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Communication is an area of health and functioning that is profoundly affected by dementia. While it is known that people living with dementia and their care partners experience disruptions to daily activities and social engagement, detailed knowledge about the lived impact of dementia-related communication changes is lacking. This study sought an in-depth understanding of the lived experience of dementia-related communication changes and the associated impact, needs, and strategies.As part of an overarching participatory design study, a qualitative (interpretive description) exploration was undertaken with people living with dementia and their care partners. Data from semi-structured interviews were analysed using thematic analysis.We interviewed 13 people living with dementia and 21 care partners and drew three themes and 10 subthemes from the interviews. The first theme illustrates how dementia changes communication which in turn changes life; the second captures the impact of changes on people living with dementia and care partners emotionally and in the context of relationships; and the third describes some positive and constructive ways of moving forward with dementia-related communication changes.Interventions to enhance function, participation, and wellbeing for people living with dementia and their care partners need to encompass support for communication changes. There is a need to ensure that people living with dementia feel dignified and respected during communication, and that care partners and inclusive communities are educated, trained, and supported to facilitate communication.

Purpose: Assessing the unique needs of each family following the diagnosis of a hearing loss is central to the delivery of family-centered hearing health care. Therefore, the aim of this study was to develop a Minimum Data Set (MDS) that could be used in the design of a needs assessment tool for families of children with hearing loss transitioning to early intervention. Method: A list of potential items for the MDS was prepared. In a two-round electronic Delphi study in Australia, hearing researchers ( N = 15 in Round 1; N = 9 in Round 2), clinicians, and professionals working in early intervention for children with hearing loss ( N = 85) were asked to review the potential items and to rate the importance of items using a Likert scale. Results: Consensus was reached on 32 main items to be included in the MDS across six categories, including informational support (13 items), professional support (five items), peer support (one item), skills and knowledge (seven items), financial support (three items), and methods of information provision (three items). Eight optional items that could be considered for inclusion in the MDS were also identified. Conclusions: The proposed MDS could support hearing professionals in identifying families' needs in order to provide individualized information and support. Future research is needed to conduct a pilot study to evaluate the needs assessment tool in terms of usability, feasibility, and therapeutic effects.

To identify the barriers and facilitators of hearing healthcare clinicians (HHC) providing information to audiology consumers on (i) the mental health impacts of hearing loss, and (ii) management options for improving mental well-being.A qualitative study using semi-structured individual and group interviews. Both the interview guide and the deductive process of data analysis were based on the COM-B model (Capabilities, Opportunities and Motivations required for Behaviour change).Fifteen HHCs with between 2 and 25 years of clinical experience (mean 9.3).Psychological Capability barriers included lack of knowledge relating to mental health signs and symptoms, management options available, referral processes, and resources/tools to assist discussion of options. Social opportunity barriers included clients' lack of openness to receive mental health-related information from their HHC. Automatic motivation factors included feeling uncomfortable and helpless when discussing mental health. Reflective motivation factors included clinician's limiting beliefs concerning their role and responsibilities regarding provision of mental health support, and doubts about whether mental health services are truly beneficial for clients with hearing loss.Application of the COM-B model for behaviour change identified factors that need to be addressed to increase the provision of mental health information in the audiology setting.

This study aimed to explore and compare families’ and professionals’ perspectives on the implementation of family-centered care (FCC) (Moeller, Carr, Seaver, Stredler-Brown, & Holzinger, 2013) during the period between diagnosis of hearing loss (HL) and enrollment in early intervention (EI). A convergent mixed-methods study incorporating self-report questionnaires and semistructured in-depth interviews was used. Seventeen family members of children with HL and the 11 professionals who support these families participated in this study. The results suggested that the services engaged during the transition period partially adhered to the principles of FCC, including the provision of timely access to EI services and provision of emotional and social support. However, areas for improvement identified include strengthening family/professional partnerships, shared decision-making processes, collaborative teamwork, program monitoring, and consistency in the provision of information and support. Qualitative and quantitative research findings also indicated a lack of consistency in service provision during the transition period.

Introduction: Newborn hearing screening is essential for early identification of hearing loss to decrease the adverse effects of hearing loss. The objective of this study was to determine the prevalence of hearing loss and risk factors of congenital hearing loss in newborns. Methods: In this analytical case-control study, a hearing screening test was performed for all newborns aged 3-14 days. Results: Of 5,500 newborns evaluated, 24 newborns had hearing loss. The prevalence of hearing loss was 4.36 per 1,000. Of 24 hearing-impaired newborns, 15 had bilateral hearing loss (BHL) (62.5%) and nine had unilateral hearing loss (UHL) (37.5%). Among the neonates with hearing loss, the prevalence of hearing loss was higher (77.8%) in the right ear. The main risk factors identified in this study were low gestational age (P=0.001), hospitalization in the neonatal intensive care unit (NICU) (P=0.008), exposure to ototoxic drugs (P=0.001), gestational diabetes P=0.01), craniofacial anomalies (P=0.01), convulsion (P=0.03), consanguineous marriage of parents (P=0.001), low birth weight (P=0.01), and hyperbilirubinemia (P=0.001). Conclusion: The prevalence of hearing loss was higher in the right ear than in the left ear. NICU stay, use of ototoxic drugs, low gestational age (

