Abstracts
Purpose
To verify the effectiveness of the DVD “Knowing and Learning about my Hearing Aid” as a tool in the hearing aid (HA) adaptation process in the elderly.
Methods
A total of 27 individuals, divided in two groups, participated in this study: a control group, which received the audiological guidance and the technical instruction manual accompanying the adapted behind-the-ear hearing aids; and an experimental group, which received the same guidance as the control group, plus the DVD. The effectiveness of the DVD was measured through a specific tool that evaluates the skills to manipulate the HA, the Practical Hearing Aid Skills Test, using descriptive statistics analysis and the non-parametric Mann-Whitney test.
Results
The experimental group obtained a better performance in the tasks of cleaning the hearing aid and the earmold, manipulating the volume control, handling the telecoil and correctly placing the phone in the ear. No difference was found between the performances of the control group and the experimental group in the Practical Hearing Aid Skills Test. Most of the experimental group affirmed to be very satisfied with the information stored in the DVD.
Conclusion
An improvement trend was observed in the experimental group regarding the understanding of the content about the HA, due to the use of the DVD, and a high level of satisfaction was observed among the participants of this group with the tool, which confirms such material is a tool possible to be used during the HA adaptation process.
Aging; Hearing aids; Telemedicine; Hearing loss; Education, distance
Objetivo
Verificar a eficácia do DVD “Conhecendo e Aprendendo sobre meu Aparelho Auditivo” como ferramenta no processo de adaptação do aparelho de amplificação sonora individual (AASI) em idosos.
Métodos
Participaram dessa pesquisa 27 indivíduos, divididos em dois grupos: grupo controle, que recebeu as orientações fonoaudiológicas e o manual técnico de instruções que acompanhava o AASI retroauricular adaptado; e grupo experimental, que recebeu as mesmas orientações do grupo controle, acrescidas do referido DVD. A eficácia do DVD foi mensurada por meio do instrumento específico de habilidades de manuseio com o AASI Practical Hearing Aid Skills Test, usando-se análise estatística-descritiva e o teste não paramétrico de Mann-Whitney.
Resultados
O grupo experimental obteve melhor desempenho nas tarefas de limpeza do AASI e molde auricular, manipulação do controle de volume, manuseio da bobina telefônica e posicionamento correto do telefone na orelha. Não houve diferença entre os desempenhos do grupo controle e grupo experimental, no Practical Hearing Aid Skills Test. A maioria do grupo experimental afirmou estar muito satisfeita com as informações contidas no DVD.
Conclusão
Foi observada tendência de melhora, no grupo experimental, quanto à compreensão do conteúdo sobre o AASI, devido ao uso do DVD e elevado grau de satisfação desse grupo com o instrumento, confirmando ser um material possível de ser utilizado durante o processo de adaptação do AASI.
Envelhecimento; Auxiliares de audição; Telemedicina; Perda auditiva; Educação a distância
INTRODUCTION
The elderly population has been increasing worldwide and the hearing impairment is present in a large part of this population. Although there is a significant number of individuals with this problem, many of them postpone or avoid, for some reason, the acquisition of the Hearing Aid (HA)(11 Bastos BG, Amorim RB, Ferrari DV. Atitudes frente às próteses auditivas. Rev CEFAC. 2009;11(Supl 1):116-28.,22 Kochkin S. MarkeTrak VIII: the key influencing factors in hearing aid purchase intent. Hear Rev. 2012;19(3):12-25.).
The difficulty in manipulating such device is one of the recurring reasons that
hinder the use of the HA(33 Campos K, Oliveira JRM, Blasca WQ. Processo de adaptação de aparelho
de amplificação sonora individual: elaboração de um DVD para auxiliar a
orientação a indivíduos idosos. Rev Soc Bras Fonoaudiol.
2010;15(1):19-25.
http://dx.doi.org/10.1590/S1516-80342010000100006
https://doi.org/10.1590/S1516-8034201000...
). Besides that, this population presents
more difficulty in understanding the information because of declining age,
which, most often, makes this process slower and more complex. In this context,
it is important to mention the time spent, the language used and the age of the
individual are some of the aspects that will interfere with the retention of the
information transmitted(44 Jokura PR, Ferrari DV. Aconselhamento informativo para adultos e
idosos usuários de aparelhos de amplificação sonora individual: avaliação da
eficácia de um material online [dissertação]. Bauru: Universidade de São Paulo;
2013.).
Therefore, to carry out a follow-up of individuals who acquired HA through SUS
and serve them in all their needs becomes a hard task, considering the
geographic size of Brazil and its people and, mainly, the heterogeneity in the
distribution of health professionals, including speech language
pathologists(55 Conselho Federal de Fonoaudiologia. Número de profissionais por
região. Brasília, DF: Conselho Federal de Fonoaudiologia; [2010] [acesso em 23
maio 2010]. Disponível em:
http://www.fonoaudiologia.org.br//servlet/ConsultaNoticia?acao=V¬Id=52
http://www.fonoaudiologia.org.br//servle...
).
Considering such reality, the Tele-education in Brazil arises as a relevant
strategy to help fulfill the demand needs(66 Blasca WQ, Campos K, Picolini MM, Silva ASC, Maximino L. A
teleducação como estratégia para a educação em saúde. In: Consorcio Red de
Educación a Distancia – CREAD, organizador. Educación a distancia: actores y
experiências. México, DF: Instituto Latinoamericano de la
Comunicación Educativa; 2010. Capítulo 5: Aplicaciones; p.
