Patient-centredness in advice delivered during audiology consultations
DOI:
https://doi.org/10.1558/japl.31838Keywords:
advice, audiology consultation, discourse analysis, hearing aids, patient-centredness, rehabilitationAbstract
Patient-centredness in audiological rehabilitation has previously been presented as possible only when attending to psychosocial aspects of hearing loss. Yet, audiologists routinely and by necessity provide technologically orientated advice about hearing aids. Although some advice is resisted, a significant number of patients are assisted and have improved quality of life because of audiological advice. This study investigates moments of advice giving during audiology consultations, in which hearing aids were discussed as rehabilitative options. Two illustrative cases selected from a collection of 20 consultations are presented, in which the audiologists' goals differed from those of the patients, but where after a process of advising (in one case offering explicit advice and in the other implicit advice), rehabilitation including hearing aids was agreed to. Hypothetical questions, voicing and patterns of pronoun use provided evidence of patient-centredness, in the absence of an obvious psychosocial focus. Demonstrating patient-centredness in discussions about hearing aids provides additional perspectives on current public commentary about the sale of hearing aids by audiologists. Additionally, demonstrating patient-centredness during hearing aid discussions suggests that audiologists may be able to transfer their skills to address areas commonly neglected in audiology consultations, including a focus on psychosocial aspects of audiological care.
References
Audiology Australia (2013) Part A: Practice operations. In Audiology Australia Professional Practice Standards Part A: Clinical Operations, 14–124. Forest Hill, VI: Audiology Australia. Available online: https://audiology.asn.au/Tenant/C0000013/Position%20Papers/Member%20Resources/Part%20A%20Professional%20Practice%20Standards%20-%20Practice%20Operations%20July2013%20EntireDoc.pdf
Australian Broadcasting Association (2017) Hearing clinics: Had it up to hear. Television segment in The Checkout, series 5 episode 9. Available online: https://www.youtube.com/watch?v=9tVO-nvrIt4
Australian Broadcasting Corporation (2014) Have I got a hearing aid for you! Background Briefing, 30 November. Available online: http://www.abc.net.au/radionational/programs/backgroundbriefing/2014-11-30/5920176
Australian Competition and Consumer Commission (2017) Issues around the Sale of Hearing Aids: Consumer and Clinician Perspectives Available online: https://www.accc.gov.au/publications/issues-around-the-sale-of-hearing-aids
Bassett, E. (2007) Voicing as an Involvement Strategy in Decision Making in Oncology Consultations. Unpublished Masters thesis, Macquarie University, Sydney.
Brouwer, C. E. (2012) Talking ‘cognition’ in the audiology clinic. In G. Rasmussen, C. E. Brouwer and D. Day (eds) Evaluating Cognitive Comptences in Interaction, 189–211. Amsterdam: John Benjamins. https://doi.org/10.1075/pbns.225.09bro
Brouwer, C. E. and Day, D. (2012) WHO/ICF guidelines and compliance in a hearing aid consultation. In M. Egbert and A. Deppermann (eds) Hearing Aids Communication: Integrating Social Interaction, Audiology and User Centered Design to Improve Communication with Hearing Loss and Hearing Technologies, 125–137. Mannheim: Verlag für Gesprächsforschung.
Candlin, C. N. (1987) Explaining moments of conflict in discourse. In R. Steele and T. Treadgold (eds) Language Topics: Essays in Honour of Michael Halliday, 413–431. Amsterdam: John Benjamins.
Collingridge, L. (2009) Patient-Professional Interaction in Clinical Settings in Audiology. Unpublished PhD Thesis, Department of Linguistics, Macquarie University, Sydney.
Collins, S. (2005) Communicating for a clinical purpose: Strategy in interaction in healthcare consultations. Communication & Medicine 2 (2): 111–122. https://doi.org/10.1515/come.2005.2.2.111
Crowe, S., Cresswell, K., Robertson, A., Huby, G., Avery, A. and Sheikh, A. (2011) The case study approach. BMC Medical Research Methodology 11 (1): 100. https://doi.org/10.1186/1471-2288-11-100
Duchan, J. F. (2004) Maybe audiologists are too attached to the medical model. Seminars in Hearing 25 (4): 347–354. https://doi.org/10.1055/s-2004-836136
Egbert, M. (2012) Technology and social interaction in the multimodal, multispace setting of audiometric testing. In M. Okumura, D. Bekki and K. Satoh (eds) New Frontiers in Artificial Intelligence: JSAI-isAI 2011. Lecture Notes in Artificial Intelligence 7258: 240–252. Berlin: Springer. https://doi.org/10.1007/978-3-642-32090-3_22
Ekberg, K., Grenness, C. and Hickson, L. (2014) Addressing patients’ psychosocial concerns regarding hearing aids within audiology appointments for older adults. American Journal of Audiology 23 (3): 337–350. https://doi.org/10.1044/2014_AJA-14-0011
English, K. (2005) Get ready for the next big thing in Audiologic Counseling. The Hearing Journal 58 (7): 10–15. https://doi.org/10.1097/01.HJ.0000286416.66547.47
Erber, N. P., Lamb, N. L. and Lind, C. (1996) Factors that affect the use of hearing aids by older people: A new perspective. American Journal of Audiology 5 (2): 11–18. https://doi.org/10.1044/1059-0889.0502.11
Gill, V. T. and Maynard, D. W. (2006) Explaining illness: Patients’ proposals and physicians’ responses. In J. Heritage and D. Maynard (eds) Communication in Medical Care: Interaction between Primary Care Physicians and Patients. 115–150. Cambridge: Cambridge University Press.
