Developing Foundational Counseling Skills for Addressing Adherence Issues in Auditory Rehabilitation

Abstract

Successfully getting patients with confirmed hearing loss to use hearing aids is a major challenge for hearing health care professionals. Treatment adherence has been defined as the active involvement of patients in collaborating with health care providers to plan and manage treatment regimens. Counseling patients with hearing loss on adherence to recommendations of hearing aid uptake and utilization is dependent upon building a patient-centered therapeutic relationship during the initial diagnostic evaluation. The purpose of this article is to provide resources, tools, and engaging learning activities for training students on the development of a hierarchy of counseling skills: informational counseling (e.g., checking comprehension and problem clarification), communication skills (e.g., promotion of shared-communication space, congruence, listening with the third ear, unconditional positive regard, and empathy), and health behavior change (e.g., Motivational Interviewing and the Teach-Back Method) that are prerequisites for addressing treatment adherence.

Keywords

Audiology - counseling - treatment adherence - health behavior change

• References

• 1 Myers L. Introduction. Adherence to treatment in medical conditions. In: Myers LB, Midence K. , eds. Adherence to Treatment in Medical Conditions. Amsterdam, The Netherlands: Harwood Academic; 1998: 1-24
• 2 Martin LR, Williams SL, Haskard KB, Dimatteo MR. The challenge of patient adherence. Ther Clin Risk Manag 2005; 1 (03) 189-199 https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=18360559&dopt=Abstract . Accessed December 18, 2017
• 3 Kessels RP. Patients' memory for medical information. J R Soc Med 2003; 96 (05) 219-222 https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12724430&dopt=Abstract . Accessed December 18, 2017
• 4 Margolis RH. What do your patients remember?. Hear J 2004; 57 (06) 10 , 12, 16–17
• 5 Boisvert I, Clemesha J, Lundmark E, Crome E, Barr C, McMahon CM. Decision-making in audiology: balancing evidenced-based practice and patient-centered care. Trends Hear 2017; 21: 2331216517706397 https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=28752808&dopt=Abstract . Accessed December 18, 2017
• 6 Greer-Clark J, English K. Counseling-Infused Audiology. Boston MA: Pearson; 2014
• 7 Manchaiah VK. Health behavior change in hearing healthcare: a discussion paper. Audiology Res 2012; 2 (01) e4 https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=26557333&dopt=Abstract . Accessed December 18, 2017
• 8 Prochaska JO, DiClemente CC. The Transtheoretical Approach: Crossing Traditional Boundaries of Therapy. Homewood, IL: Dow/Jones Irwin; 1984
• 9 Donahue A, Dubno JR, Beck L. Guest editorial: accessible and affordable hearing health care for adults with mild to moderate hearing loss. Ear Hear 2010; 31 (01) 2-6 https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=20040828&dopt=Abstract . Accessed December 18, 2017
• 10 Davis A, Smith P, Ferguson M, Stephens D, Gianopoulos I. Acceptability, benefit and costs of early screening for hearing disability: a study of potential screening tests and models. Health Technol Assess 2007; 11 (42) 1-294 https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17927921&dopt=Abstract . Accessed December 18, 2017
• 11 Cox RM, Alexander GC. Expectations about hearing aids and their relationship to fitting outcome. J Am Acad Audiol 2000; 11 (07) 368-382 , quiz 407 https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10976498&dopt=Abstract . Accessed December 18, 2017
• 12 Sandridge SA, Newman CW. Improving the efficiency and accountability of the hearing aid selection process—use of the COAT. Audiology Online 2006. Available at: http://www.audiologyonline.com/articles/improving-efficiency-and-accountability-hearing-995 . Accessed September 7, 2017
• 13 Schow RL, Nerbonne MA. Communication screening profile: use with elderly clients. Ear Hear 1982; 3 (03) 135-147 https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7095322&dopt=Abstract
• 14 Hodes M, Schow R, Brockett J. New support for hearing aid outcome measures: The computerized SAC and SOAC. Hear Rev 2009; 16 (12) 26-36
• 15 Rollnick S, Miller WR, Butler CC. Readiness to Change Line. In: Motivational Interviewing in Health Care. New York, NY: Guilford Press; 2008
• 16 Janis IL, Mann L. Decisional Balance Box. In Decision Making: A Psychological Analysis of Conflict, Choice, and Commitment. New York, NY: Free Press; 1977