509-27.). It is an additional opportunity
the patient has to have access, as many times as necessary, to the information
given in the appointment with the speech-language pathologist. The way such
information is presented is essential not only for the assimilation but also for
the understanding of the individual(44 Jokura PR, Ferrari DV. Aconselhamento informativo para adultos e
idosos usuários de aparelhos de amplificação sonora individual: avaliação da
eficácia de um material online [dissertação]. Bauru: Universidade de São Paulo;
2013.,77 Margolis RH. What do your patients remember? Hear J.
2004;7(6):10-17.
http://dx.doi.org/10.1097/01.HJ.0000292451.91879.a8
https://doi.org/10.1097/01.HJ.0000292451...
,88 Blasca WQ, Beviclaqua MC. A multimídia como uma nova proposta de
ensino em Audiologia. Salusvita.
2007;25:113-26.).
This strategy shows to be important because the time spent to provide the
information and the guidance about the use, cares and manipulation of the HA is
42 minutes(99 Kochkin S, Beck DL, Christensen LA, Compton-Conley C, Fligor BJ,
Kricos PB et al. MarkeTrak VIII: The impact of the hearing healthcare
professional on hearing user success. Hear Rev. 2010;7(4):12.); this time can be smaller, about 15 and 20
minutes(1010 Reese JL, Hnath-Chisolm T. Recognition of hearing aid orientation
content by first-time users. Am J Audiol. 2005;14(1):94-104.
http://dx.doi.org/10.1044/1059-0889(2005/009)
https://doi.org/10.1044/1059-0889(2005/0...
). The fact gets even more worrying with the
knowledge that the understanding of the information provided can become even
more difficult for new users of HA, mainly for those who have the age factor
associated with deficits in the working memory(1111 Desjardins JL, Doherty KA. Do experienced hearing aid users know how
to use their hearing AIDS correctly? Am J Audiol. 2009;18(1):69-76.
http://dx.doi.org/10.1044/1059-0889(2009/08-0022)
https://doi.org/10.1044/1059-0889(2009/0...
). Furthermore, it is also known
that after the guidance is provided, the individual immediately remembers only
80% of the content said and that, after the first month, the individual retains
77% of the information provided(1212 Reese JL, Smith SL. Recall of hearing aid orientation content by
first-time hearing aid users. Semin Hear. 2006;27(4):337-44.
http://dx.doi.org/10.1055/s-2006-954862
https://doi.org/10.1055/s-2006-954862...
).
Therefore, it is important to use the Tele-education resources to develop
educational materials for the hearing impaired and their families aiming to add
a reinforcement to the information about the HA use and manipulation, so that
they can access such information whenever they judge necessary. The DVD is an
audiovisual resource that helps the users to retain the information obtained in
the health professional`s office(77 Margolis RH. What do your patients remember? Hear J.
2004;7(6):10-17.
http://dx.doi.org/10.1097/01.HJ.0000292451.91879.a8
https://doi.org/10.1097/01.HJ.0000292451...
,1313 Campos K, Blasca WQ. Conhecendo e aprendendo sobre o meu aparelho
auditivo [DVD]. Bauru: Faculdade de Odontologia de Bauru; 2010.,1414 Locaputo-Donnellon AE, Clark JG. Hearing AID orientation supplement
through DVD instruction. Hear J. 2011;64(3):44-50.
http://dx.doi.org/10.1097/01.HJ.0000395481.16701.d1
https://doi.org/10.1097/01.HJ.0000395481...
).
In order to minimize the difficulties found by HA users in the use of the device,
some initiatives have arisen based on Tele-education proposals. The DVD “Knowing
and Learning about my Hearing Aid” was developed to help the hearing impaired
elderly with no previous experience in the HA adaptation process. This
educational material addressed aspects about cares, use and maintenance of the
HA(33 Campos K, Oliveira JRM, Blasca WQ. Processo de adaptação de aparelho
de amplificação sonora individual: elaboração de um DVD para auxiliar a
orientação a indivíduos idosos. Rev Soc Bras Fonoaudiol.
2010;15(1):19-25.
http://dx.doi.org/10.1590/S1516-80342010000100006
https://doi.org/10.1590/S1516-8034201000...
).
Thus, this study objective is to verify the effectiveness of the DVD “Knowing and Learning about my Hearing Aid” Volume 2(1313 Campos K, Blasca WQ. Conhecendo e aprendendo sobre o meu aparelho auditivo [DVD]. Bauru: Faculdade de Odontologia de Bauru; 2010.) in the adaptation process of the behind-the-ear HA of the hearing impaired elderly.
METHODS
This study integrated the Research Line Telehealth in Speech-Language and Hearing Sciences of the Department of Speech-Language Pathology and Audiology, Bauru School of Dentistry, Universidade de São Paulo (USP), with the approval of this institution’s Ethics Committee under the Protocol No 033/2007. All participants agreed to take part of the study and signed a Consent Form.
Casuistry
In order to verify the effectiveness of the educational material, 27 elderly individuals were selected and divided into two groups: a control group, comprised of 14 individuals and an experimental group, comprised of 13 individuals. The inclusion criteria were: sensorineural hearing impairment, mixed or conductive, mild/moderate; bilateral and/or unilateral involvement; age between 60 and 91; new users of behind-the-ear Hearing Aid, with different types of earmold, made in silicone and acrylic materials. Regarding the exclusion criteria, the following were established: unsatisfactory speech understanding; unavailability to return in a month; hindered manual dexterity; memory alteration and open-fit adjustment of the behind-the-ear hearing aids.
