Family Oriented Communication Assessment and Solutions (FOCAS-ME): A Qualitative Analysis of a Family-Centred Tool

Abstract

Objective: To compare the Family Oriented Communication Assessment and Solutions: Motivation and Experience (FOCAS-ME) tool with current standard adult audiology practice. Themes relevant to service provision, including family-centred-care and third-party disability, were explored through the qualitative analysis of case records. Introduction: Hearing loss impacts the quality of life of individuals, as well as those close to them through the impact of third-party disability. This can be addressed through family-centred care (FCC). The FOCAS-ME tool aims to incorporate FCC, as well as address recently identified gaps in adult audiology service provision. For the purposes of this study, the term "family member/s" will be used to represent any person who is a main communication partner of hearing-impaired individuals, including caregivers and friends. Methods: A sample of Hearing Aid Discussions (HADs) from the University of Auckland Hearing and Tinnitus Clinic (UoA HATC) and completed FOCAS-ME forms from a pilot study in Australia, were collected and qualitatively analysed. This was conducted through the classification of FOCAS-ME themes, and identification of their occurrence in the HAD cases, as well as additional elements determined to be relevant to service provision. General themes relating to audiological service provision were also analysed. Results: The FOCAS-ME tool shows promise regarding the exploration of the emotional impact of hearing loss and third-party disability. Family member involvement was intrinsic to the FOCAS-ME appointments. Current standard practice does not preclude family member involvement. Tinnitus, sound sensitivity, and physical limitations such as dexterity or vision problems are not part of the FOCAS-ME tool. All cases showed similar themes regarding the impact of hearing loss on hearing-impaired people and their families. Conclusions: This research reinforced existing literature regarding the emotional, psychosocial, and third-party impact of hearing loss. Further investigation into the benefits of implementing FCC in adult audiology is encouraged. In order to establish the efficacy of the FOCAS and FOCAS-ME tools to incorporate FCC and address the recent gaps in adult audiology service provision identified in the literature, ongoing validation is required.