Effects of Patient-centred Counselling on Attitudes towards Hearing Loss and Hearing Aids in Adults with Untreated Hearing Loss

Abstract

Objective: To evaluate the effectiveness of a patient-centred counselling intervention aimed at facilitating hearing aid uptake through improving readiness to change, hearing health attitudes relating to the constructs of the Health Belief Model (HBM), and implicit attitude towards hearing aids. Introduction: Untreated hearing loss negatively impacts on quality of life and psychosocial well-being and a large proportion of adults live with untreated hearing loss when they could benefit from aural rehabilitation (Greville, 2001). There are arguments for more patient-centred methods to facilitate hearing aid uptake as persuasion using external motivators, typically applied in clinical audiology, is often met with disregard and resistance (Clark & English, 2004). Motivational Interviewing (MI) is a patient-centred approach that uses specific counselling tools and techniques to nurture the patient’s internal motivation to change and to improve readiness to change. Methods: A randomised control design was implemented. The Treatment group received a single, brief counselling session integrated into the explanation of hearing test results. Controls received only an explanation of hearing test results. Outcome measures were readiness to change assessed using a Stage of Change questionnaire, hearing health attitudes assessed using the Hearing Beliefs Questionnaire (HBQ), and implicit attitude towards hearing aids assessed using the Implicit Association Test (IAT). Outcome measures were taken at pre-intervention, post-intervention and 4 weeks post-intervention. Results were analysed using repeated measures ANOVAs. Results: Readiness to acquire hearing aids was significantly improved at post-intervention for the Treatment group compared to Controls, which was marginally sustained at 4 weeks postintervention. Relative to the Control group, the Treatment group significantly increased in perceived benefits and decreased in perceived barriers at post-intervention, but this was not sustained at 4 weeks post-intervention. There were no effects of the intervention on ‘cues to action’, self-efficacy or implicit attitude towards hearing aids. Conclusions: The counselling intervention had beneficial effects for increasing participants’ readiness to acquire hearing aids and perceived benefits of hearing aids and for decreasing perceived barriers/costs of hearing aids, in at least the short term. Further research is needed to ascertain if the findings are repeatable, to evaluate longer term outcomes and to measure objective behaviour change.