November 30, 2018, by Mel Ferguson
Welcome to the November issue of the Hearing Matters blog by the Mild to Moderate Hearing Loss Group at the NIHR Nottingham Biomedical Research Centre. This month, Rachel Gomez explores patient-centred care in audiology and the research we are doing on this.
What is patient-centred care?
Patient-centred care in audiology is a journey that includes the patient, their family/friends and their audiologist. What patient-centred care is to one person might be different to another – in other words, it’s personal!
Why patient-centred care matters
Patient-centred care empowers patients to be involved in all aspects of their healthcare, with clinicians and significant others supporting the patient to make informed choices that are right for them. Systematic reviews of the highest-quality research evidence (randomised controlled trials) from different health conditions show that patient-centred care can lead to:
- improved patient satisfaction with their care
- improved clinical outcomes (e.g. better controlled blood sugar levels in patients living with diabetes)
- increased use of treatments (e.g. continuing to take medication)
- increased job satisfaction for health care professionals
For these reasons, the benefits of patient-centred care are too good to miss! Patient-centred care has been integral to UK NHS healthcare since the launch of ‘No decision about me, without me’ in 2012 and is embedded within the NHS Constitution for England. Of importance to hearing services, patient-centred care is integral to the recent NICE guidance on assessment and management of adult hearing loss.
Our MMHL team contributes to helping audiology patient-centred care in several ways:
- Shared decision making
A key part of patient-centred care is supporting patients to engage in shared decision making with their audiologist and family. One of our studies aimed to improve the motivation of hearing aid users to more actively engage in their care using Ida Institute tools. This study showed that compared to standard care, hearing aid users reported:
- increased levels of shared decision making
- greater confidence in their ability to manage hearing aids
- reduced anxiety levels
A second study also showed that preparing patients for their audiology appointments before they attend audiology, had numerous benefits. Patients reported they were more actively involved in their care and felt more motivated and ready to wear hearing aids.
From these results, we concluded that bringing shared decision making into the audiology clinic enhances patient-centred care.
- Self-management of hearing loss
In audiology, one aim is to empower patients to self-manage their hearing in the long-term. In our August edition of our blog, we discussed our research using eHealth to support self-management. This discussed how the use of multimedia videos resulted in better knowledge and practical hearing aid handling skills, and increased hearing aid use compared to those receiving standard care. C2Hear online are currently freely available online, just search for C2Hear Online. By using an eHealth platform to support self-management, patients can access this information at a time and pace to suit them.
- Impact of hearing loss
Our research has also helped demonstrate how hearing loss can lead to difficulties in patients social life, wellbeing and work/education (see June 2018 Hearing Matters blog for further details). This research has led to a new questionnaire to help researchers and audiologists capture the impact of mild to moderate hearing loss on taking part in social and work situations. By learning the true effects of hearing loss on individual patients, audiologists are better placed to help them make informed decisions on their particular hearing needs.
Research evidence shows that patient-centred care is an essential part of hearing healthcare. What’s more audiologists, and importantly, patients, agree!
Rachel Gomez, Research Audiologist, Clinical Scientist (Audiology) at NIHR Biomedical Research Centre, Mild to Moderate Hearing Loss