• 17 Greer-Clark J. The geometry of patient motivation: circles, lines, and boxes. Audiol Today 2010; 22 (04) 32-40
• 18 Miller WR, Rollnick S. Motivational Interviewing: Preparing People for Change, 2nd ed. New York, NY: Guilford Press; 2002
• 19 Aazh H. Feasibility of conducting a randomized controlled trial to evaluate the effect of motivational interviewing on hearing-aid use. Int J Audiol 2016; 55 (03) 149-156 https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=26328620&dopt=Abstract . Accessed December 18, 2017
• 20 Schillinger D, Piette J, Grumbach K. , et al. Closing the loop: physician communication with diabetic patients who have low health literacy. Arch Intern Med 2003; 163 (01) 83-90 https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12523921&dopt=Abstract
• 21 Teach-Back Training. Always use Teach-Back! Training toolkit. 2017. Available at: http://www.teachbacktraining.org/ . Accessed December 18, 2017
• 22 Fabry DA. I, robot: self-learning hearing aids. Paper presented at: American Academy of Audiology AudiologyNow Annual Convention; April 18–21, 2007; Denver CO
• 23 Gaffney P. Reported hearing aid use versus datalogging in a VA population. Available at: http://www.hearingreview.com/2008/06/reported-hearing-aid-use-versus-datalogging-in-a-va-population/ . 2008. Accessed September 7, 2017
• 24 Laplante-Lévesque A, Nielsen C, Jensen LD, Naylor G. Patterns of hearing aid usage predict hearing aid use amount (data logged and self-reported) and overreport. J Am Acad Audiol 2014; 25 (02) 187-198 https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=24828219&dopt=Abstract . Accessed December 18, 2017
• 25 Nielsen C, Laplante-Levesque A, Jensen LD. What do we really know about hearing aid use?. Paper presented at: Annual Meeting of the Academy of Rehabilitative Audiology; September 9–11, 2012; Providence RI
• 26 Jilla AM. Visual Analog Scale of Hearing Aid Use (VASuse). Oklahoma City, OK: Author; 2016
• 27 Doherty KA, Desjardins JL. The Practical Hearing Aids Skills Test—Revised. Am J Audiol 2012; 21 (01) 100-105 https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=22354604&dopt=Abstract
• 28 Weinstein BE. Geriatric Audiology, 2nd ed. New York, NY: Thieme; 2012
• 29 Babeu LA, Kricos PB, Lesner SA. Application of the stages-of change model in audiology. J Acad Rehabil Audiol 2004; 37: 41-56
• 30 Grenness C, Hickson L, Laplante-Levesque A, Meyer C, Davidson B. The nature of communication throughout diagnosis and management planning in initial audiologic rehabilitation consultations. J Am Acad Audiol 2015; 26: 36-50
• 31 Milstein D, Weinstein BE. Effects of information sharing on followup after screening for older adults. J Acad Rehabil Audiol 2002; 35: 43-48
• 32 Noh S, Gagné JP, Kaspar V. Models of health behaviors and compliance: applications to audiological rehabilitation research. In: Gagné JP, Tye-Murray N. , eds. Research in Audiological Rehabilitation: Current Trends and Future Directions. Gainesville, FL: J Acad Rehabil Audiol Monograph supplement; 1994. ;37: 375-389
• 33 Rawool VW, Colligon-Wayne LA. Auditory lifestyles and beliefs related to hearing loss among college freshman in the USA. Noise Health 2008; 2008 (10) 1-10 Available at http://www.noiseandhealth.org/article.asp?issn=1463-1741;year=2008;volume=10;issue=38;spage=1;epage=10;aulast=Rawool Accessed September 7, 2017
• 34 Sobel J, Meikle M. Applying health behavior theory to hearing conservation interventions. Semin Hear 2008; 29: 81-89
• 35 Barker F, McKenzie E, Elliott L, Jones S, de Lusignan S. Interventions to improve hearing aid use in adult auditory rehabilitation. Cochrane Database Syst Rev 2012;
• 36 Ida Institute. Tool Box: Motivational Tools. Available at: http://idainstitute.com/toolbox/motivation_tools/ . Accessed September 7, 2017
• 37 Ida Institute. Tool Box: Change Guide. Available at: http://idainstitute.com/toolbox/change_guide/ . Accessed September 7, 2017
• 38 McConnaughy EA, Prochaska JO, Velicer WF. Stages of change in psychotherapy: Measurement and sample profiles. Psychother: Theory, Research, and Practice 1983; 26: 494-503
• 39 Dillon H, James A, Ginis J. Client Oriented Scale of Improvement (COSI) and its relationship to several other measures of benefit and satisfaction provided by hearing aids. J Am Acad Audiol 1997; 8: 27-43
• 40 West RL, Smith SL. Development of a hearing aid self-efficacy questionnaire. Int J Audiol 2007; 46: 759-771 . PMID: 18049965. doi: 10.1080/14992020701545898