Hearing care professionals are intimately aware of the communication demands of the geriatric population and the critical nature of good hearing on day-to-day communication, such as a patient’s visit with their doctor. That awareness, however, does not hold true for medical researchers, according to a recent evidence-based review article published on-line by the Journal of the American Geriatric Association on April 24th.
The authors of the review, including audiologist Barbara Weinstein of the CUNY Graduate Center and physician Jan Blustein of NYU School of Medicine identified 67 pertinent papers, published since 2000 that evaluated “older patient-physician communication.” Of the 67 relevant papers involved in the systematic review, just 16 (24%) of the studies included any mention of hearing loss and the impact it might have on patient-physician communication.
In a mere two of the 16 studies was the extent of the hearing loss measured and reported.
Impact of Hearing Loss: Too Often Overlooked?
More than 75% of the studies that met the authors’ criteria for inclusion in their review had no mention of hearing loss, even though issues such as patient knowledge, shared decision making, quality of communication and patient-centered care – all of which necessitate reasonably normal or corrected hearing — were components of most of the studies reviewed by the authors.
Given the importance of hearing to these constructs it may be surprising to hearing care professionals the general lack of awareness hearing loss has on communication issues among medical researchers. At the same time, it represents an opportunity for audiologists and other industry professionals to raise awareness with physicians and medical researchers about the consequences of uncorrected hearing loss in older adults.
The findings suggest that research on communication between healthcare professionals and older adults has largely overlooked a highly prevalent, important, and remediable influence on the quality of communication.
“Patients are often older people, for whom hearing loss is a daily issue. It’s also an issue that’s ripe for research: how can we attend to and improve hearing and understanding so that patients get the best quality care possible?” said Dr. Blustein. Co-author Barbara Weinstein, added that by adopting strategies to optimize communication between physicians and those under their care, the clinical encounter can be more productive with less effort required on the part of both parties. Some of these strategies were discussed at the recent AudiologyNow Featured Session in Indianapolis by Lori Zitelli of the University of Pittsburgh Medical Center and Nicholas Reed of Johns Hopkins School of Medicine and Towson State University.
Highlighting Opportunities for Improvement
In an accompanying editorial, Frank Lin of the Johns Hopkins School of Medicine and Heather Whitson of the Duke University School of Medicine noted that the review offers a major opportunity for practice improvement. “Common sense, low (or no) cost strategies can be employed to mitigate the negative impact of both hearing and vision loss in patient communication and some accommodations (e.g., minimizing ambient noise, speaking face to face, creating patient education materials with large-print font) are so simple and potentially beneficial that they could be implemented universally.”
*featured image courtesy flckr
Doctors typically do not counsel patients, but for geriatrics they may speak with a caregiver on general issues. Most doctors also do not know the art of communication with the hearing impaired. They need to learn a lot about counseling techniques., even it it means spending more time with the patient.