Family-centred care (FCC) has long been acknowledged as best practice for meeting the needs of families of children with hearing loss (HL) and improving early intervention (EI) outcomes. Although the literature has reported some gaps in service provision to families of children with HL, and the period from the time of diagnosis to enrolment in EI has been identified as a significant decision-making period, there is a lack of in-depth knowledge regarding families’ needs during this period. In addition, no study has addressed the current gaps in FCC for children with HL with or without additional disabilities transitioning to EI. Therefore, the overarching aim of this thesis was to develop a family-centred intervention to support families of children with HL transitioning to EI, using an implementation science approach. The specific aims of this thesis were: (1) to explore families’ needs in the transition to EI after diagnosis of HL from both families’ and professionals’ perspectives; (2) to investigate families’ and professionals’ perspectives on the provision of FCC in the transition to EI; and (3) to develop a family-centred intervention for children with HL—with or without additional disabilities—transitioning to EI.Chapter 2 describes the overarching framework applied throughout this thesis, the Behaviour Change Wheel (BCW). The BCW is a step-by-step guide for planning interventions that involves three tasks, including (a) understanding the behaviour that needs to be changed (Chapters 3 and 4), (b) identifying intervention options (Chapter 5), and (c) identifying implementation options and content of the intervention (Chapter 6).Chapter 3 explored families’ needs in the transition to EI using a qualitative approach incorporating semi-structured interviews with families and professionals. Four major themes were identified from the interviews: (1) families require information that meet their specific needs; (2) families require supportive professionals to “walk the journey” with them; (3) some families want to connect with other families who “are in the same boat”; and (4) professional support needs differ for children with HL who have additional disabilities.Chapter 4 investigated families’ and professionals’ perspectives on the implementation of FCC during the transition period. In a convergent mixed-methods study, quantitative data were collected by self-report questionnaires (MPOC-20 and MPOC-SP) and qualitative data by interviews. The results suggested that services provided during the transition period adhered to some of the principles of FCC, including the provision of timely access to EI services and giving emotional and social support. However, areas for improvement included the need to strengthen family/professional partnerships, provide more family-centred training for professionals, and improve shared decision-making processes, program monitoring, and consistency in the provision of information and support.The overarching findings of chapters 3 and 4 indicated that families of children with HL required individualised information and support, and that there was inconsistency in information and services provided to families during the transition period. The research team defined the problem to be addressed as the “provision of individualised information and support to families of children with HL in transition to EI.” To address the problem, the administration of a needs assessment was identified as the behaviour that needed to be changed, with a resource limitation being identified as the main barrier. Thus, the research team developed a Minimum Data Set (MDS) to facilitate a discussion about families’ individual needs during the transition period.Chapter 5 describes a two-round eDelphi study for developing a MDS for assessing the needs of families of children with HL transitioning to EI. Consensus was reached among hearing researchers and professionals on 32 items across six categories, including informational support, professional support, peer support, skills and knowledge, financial support, and methods of information provision. The MDS can be incorporated into a Needs Assessment Tool to support professionals to identify and address families’ unique needs during the transition to EI.To improve the pace of service delivery during the transition period, the provision of eHealth services is recommended in the literature. As the MDS could be delivered online through eHealth or administered in-person, Chapter 6 explored factors influencing the use of eHealth in the context of barriers and facilitators related to capability, opportunity, and motivation. The results indicated that both families’ and professionals’ knowledge of and confidence in using the Internet and technology, as well as families’ access to reliable Internet and affordable equipment, were important factors that influenced the use of eHealth services. Families’ and professionals’ beliefs that there were benefits associated with using eHealth services was also identified as an important facilitator. Professionals’ and families’ preferences and a culture of face-to-face services were identified as barriers for using eHealth interventions.Overall, this thesis has demonstrated that families transitioning to EI following the diagnosis of HL require individualised information and support. The MDS has the potential to facilitate the assessment and management of families’ individual needs during the transition period.

Background Prior to developing a successful eHealth intervention, it is important that we explore stakeholders’ capacity to adapt to eHealth. Objective To explore what factors influence the use eHealth services from the perspectives of families of children with hearing loss and professionals who support families as they transition into early intervention. Methods A qualitative study incorporating semi-structured in-depth interviews was conducted with families (n = 17) and professionals (n = 11). Interview topic guides were developed based on the COM-B model of behaviour change to explore barriers and facilitators related to capability, opportunity, and motivation. Results The COM-B model captured several factors that may influence the use eHealth interventions for families of children with hearing loss. The capability factors included computer literacy and familiarity with social media. The opportunity factors were access to online resources, reliable Internet, and affordable equipment. Professionals’ and families’ preferences and a culture of face-to-face services were also identified as barriers for using eHealth. The motivation factors included families’ and professionals’ confidence in using technology and beliefs that there were benefits (e.g., saving travel) associated with using eHealth services. In contrast, beliefs that eHealth may be difficult to set up and not able to replace in-person communication identified as barriers to families and professionals adopting eHealth interventions. Conclusion Findings of this study indicated that implementation of an eHealth intervention could be facilitated by addressing the barriers in stakeholders’ capabilities, opportunities (e.g., equipment and social support), and motivation (e.g., negative beliefs about eHealth) before developing eHealth services.