Materials
For both groups (control and experimental), the PHAST (Practical Hearing Aid
Skills Test)(1111 Desjardins JL, Doherty KA. Do experienced hearing aid users know how
to use their hearing AIDS correctly? Am J Audiol. 2009;18(1):69-76.
http://dx.doi.org/10.1044/1059-0889(2009/08-0022)
https://doi.org/10.1044/1059-0889(2009/0...
), translated to Brazilian Portuguese,
was applied when the user came for the maintenance of the HA in order to
verify the retaining of the information provided. The instrument PHAST is a
way to objectively obtain the ability the HA user has to manipulate the HA
functions and keep the device appropriately clean(1515 Doherty KA, Desjardins JL. The Practical Hearing Aids Skills Test -
revised. Am J Audiol. 2012;21(1):100-5.
http://dx.doi.org/10.1044/1059-0889(2012/11-0019)
https://doi.org/10.1044/1059-0889(2012/1...
).
Such instrument was used by another speech-language pathologist, appropriately trained, who did not know if the individual had taken home or not the educational material. Three different professionals, who work in the area of amplification, were trained in the application of the questionnaire so that there was no bias in the methodology, with difference between the evaluators. These professionals attended the adapted individuals when they returned, after a month of adaptation. This instrument presents some tasks related to the use and manipulation of the HA. These tasks are requested by the speech-language pathologist, who scores the performance of such tasks by the user. The aspects included are the following:
-
Inserting the HA: (a) ability to hold and (b) insert the device in the ear;
-
Removing the HA: (a) ability to hold and (b) remove the devices from the ear;
-
Opening the battery compartment: (a) locate the compartment and (b) open the battery compartment;
-
Changing the battery: remove the old battery and (b) insert the new battery;
-
Cleaning: in this study, the cleaning of the earmold was considered instead of the cleaning of the HA;
-
Manipulating the volume control;
-
Using the phone: correct use of the software or telecoil and (b) placement of the phone related to the ear;
-
Using the directional microphone or the noise software: this aspect was not considered in this study as the individuals who had such feature in the adapted HA would receive this guidance afterwards.
The instrument presents five options to classify the participant`s resourcefulness: “excellent” (four points), “more than satisfactory” (three points), “satisfactory” (two points), “less than satisfactory” (one point) and “unable to perform” (zero point).
The highest score of the questionnaire is 32 as it consists of eight tasks whose highest scores are 4 each. To obtain the score, all points are summed, reaching the gross score. To obtain the total score, in percentage, the number obtained is divided by the number of highest possible points, considering the tasks evaluated and, afterwards, this number is multiplied by 100 to reach the percentage that is classified as:
-
Excellent: 90% to 100%
-
Good: 80 to 89%
-
Satisfactory: 65% to 79%
-
- Unsatisfactory: Less than 65%
A multiple choice questionnaire, evaluating how much the information on the DVD helped the individual, was applied only to the experimental group when they came to do the maintenance and the follow up of the HA. The questionnaire consisted of two parts. The first part was about the amount of knowledge the DVD provided and the second part consisted of a question on the satisfaction regarding the information received.
Procedures
Control Group
At the time of the HA adaptation, this group participants received guidance about the “HA/earmold’ through traditional methods (audiological guidance and a technical instruction manual of the adapted HA model), but with no loss of content and/or quality of the guidance.
Experimental group
Also at the time of the HA adaptation, this group participants received guidance on the “HA/earmold” through traditional methods (a technical instruction manual of the adapted HA model and verbal audiological guidance) and, in addition, they received the DVD “Knowing and Learning about my Hearing Aid” Volume 2 to consult at home.
The individuals in this group received the educational material for free and kept it with them for a period of 30 days so that they could use it. When they returned, the patients told the researcher, before being attended by the speech-language pathologist, how many times they had watched the DVD in order to clarify doubts.
The guidance was given by the same speech-language pathologist (so that the meetings were standardized) and, after a month of adaptation, the individuals of the control and experimental group returned for the procedure of maintenance and follow up of the HA, with the same professional, and that was when the evaluation instrument Practical Hearing Aid Skills Test (PHAST) was applied.
It is important to mention that the process of audiological guidance
concerning the use, care and manipulation of the HA/earmold was planned
and followed the literature(1010 Reese JL, Hnath-Chisolm T. Recognition of hearing aid orientation
content by first-time users. Am J Audiol. 2005;14(1):94-104.
http://dx.doi.org/10.1044/1059-0889(2005/009)
https://doi.org/10.1044/1059-0889(2005/0...
); it was adapted to the
specificities of the cases that were attended. Besides that, the
training with the participants about the HA and the earmold, during the
guidance process, occurred so that the users from both groups learned,
from the first moment, to deal with this amplification device.
Statistical analysis
The results of the Evaluation Protocol of the DVD “Knowing and Learning about my Hearing Aid” and the questions addressed by the instrument PHAST to evaluate the use and the care with the HA were analyzed through descriptive statistics.
The comparison of the total score obtained by the instrument PHAST, between the control group and the experimental group, expressed in percentage, was analyzed through the nonparametric statistical Mann-Whitney test, adopting a significance level of 0.05.
The methodology adopted in this study is represented in Figure 1.
RESULTS
Regarding the comparison of the performance results of the control and experimental groups, obtained by the Evaluation Instrument PHAST, the tasks selected were the ones whose results showed more discrepancy in the groups evaluated and the highest difficulties presented by the participants of each group. Among the participants of the experimental group, 69.23% (9) obtained an excellent performance against 42.86% (6) of the control group that had the same performance in the task of removing the HA from the ear. On the other hand, 64.29% (9) were excellent in the task of inserting the HA in the ear, while 38.46% (5) of the experimental group obtained this result.
