Healthcare-seeking behaviour of primary caregivers for acute otitis media in children

Villarreal, I. et al. BMC Pediatrics. Published online: 5 January 2017

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Background: Acute otitis media (AOM) is the most common bacterial childhood infection. However, caregivers with children having mild episodes often do not seek healthcare services, which may lead to an under-appreciation of the disease experienced by the community. The objectives of this survey were to estimate the proportion of primary caregivers who went to a healthcare facility when they suspected that their child aged 6 to <30 months was having an AOM episode during the past 6 months and to assess what factors influenced their decision.


Conclusions: When confronted with a child with obvious symptoms of AOM, the majority of caregivers reported seeking healthcare. This behaviour appeared to be associated with factors related to the severity of the illness, the length of time since the last episode, as well as with the income and occupational status of the caregivers themselves. As many episodes of AOM present with non-specific respiratory symptoms, our results apply only to caregivers who were confronted with children with an obvious symptom.

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Experiences of hearing loss and views towards interventions to promote uptake of rehabilitation support among UK adults

Rolfeab, . & Gardner, C. International Journal of Audiology. Published online: 5 July 2016
Image source: clement127 – Flickr // CC BY-NC-ND 2.0

Objective: Effective hearing loss rehabilitation support options are available. Yet, people often experience delays in receiving rehabilitation support. This study aimed to document support-seeking experiences among a sample of UK adults with hearing loss, and views towards potential strategies to increase rehabilitation support uptake. People with hearing loss were interviewed about their experiences of seeking support, and responses to hypothetical intervention strategies, including public awareness campaigns, a training programme for health professionals, and a national hearing screening programme.

Design: Semi-structured qualitative interview design with thematic analysis.

Study sample: Twenty-two people with hearing loss, aged 66–88.

Results: Three themes, representing barriers to receiving rehabilitation support and potential areas for intervention, were identified: making the journey from realization to readiness, combatting social stigma, and accessing appropriate services. Barriers to receiving support mostly focused on appraisal of hearing loss symptoms. Interventions enabling symptom appraisal, such as routine screening, or demonstrating how to raise the topic effectively with a loved one, were welcomed.

Conclusions: Interventions to facilitate realization of hearing loss should be prioritized. Raising awareness of the symptoms and prevalence of hearing loss may help people to identify hearing problems and reduce stigma, in turn increasing hearing loss acceptance.

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Application of the transtheoretical model of behaviour change for identifying older clients’ readiness for hearing rehabilitation during history-taking in audiology appointments

Ekberg, K. et al. International Journal of Audiology. Published online: 13 Apr 2016

Objectives: The transtheoretical model (TTM) of behaviour change focuses on clients’ readiness for adopting new health behaviours. This study explores how clients’ readiness for change can be identified through their interactions with audiologists during history-taking in initial appointments; and whether clients’ readiness has consequences for the rehabilitation decisions they make within the initial appointment.

Design: Conversation analysis (CA) was used to examine video-recorded initial audiology appointments with older adults with hearing impairment.

Study sample: The data corpus involved 62 recorded appointments with 26 audiologists and their older adult clients (aged 55+ years). Companions were present in 17 appointments.

Results: Clients’ readiness for change could be observed through their interaction with the audiologist. Analysis demonstrated that the way clients described their hearing in the history-taking phase had systematic consequences for how they responded to rehabilitation recommendations (in particular, hearing aids) in the management phase of the appointment. In particular, clients identified as being in a pre-contemplation stage-of-change were more likely to display resistance to a recommendation of hearing aids (80% declined).

Conclusions: The transtheoretical model of behaviour change can be useful for helping audiologists individualize management planning to be congruent with individual clients’ needs, attitudes, desires, and psychological readiness for action in order to optimize clients’ hearing outcomes.

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Factors influencing pursuit of hearing evaluation: Enhancing the health belief model with perceived burden from hearing loss on communication partners

Schulz, K. A. et al. International Journal of Audiology. Published online: 15 Feb 2016.

Objective: There is limited application of health behavior-based theoretical models in hearing healthcare, yet other fields utilizing these models have shown their value in affecting behavior change. The health belief model (HBM) has demonstrated appropriateness for hearing research. This study assessed factors that influence an individual with suspected hearing loss to pursue clinical evaluation, with a focus on perceived burden of hearing loss on communication partners, using the HBM as a framework.

Design: Cross-sectional design collecting demographics along with three validated hearing-loss related questionnaires.

Study sample: Patients from Duke University Medical Center Otolaryngology Clinic aged 55–75 years who indicated a communication partner had expressed concern about their hearing. A final sample of 413 completed questionnaire sets was achieved.

Results: The HBM model construct ‘cues to action’ was a significant (p <0.001) predictor of pursuing hearing evaluation. Perceived burden of hearing loss on communication partners was a significant (p <0.001) predictor of pursuing hearing evaluation and improves the model fit when added to the HBM: 72.0% correct prediction when burden is added versus 66.6% when not (p <0.0001).

Conclusions: Hearing healthcare initiatives that incorporate these factors may improve hearing help-seeking behavior. More research using sound theoretical models in hearing healthcare is warranted.

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