Background and Objectives: Conductive hearing loss is common among children and adults. This study aims at comparing the results of conductive hearing loss in summer and autumn. Subjects and Methods: Puretone audiometry and tympanometry tests were done for all patients who referred to the Iranian-based audiology center of Imam Khomeini Hospital in Ahvaz. Data on the patients with conductive or mixed hearing loss were analyzed. The im- pacts of season, age, and etiology of the disease were analyzed on the patients who visited the audiology clinic due to the conductive hearing loss in summer and autumn. Results: One hundred and fifty nine patients in summer and 123 patients in autumn had conductive or mixed hearing loss. Their age ranged from four to 82 years, with the average age of 35. The percentage of the patients, with acute otitis media and chronic otitis media (COM), who visited this clinic, was significantly higher than those with middle ear problems. COM and mastoid surgeries rate was higher in summer than autumn among adults. Conclusions: There is no relationship between season and middle ear diseases between children and juveniles, but COM and mastoid problems are more common in summer among adults visiting this clinic. Most of the patients had mild conductive hearing loss and bilateral middle ear impairments. Korean J Audiol 2014;18(1):13-18

SUMMARY Quality of life (QOL) in families can be affected when a child has cerebral palsy (CP). The aim of this research was to determine the effect of a child’s disability on the mother’s quality of life by comparing mothers of children with CP and mothers of normal children. Two sample groups were chosen from a total of 42 mothers to answer a short-form health survey (SF-36) questionnaire. The first group included 21 mothers of children with cerebral palsy who were referred to the speech therapy clinic of Jundishapur University of Medical Sciences in Ahvaz. The second group consisted of 21 mothers of normal children living in Ahvaz. T-tests by SPSS were used for statistical analysis. There were significant differences in all domains of QOL between mothers of healthy children and mothers of children with cerebral palsy (p=0.001). This research found that the quality of life of mothers of children with CP was significantly different compared to mothers of healthy children. Therefore, appropriate planning is necessary to improve their quality of life in different domains.

Introduction: Audiology students should possess clinical competence and skills. To achieve this, their clinical skills must be properly assessed. The Objective Structured Clinical Examination (OSCE) is a standard and fair examination of clinical competence. The goal of this study is to devise a checklist of OSCE examination criteria and study their validity and reliability for assessing the clinical competence of Audiology students. Methods: Among the various procedures in which audiology students should possess demonstrated competence, 10 specific skills were selected and checklists were prepared. Faculty members of university’s Audiology Department were consulted to determine the validity of the checklists. Subsequently, the examination was administered to all 14 fourth-year audiology students in their final semester of study at Ahvaz Jundishapur University of Medical Sciences. The examination consisted of three question stations and seven procedure stations. Each station was managed by two examiners who independently used a checklist to score each student’s performance in a given procedure. To determine reliability, the Spearman test was used. Results: The correlation between each examiner’s scores of students at question stations was 0.908. The correlation between each examiner’s scores at procedure stations was 0.857 (p=0). The site of lesion test had the highest correlation (0.948) and immittance audiometry had the lowest correlation (0.585). Conclusion: The prepared checklists had good validity and reliability and can be used to evaluate the clinical competence of audiology students in their final semester of study.

Background and Aim: Providing high quality health care is not possible without information related to the past and current condition of the patient. Records show which services, where, when and by whom was delivered. Documentation is referred to the process of precisely recording the information regarding patient care and treatment. The purpose of this study is to determine the essential data set required in audiology record keeping and designing a model for Iran. Methods: In an applied research of a descriptive-comparative type which was carried out in 2010, data elements of audiology records of domestic and foreign patient notes were used to compile a check list which was subjected to debate by Iranian audiologists in Delphi method. 110 audiologists and 17 faculty members responded to the opinion poll. Results: From 51 elements which were subjected to discussion, 37 elements by more than 75 percent of the participants, nine elements by 50 to 75 percent of the participants and five elements by less than 50 percent of the participants, were agreed upon. The only element to be considered more important by faculty members than audiologists was “Gender” (p=0.018). Seventy percent of the participants valued the effectiveness of information in patient records very high. Conclusion: The minimum data set for audiology records must include demographic information, past medical history, patient assessment and treatment plan. With reference to record design principles this information was used to develop amodel for patient audiology record which also included the necessary instructions for completing it.