Regarding the cleaning of the HA earmold, 53.85% of the participants of the experimental group (7) had an excellent performance, while, in the control group, this percentage was of 35.71% of the participants (5). The percentage of those who were unable to perform such task was of 7.69% in the experimental group and 14.29% in the control group.
With regard to the manipulation of the volume control, there was proximity in the percentages of the participants that obtained excellent results, in the control and experimental groups, 28.75% and 33.33%, respectively. However, some individuals presented difficulty in performing this task, 35.71% of the participants of the control group were unable to manipulate the volume control, while 22.22% of the participants of the experimental group presented a similar result. In this context, it is important to emphasize that, both in the control group and in the experimental group, there were HA users with volume control (9 participants and 14 participants, respectively).
Regarding the telecoil, 9.09% of the participants of the control group performed the task of manipulating it with excellence, against 37.50% of the participants of the experimental group that had such performance. The percentage of those who were unable to manipulate the telecoil was of 54.55% of the control group, against 37.50% of the experimental group. It is important to emphasize that among the participants of the control group, 11 individuals were users of HA with telecoil, while in the experimental group this number was 8.
With regard to the appropriate placement of the telephone in the HA, the participants who obtained an excellent result were 28.75% of the control group and 66.67% of the experimental group. The participants who obtained a result classified as poor were 35.71% of the control group and 8.33% of the experimental group; a total of 14 participants of the control group performed this task, while only 12 of the experimental group did it.
Regarding the comparison of the percentage of the total score obtained in the evaluation instrument PHAST, in each question evaluated, no statistical significance was found between the difference of the results obtained by the control group and the experimental group. These results were computed through the non-parametric Mann-Whitney test, with a significance level of 0.05.
The results of the performance of the control and experimental group are shown in Table 1.
Classification of the performance obtained in the PHAST, by the Control and Experimental groups
The experimental group was submitted to a questionnaire that evaluated, under the user´s point of view, the effectiveness of the information provided in the DVD to help the understanding of the content about the use/manipulation and cleaning of the HA. It is noteworthy that most of the DVD users reported that it “helped a lot” concerning the function of the Hearing device, how it works, how to clean the earmold and change the battery (Figure 2).
Distribution in percentage of the user self-perception regarding the help of the DVD for the acquisition of knowledge on what it does, functioning of the HA, cleaning of the earmold and battery change.
Regarding the aspect of manipulating, inserting and removing the HA from the ear, volume control and also knowing how to protect it appropriately and identifying and solving the problems it can present, most of the evaluators considered that the DVD helped a lot (Figure 3).
Self-perception of the user regarding the help of the DVD for the acquisition of how to manipulate the HA, protect it, identify and solve its problems
Regarding the level of satisfaction with the information in the DVD, 76.92% claimed to be very satisfied, 7.69% to be satisfied and 15.38% mentioned to be more or less satisfied.
DISCUSSION
In a context of large territory extensions, like in Brazil, and heterogeneity in
the distribution of the health professionals, mostly the audiologists, the
Tele-health aims to minimize the discrepancies of accessibility to
service(66 Blasca WQ, Campos K, Picolini MM, Silva ASC, Maximino L. A
teleducação como estratégia para a educação em saúde. In: Consorcio Red de
Educación a Distancia – CREAD, organizador. Educación a distancia: actores y
experiências. México, DF: Instituto Latinoamericano de la
Comunicación Educativa; 2010. Capítulo 5: Aplicaciones; p.
509-27.). Tele-health is defined as the use of
communication and information technology to provide long-distance health
serices(1616 Swanepoel DW, Clark JL, Koekemoer D, Hall JW 3rd, Krumm M, Ferrari
DV et al. Telehealth in audiology: the need and potential to reach underserved
communities. Int J Audiol. 2010;49(3):195-202.
http://dx.doi.org/10.3109/14992020903470783
https://doi.org/10.3109/1499202090347078...
) and is has the Tele-education as one of
its parts.
Tele-education is a learning strategy that has shown to be efficient in many areas, including the health area(66 Blasca WQ, Campos K, Picolini MM, Silva ASC, Maximino L. A teleducação como estratégia para a educação em saúde. In: Consorcio Red de Educación a Distancia – CREAD, organizador. Educación a distancia: actores y experiências. México, DF: Instituto Latinoamericano de la Comunicación Educativa; 2010. Capítulo 5: Aplicaciones; p. 509-27.,1717 Alcaraz Baños M, Sánchez PC, Martinez Beneyto Y, Barrabci DA, Nesegyer Gebarehis AB, Alcarez Saura M. Tele-enseñanza a través de internet: la protección radiológica en ciencias de la salud. TESI. 2010;11(2):232-60.). It is a tool that can potentiate concepts related to health among patients. Through educational materials designed for patients and their families, it is possible for them to have access to the content that had been provided in the speech language pathologist office, whenever necessary, respecting, therefore, each one´s individual learning time.
In the whole process of this study, it was possible to verify the control and experimental groups showed a similar performance in the tasks evaluated by the instrument PHAST. However, it is possible to observe there was a greater easiness in certain tasks for the group that used the DVD.
Regarding the task of removing the HA from the ear specifically, a great
difficulty was identified, greater in the control group than in the experimental
group. In the task of inserting the HA in the ear, the difficulty kept present
in both groups. The rate of such difficulty confirms other findings of
literature, that show the difficulty with the insertion and removal of the HA
from the ear(33 Campos K, Oliveira JRM, Blasca WQ. Processo de adaptação de aparelho
de amplificação sonora individual: elaboração de um DVD para auxiliar a
orientação a indivíduos idosos. Rev Soc Bras Fonoaudiol.
