The acceptability of teleaudiology and access to audiological services outside of major urban areas: New Zealand patient and provider perspectives

Abstract

Aims: To investigate the accessibility of audiological services in rural and non-major centres of New Zealand and the acceptability of teleaudiology as a service delivery intervention for rural and non-major populations. Background: Hearing loss is a common disability which largely goes undiagnosed and untreated and costs the New Zealand economy billions each year. Population projections predict rural areas will see the largest increases in the proportion of elderly. Consequently, it is expected that rural and non-major urban areas will see more elderly with more severe hearing impairments. Accessibility of healthcare services is a challenge in rural areas which telehealth has the potential to overcome. Research on the acceptability of teleaudiology services is limited, and there is no research on the accessibility and uptake of audiological services in the context of New Zealand rural and non-major urban areas. Methods: Semi-structured interviews were conducted with seven patients who had used a teleaudiology service, and four each of private and public audiological service providers. A thematic analysis of interview transcripts was conducted using an inductive approach. Results: Seven common themes across participant groups were identified. These were accessibility, financial barriers, communication, attitudes, technology, preference of service delivery, and knowledge and awareness. In addition, three lifestyle factors relating to the uniqueness of living rurally and outside of major urban areas were identified. Conclusions: Staff shortages, distance, and transportation were key accessibility barriers for patients living outside of major urban areas, for which teleaudiology offers a solution. This research has highlighted ways in which communication, trust, and knowledge and awareness of hearing loss and audiological services can be improved to increase the acceptability of teleaudiology services. However, in-person services remain an important part of service provision in these populations, and this study indicates audiological services are not being adequately provided in these communities.