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"What brings you here today?" : perspectives of older women on hearing, help-seeking for hearing problems, and their first audiology appointment Carson, Arlene Jane

Abstract

Persons with hearing problems typically wait many years from the time hearing difficulties are noticed until an appointment is made for an audiologic assessment. Some hard-of-hearing persons never seek help. Many who finally seek and could benefit from rehabilitative help delay taking further action after their hearing is tested. These facts suggest the need for more research into the nature of help-seeking for hearing loss. The present study explored the perspectives of older women on their hearing, hearing problems, and help-seeking for hearing problems around the time of their first audiologic assessment. A major goal of this research was to explore the links between individuals' experiences living with a hearing loss and the process of help-seeking. A related goal was to examine how these experiences and the help-seeking process may influence and be influenced by the interaction of help-seekers with the audiology system. The main participants in this study were older women living in the community who were seeking help for age-related hearing loss (presbycusis). They were interviewed indepth from the time they booked their first audiology appointment, through the appointment itself, and up to six weeks following the appointment. Data also included interviews with family members and the assessing audiologist, participant observation of the audiology appointments by the researcher, and journal writing by each participant. Data were coded and organized into a theoretical framework, guided by the principles of grounded theory. The findings of this study indicate that participants engaged in a protracted selfassessment of their hearing before, during, and after seeking help for hearing problems. The self-assessing process is influenced by many factors that facilitate or delay helpseeking; some factors may do each at different points in time. The result of the complex combining of these factors is a "push-pull" effect that moves persons iteratively toward and away from help-seeking. This finding is expressed in the core category of the theoretical framework of this study: "the spiral of decision-making in self-assessing hearing". Findings suggest that the audiology assessment itself and, in particular, the different rehabilitative foci of the audiologist and the hard-of-hearing person may be an important influence in self-assessing and decision-making regarding hearing problems. Three themes: contrasting/comparing, cost vs. benefits, and control, were identified as significant in self-assessing. Persons contrast and compare their hearing against many "yardsticks". They evaluate the relative costs and benefits, including the perceived loss of control, of specific actions taken for hearing problems. The exact nature of the relationships among these three themes remains to be determined. The results of this study underscore the need for further research into the nature of the interaction between audiologists and hard-of-hearing persons. As well, the findings of this study may be applicable to the more general study of help-seeking for health conditions related to aging.

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