2010;15(1):19-25.
http://dx.doi.org/10.1590/S1516-80342010000100006
https://doi.org/10.1590/S1516-8034201000...
,1818 Campos CAH, Russo ICP, Almeida K. Indicação, seleção e adaptação de
próteses auditivas: princípios gerais. In: Almeida K, Iorio MCM, organizadores
Próteses auditivas: fundamentos teóricos e aplicações clínicas. São Paulo:
Lovise; 2003. p. 35-54.,1919 Buriti AKL, Oliveira SHS. Adaptação à prótese auditiva em usuários
assistidos pelo Sistema Único de Saúde. Rev Soc Bras Fonoaudiol.
2012;17(1):41-6.
http://dx.doi.org/10.1590/S1516-80342012000100009
https://doi.org/10.1590/S1516-8034201200...
). The DVD showed to be efficient in
helping with the removal of the HA, but it did not have the same effect for the
insertion of this device, possibly because this task demands a greater control
and manual dexterity, if compared to the removal.
Regarding the cleaning of the HA and the earmold, difficulties were also found in
a greater degree for the control group and in a lower degree for the
experimental group. The difficulty found corroborates with the study carried
out(1111 Desjardins JL, Doherty KA. Do experienced hearing aid users know how
to use their hearing AIDS correctly? Am J Audiol. 2009;18(1):69-76.
http://dx.doi.org/10.1044/1059-0889(2009/08-0022)
https://doi.org/10.1044/1059-0889(2009/0...
) that, in the use of the instrument PHAST,
revealed that only 38% of the 50 individuals evaluated obtained an excellent
performance in this task. The result of this research refers to a study carried
out that highlights the importance of the appropriate cleaning of the earmold to
avoid the appearance of pathogen agents, which can even result in a severe
infection in the auditory canal(2020 Mehdinejad M, Khosravi AD, Mahmoudabadi AZ. Study of bacterial flora
in children’s with hearing aid earmoulds in Ahvaz, Iran. Pak J Biol Sci .
2010;13(5):245-58. http://dx.doi.org/10.3923/pjbs.2010.245.248
https://doi.org/10.3923/pjbs.2010.245.24...
).
The manipulation of the volume control was evaluated and only one third of the
sample of the experimental group achieved an excellent performance in this task,
this index was smaller in the control group. Equivalent percentages in both
groups were unable to perform the action. Such difficulty was also found in
other studies in literature(2121 Franks JR, Beckmann NJ. Rejection of hearing aids: attitudes of a
geriatric sample. Ear Hear.1985;6(3):161-66.
http://dx.doi.org/10.1097/00003446-198505000-00007
https://doi.org/10.1097/00003446-1985050...
,2222 Kochkin S. MarkeTrak VII: obstacles to adult non-user adoption of
hearing aids. Hear J. 2007;60(4):24-51.
http://dx.doi.org/10.1097/01.HJ.0000285745.08599.7f
https://doi.org/10.1097/01.HJ.0000285745...
). Authors even mention that the
presence of the volume control can be satisfactory to some users, but
complicated to others, due to a difficulty in manipulating it, mainly to the
elderly(1818 Campos CAH, Russo ICP, Almeida K. Indicação, seleção e adaptação de
próteses auditivas: princípios gerais. In: Almeida K, Iorio MCM, organizadores
Próteses auditivas: fundamentos teóricos e aplicações clínicas. São Paulo:
Lovise; 2003. p. 35-54.).
With regard to the use of the telephone, considering the use of the telecoil,
little more than a third of the experimental group, only, obtained an excellent
performance. As to the telecoil, less than 10% of the participants of the
control group were able to achieve an excellent score. More than half of the
control group and more than 35% of the experimental group were unable to perform
the task. Regarding the right placement of the telephone in relation to the HA,
most of the experimental group and less than a third of the control group
performed the task with an excellent score. The index of difficulty in this task
must alert the professionals who deal with the adaptation of the HA about the
importance of a greater dedication in the training. Apparently, the DVD showed
to be efficient in helping the users of the experimental group to have a greater
domain regarding the use of the telephone, as a whole. These results corroborate
with some studies(33 Campos K, Oliveira JRM, Blasca WQ. Processo de adaptação de aparelho
de amplificação sonora individual: elaboração de um DVD para auxiliar a
orientação a indivíduos idosos. Rev Soc Bras Fonoaudiol.
2010;15(1):19-25.
http://dx.doi.org/10.1590/S1516-80342010000100006
https://doi.org/10.1590/S1516-8034201000...
,1111 Desjardins JL, Doherty KA. Do experienced hearing aid users know how
to use their hearing AIDS correctly? Am J Audiol. 2009;18(1):69-76.
http://dx.doi.org/10.1044/1059-0889(2009/08-0022)
https://doi.org/10.1044/1059-0889(2009/0...
,2222 Kochkin S. MarkeTrak VII: obstacles to adult non-user adoption of
hearing aids. Hear J. 2007;60(4):24-51.
http://dx.doi.org/10.1097/01.HJ.0000285745.08599.7f
https://doi.org/10.1097/01.HJ.0000285745...
), showing to be important, because the
fact of not using the telephone will reflect on the perception the users have in
their HA adaptation(2323 Lessa AH, Costa MJ, Becker KT, Vaucher AV. Satisfação de usuários de
próteses auditivas, com perda auditiva de graus severo e profundo. Arq Int
Otorrinolaringol. 2010;14(3):338-45.
http://dx.doi.org/10.1590/S1809-48722010000300011
https://doi.org/10.1590/S1809-4872201000...
