South Africa Audiologists. (Unpublished master s thesis). University of KwaZulu-Natal: Durban. Swanepoel, D.W. (2006). Audiology in South Africa. International Journal of Audiology, 45, Retrieved on February 09, 2013 from: Tye Murray, N. (2004). Foundations of aural rehabilitation. Children, adults and their families. Baltimore: Lippincott, Williams and Wilkins.

13 Acknowledgements & Thanks My family members and fiancé, for their continued support and for always motivating and inspiring me, in-spite of the great geographical distance between us; Dr. Lavanithum (Neethie) Joseph for hours of supervision, advice and direction with competence, professionalism and compassion; thank you. My late dad, thank you for the strong values of education you have instilled in me I miss you every day, wishing you were here.