,2424 Paiva KM, Maciel PMA, Cintra LG. Compreendendo o idoso usuário de
próteses auditivas. Cienc Saúde Coletiva. 2011;16(6):2927-34.
http://dx.doi.org/10.1590/S1413-81232011000600030
https://doi.org/10.1590/S1413-8123201100...
).
With regard to the experimental group performance, compared with the control group, in the seven questions tested in the PHAST, no significant difference was found. Such information is reinforced in Table 1, with the classification of the performance obtained in the Questionnaire PHAST. However, it can be considered that the material can be used to supplement the guidance provided in the speech-language pathologist office, stimulating the co-participation of the elderly in the process of adaptation of the HA, dividing this group responsibilities to success with the professional.
In the self-perception questionnaire on the help the DVD provided in specific knowledge about the HA, most evaluators reported the educational material “helped a lot” to understand all knowledge about the HA. That demonstrates the importance of the DVD to help the participants perform the more common daily tasks of the HA, verifying once more the information provided by the speech-language pathologist in the service.
It is important to affirm the content of the DVD “Knowing and Learning about my Hearing Aid” does not comprise a specific approach for identifying and solving problems that can occur with the “HA/earmold”. However, more than half reported the DVD helped a lot in this aspect (Figure 2). When questioned about how this help had occurred, some answered: “It was watching the DVD that I found out the beep that happened in the device was to change the batteries, otherwise, I wouldn`t know it” and “I didn´t know the beep of the device was to change the battery, I learned in the DVD”. A study(2525 Knowles M, Holton III EF, Swanson RA. The adult learner: the definitive classic in adult education and human resourse development. Knowles: Gulf; 1977.) referred that the material addressed to adults must have a dynamic concept of intelligence and this occurred with the incentive to reasoning in this DVD.
Regarding the level of satisfaction with the information comprised in the DVD, most participants reported to be very satisfied. Therefore, based on the exposed above, it is possible to affirm the DVD “Knowing and Learning about my Hearing Aid” achieved its objective, analyzing, even some comments of the individuals, for example: “I liked the DVD a lot, I watched it many times and I´ll watch it more times. Seeing how one must do it is different from just saying it!” and “Thank you, because you do researches that help you, help professionals, and, mainly, us, who are patients”.
It is noteworthy that, in this study, a process of guidance was carried out
concerning the use and manipulation of the HA/earmold, including a training with
the participants, so that they could leave the service already knowing how to
manipulate the HA. Besides, the guidance was based in the
literature(1010 Reese JL, Hnath-Chisolm T. Recognition of hearing aid orientation
content by first-time users. Am J Audiol. 2005;14(1):94-104.
http://dx.doi.org/10.1044/1059-0889(2005/009)
https://doi.org/10.1044/1059-0889(2005/0...
), being adapted to the specificities of
each individual.
Although, literature mentions that besides the level of information retained by
the individuals, in the guidance process, be low compared with the level of
information provided(1010 Reese JL, Hnath-Chisolm T. Recognition of hearing aid orientation
content by first-time users. Am J Audiol. 2005;14(1):94-104.
http://dx.doi.org/10.1044/1059-0889(2005/009)
https://doi.org/10.1044/1059-0889(2005/0...
,1212 Reese JL, Smith SL. Recall of hearing aid orientation content by
first-time hearing aid users. Semin Hear. 2006;27(4):337-44.
http://dx.doi.org/10.1055/s-2006-954862
https://doi.org/10.1055/s-2006-954862...
,2626 Beck D, McGuire R. A multimedia: better tools facilitate a better
process. Hear Rev. 2006 [acesso em: 20 mar 2009]. Disponível em:
http://www.oticonusa.com/eprise/main/SiteGen/Uploads/Public/Downloads_Oticon/The_Hearing_Review/May_2006_HR.pdf
http://www.oticonusa.com/eprise/main/Sit...
), a lot of information is remembered
incorrectly(77 Margolis RH. What do your patients remember? Hear J.
2004;7(6):10-17.
http://dx.doi.org/10.1097/01.HJ.0000292451.91879.a8
https://doi.org/10.1097/01.HJ.0000292451...
). These pieces of information corroborate
with the results obtained and discussed before, regarding the users´ performance
in the use, manipulation and cleaning of the HA/earmold. Another fact that
confirms the results found by the studies mentioned(77 Margolis RH. What do your patients remember? Hear J.
2004;7(6):10-17.
http://dx.doi.org/10.1097/01.HJ.0000292451.91879.a8
https://doi.org/10.1097/01.HJ.0000292451...
,1010 Reese JL, Hnath-Chisolm T. Recognition of hearing aid orientation
content by first-time users. Am J Audiol. 2005;14(1):94-104.
http://dx.doi.org/10.1044/1059-0889(2005/009)
https://doi.org/10.1044/1059-0889(2005/0...
,1212 Reese JL, Smith SL. Recall of hearing aid orientation content by
first-time hearing aid users. Semin Hear. 2006;27(4):337-44.
http://dx.doi.org/10.1055/s-2006-954862
https://doi.org/10.1055/s-2006-954862...
,2626 Beck D, McGuire R. A multimedia: better tools facilitate a better
process. Hear Rev. 2006 [acesso em: 20 mar 2009]. Disponível em:
http://www.oticonusa.com/eprise/main/SiteGen/Uploads/Public/Downloads_Oticon/The_Hearing_Review/May_2006_HR.pdf
http://www.oticonusa.com/eprise/main/Sit...
) is what two
participants reported about not knowing the meaning of the “beep” until watching
the DVD and what other two participants reported, pointing the “cotton bud” as
the correct way of dealing with the excess of wax in the external auditory
canal, also mentioning, that the DVD had such information and emphasized the
importance of looking for a otorhinolaryngologist to solve this problem.
Another important aspect is associated with the age of the group studied.
Literature mentions the cognitive decline is present in the elderly
population(2727 Carvalho FCR, Neri AL, Yassuda MS. Treino de memória episódica com
Ênfase em categorização para idosos sem demência e depressão. Psicologia:
Reflexão e Crítica. 2010;23:317-23.), with complaints regarding the
memory(2828 Barbosa CMO, Martin JIG. Ajudas externas à memória na intervenção em
pessoas idosas com comprometimento mnésico. Psicol Reflex Crít.
2012;25(2):320-9.
http://dx.doi.org/10.1590/S0102-79722012000200014
https://doi.org/10.1590/S0102-7972201200...
)
and a slower reasoning(2929 Almeida MHM, Beger MLM, Watanabe HAW. Oficina de memória para
idosos: estratégia para promoção da saúde. Interface. 2007;11(22):271-80.
http://dx.doi.org/10.1590/S1414-3283200700020000
https://doi.org/10.1590/S1414-3283200700...
) that consequently, explains confusing
situations caused by lack of memory.
Thus, it is important that the scientific community of universities and research centers develop strategies in order to solve and/or minimize these difficulties found by hearing impaired individuals, including the elderly, considering all factors that are not related to the hearing. The use of Tele-education as a tool can be a facilitator to break physical and demographical barriers, such as the ones existing in Brazil.
The development of the DVD “Knowing and Learning about my Hearing Aid”, this study objective, is confirmed, as the material can be made available in many health segments, from Basic Health Units (BHU) to High Complexity Hearing Centers. The highly need of including training for the new users of HA is emphasized, including the elderly, in addition to developing methods and strategies that reach such population with the intention that the learning on the use and cleaning of the HA is internalized by the individual.
CONCLUSION
The material presented in the DVD showed to be effective to help in the learning of the HA user; it can be one more resource used in the adaptation of this kind of device.
ACKNOWLEDMENTS
To the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) for the support given to this research, process number 2010/04023-7.
REFERENCIAS
-
1Bastos BG, Amorim RB, Ferrari DV. Atitudes frente às próteses auditivas. Rev CEFAC. 2009;11(Supl 1):116-28.
-
2Kochkin S. MarkeTrak VIII: the key influencing factors in hearing aid purchase intent. Hear Rev. 2012;19(3):12-25.
-
3Campos K, Oliveira JRM, Blasca WQ. Processo de adaptação de aparelho de amplificação sonora individual: elaboração de um DVD para auxiliar a orientação a indivíduos idosos. Rev Soc Bras Fonoaudiol. 2010;15(1):19-25. http://dx.doi.org/10.1590/S1516-80342010000100006
» https://doi.org/10.1590/S1516-80342010000100006 -
4Jokura PR, Ferrari DV. Aconselhamento informativo para adultos e idosos usuários de aparelhos de amplificação sonora individual: avaliação da eficácia de um material online [dissertação]. Bauru: Universidade de São Paulo; 2013.
-
5Conselho Federal de Fonoaudiologia. Número de profissionais por região. Brasília, DF: Conselho Federal de Fonoaudiologia; [2010] [acesso em 23 maio 2010]. Disponível em: http://www.fonoaudiologia.org.br//servlet/ConsultaNoticia?acao=V¬Id=52
» http://www.fonoaudiologia.org.br//servlet/ConsultaNoticia?acao=V¬Id=52 -
6Blasca WQ, Campos K, Picolini MM, Silva ASC, Maximino L. A teleducação como estratégia para a educação em saúde. In: Consorcio Red de Educación a Distancia – CREAD, organizador. Educación a distancia: actores y experiências. México, DF: Instituto Latinoamericano de la Comunicación Educativa; 2010. Capítulo 5: Aplicaciones; p. 509-27.
-
7Margolis RH. What do your patients remember? Hear J. 2004;7(6):10-17. http://dx.doi.org/10.1097/01.HJ.0000292451.91879.a8
» https://doi.org/10.1097/01.HJ.0000292451.91879.a8 -
8Blasca WQ, Beviclaqua MC. A multimídia como uma nova proposta de ensino em Audiologia. Salusvita. 2007;25:113-26.
-
9Kochkin S, Beck DL, Christensen LA, Compton-Conley C, Fligor BJ, Kricos PB et al. MarkeTrak VIII: The impact of the hearing healthcare professional on hearing user success. Hear Rev. 2010;7(4):12.
-
10Reese JL, Hnath-Chisolm T. Recognition of hearing aid orientation content by first-time users. Am J Audiol. 2005;14(1):94-104. http://dx.doi.org/10.1044/1059-0889(2005/009)
» https://doi.org/10.1044/1059-0889(2005/009) -
11Desjardins JL, Doherty KA. Do experienced hearing aid users know how to use their hearing AIDS correctly? Am J Audiol. 2009;18(1):69-76. http://dx.doi.org/10.1044/1059-0889(2009/08-0022)
» https://doi.org/10.1044/1059-0889(2009/08-0022) -
12Reese JL, Smith SL. Recall of hearing aid orientation content by first-time hearing aid users. Semin Hear. 2006;27(4):337-44. http://dx.doi.org/10.1055/s-2006-954862
» https://doi.org/10.1055/s-2006-954862 -
13Campos K, Blasca WQ. Conhecendo e aprendendo sobre o meu aparelho auditivo [DVD]. Bauru: Faculdade de Odontologia de Bauru; 2010.
-
14Locaputo-Donnellon AE, Clark JG. Hearing AID orientation supplement through DVD instruction. Hear J. 2011;64(3):44-50. http://dx.doi.org/10.1097/01.HJ.0000395481.16701.d1
» https://doi.org/10.1097/01.HJ.0000395481.16701.d1 -
15Doherty KA, Desjardins JL. The Practical Hearing Aids Skills Test - revised. Am J Audiol. 2012;21(1):100-5. http://dx.doi.org/10.1044/1059-0889(2012/11-0019)
» https://doi.org/10.1044/1059-0889(2012/11-0019) -
16Swanepoel DW, Clark JL, Koekemoer D, Hall JW 3rd, Krumm M, Ferrari DV et al. Telehealth in audiology: the need and potential to reach underserved communities. Int J Audiol. 2010;49(3):195-202. http://dx.doi.org/10.3109/14992020903470783
» https://doi.org/10.3109/14992020903470783 -
17Alcaraz Baños M, Sánchez PC, Martinez Beneyto Y, Barrabci DA, Nesegyer Gebarehis AB, Alcarez Saura M. Tele-enseñanza a través de internet: la protección radiológica en ciencias de la salud. TESI. 2010;11(2):232-60.
-
18Campos CAH, Russo ICP, Almeida K. Indicação, seleção e adaptação de próteses auditivas: princípios gerais. In: Almeida K, Iorio MCM, organizadores Próteses auditivas: fundamentos teóricos e aplicações clínicas. São Paulo: Lovise; 2003. p. 35-54.
-
19Buriti AKL, Oliveira SHS. Adaptação à prótese auditiva em usuários assistidos pelo Sistema Único de Saúde. Rev Soc Bras Fonoaudiol. 2012;17(1):41-6. http://dx.doi.org/10.1590/S1516-80342012000100009
» https://doi.org/10.1590/S1516-80342012000100009 -
20Mehdinejad M, Khosravi AD, Mahmoudabadi AZ. Study of bacterial flora in children’s with hearing aid earmoulds in Ahvaz, Iran. Pak J Biol Sci . 2010;13(5):245-58. http://dx.doi.org/10.3923/pjbs.2010.245.248
» https://doi.org/10.3923/pjbs.2010.245.248 -
21Franks JR, Beckmann NJ. Rejection of hearing aids: attitudes of a geriatric sample. Ear Hear.1985;6(3):161-66. http://dx.doi.org/10.1097/00003446-198505000-00007
» https://doi.org/10.1097/00003446-198505000-00007 -
22Kochkin S. MarkeTrak VII: obstacles to adult non-user adoption of hearing aids. Hear J. 2007;60(4):24-51. http://dx.doi.org/10.1097/01.HJ.0000285745.08599.7f
» https://doi.org/10.1097/01.HJ.0000285745.08599.7f -
23Lessa AH, Costa MJ, Becker KT, Vaucher AV. Satisfação de usuários de próteses auditivas, com perda auditiva de graus severo e profundo. Arq Int Otorrinolaringol. 2010;14(3):338-45. http://dx.doi.org/10.1590/S1809-48722010000300011
» https://doi.org/10.1590/S1809-48722010000300011 -
24Paiva KM, Maciel PMA, Cintra LG. Compreendendo o idoso usuário de próteses auditivas. Cienc Saúde Coletiva. 2011;16(6):2927-34. http://dx.doi.org/10.1590/S1413-81232011000600030
» https://doi.org/10.1590/S1413-81232011000600030 -
25Knowles M, Holton III EF, Swanson RA. The adult learner: the definitive classic in adult education and human resourse development. Knowles: Gulf; 1977.
-
26Beck D, McGuire R. A multimedia: better tools facilitate a better process. Hear Rev. 2006 [acesso em: 20 mar 2009]. Disponível em: http://www.oticonusa.com/eprise/main/SiteGen/Uploads/Public/Downloads_Oticon/The_Hearing_Review/May_2006_HR.pdf
» http://www.oticonusa.com/eprise/main/SiteGen/Uploads/Public/Downloads_Oticon/The_Hearing_Review/May_2006_HR.pdf -
27Carvalho FCR, Neri AL, Yassuda MS. Treino de memória episódica com Ênfase em categorização para idosos sem demência e depressão. Psicologia: Reflexão e Crítica. 2010;23:317-23.
-
28Barbosa CMO, Martin JIG. Ajudas externas à memória na intervenção em pessoas idosas com comprometimento mnésico. Psicol Reflex Crít. 2012;25(2):320-9. http://dx.doi.org/10.1590/S0102-79722012000200014
» https://doi.org/10.1590/S0102-79722012000200014 -
29Almeida MHM, Beger MLM, Watanabe HAW. Oficina de memória para idosos: estratégia para promoção da saúde. Interface. 2007;11(22):271-80. http://dx.doi.org/10.1590/S1414-3283200700020000
» https://doi.org/10.1590/S1414-3283200700020000
-
Research carried out in the Department of Speech-Language Pathology and Audiology, Bauru School of Dentistry and in the Hearing Health Division of the Hospital for Rehabilitation of Craniofacial Anomalies, Universidade de São Paulo – USP – Bauru (SP), Brazil.
Publication Dates
-
Publication in this collection
Oct-Dec 2014
History
-
Received
9 June 2014 -
Accepted
5 Nov 2014