Goffman, E. (1967) Interaction Ritual: Essays on Face to Face Behavior. New York: Doubleday Anchor.
Goldsmith, D. J. (1999) Content-based resources for giving face sensitive advice in troubles talk episodes. Research on Language & Social Interaction 32 (4): 303–336. https://doi.org/10.1207/S15327973rls3204_1
Grenness, C., Hickson, L., Laplante-Lévesque, A. and Davidson, B. (2014a) Patient-centred audiological rehabilitation: Perspectives of older adults who own hearing aids. International Journal of Audiology 53 (S1): S68–S75. https://doi.org/10.3109/14992027.2013.866280
Grenness, C., Hickson, L., Laplante-Lévesque, A. and Davidson, B. (2014b) Patient-centred care: A review for rehabilitative audiologists. International Journal of Audiology 53 (S1): S60–S67. https://doi.org/10.3109/14992027.2013.847286
Grenness, C., Hickson, L., Laplante-Lévesque, A., Meyer, C. and Davidson, B. (2015a) Communication patterns in audiologic rehabilitation history-taking: Audiologists, patients, and their companions. Ear & Hearing 36 (2): 191–204. https://doi.org/10.1097/AUD.0000000000000100
Grenness, C., Hickson, L., Laplante-Lévesque, A., Meyer, C. and Davidson, B. (2015b) The nature of communication throughout diagnosis and management planning in initial audiologic rehabilitation consultations. Journal of the American Academy of Audiology 26 (1): 36–50. https://doi.org/10.3766/jaaa.26.1.5
Heritage, J. and Sefi, S. (1992) Dilemmas of advice: Aspects of delivery and reception of advice between health visitors and first-time mothers. In P. Drew and J. Heritage (eds) Talk at Work, 359–417. Cambridge: Cambridge University Press.
Hetu, R. (1996) The stigma attached to hearing impairment. Scandinavian Audiology 25 (Suppl. 43): S12–S24.
Holland, A. (2007) Counseling in Communication Disorders: A Wellness Perspective. San Diego: Plural Publishing.
Leppänen, V. (1998) The straightforwardness of advice: Advice giving in interactions between Swedish district nurses and patients. Research on Language & Social Interaction 31 (2): 209–239. https://doi.org/10.1207/s15327973rlsi3102_3
McCarthy, P. A. and Alpiner, J. G. (2013) History of adult audiologic rehabilitation: A map for the future. In J. J. Montano and J. B. Spitzer (eds) Adult Audiologic Rehabilitation (2nd edition), 3–21. San Diego: Plural Publishing.
Meyer, C., Barr, C., Khan, A. and Hickson, L. (2017) Audiologist-patient communication profiles in hearing rehabilitation appointments. Patient Education and Counseling 100 (8): 1490–1498. https://doi.org/10.1016/j.pec.2017.03.022
Montano, J. J. (2011) Building relationships: An important component to the aural rehabilitation process. ENT and Audiology 204 (4): 91–92.
Parliament of the Commonwealth of Australia (2017) Still Waiting to be Heard… Report on the Inquiry into the Hearing Health and Wellbeing of Australia. Canberra: Commonwealth of Australia. Available online: https://www.aph.gov.au/Parliamentary_Business/Committees/House/Health_Aged_Care_and_Sport/HearingHealth/Report_1
Ridgway, J., Hickson, L. and Lind, C. (2015) Autonomous motivation is associated with hearing aid adoption. International Journal of Audiology 54 (7): 476–484. https://doi.org/10.3109/14992027.2015.1007213
Roberts, C. and Sarangi, S. (2005) Theme-oriented discourse analysis of medical encounters. Medical Education 39 (6): 632–640. https://doi.org/10.1111/j.1365-2929.2005.02171.x
Sacks, H. (1974) On the analyzability of stories by children. In R. Turner (ed.) Ethnomethodology, 216–232. Harmondsworth, UK: Penguin.
Sarangi, S. (2000) Activity types, discourse types and interactional hybridity: The case for genetic counselling. In S. Sarangi and M. Coulthard (eds) Discourse and Social Life, 1–27. New York: Longman.
Sarangi, S. (2008) Other-orientation in patient-centred healthcare communication: Unveiled ideology or discoursal ecology? In G. Garzone and S. Sarangi (eds) Discourse, Ideology and Specialized Communication. Special issue of Linguistic Insights 33: 39–71. Berlin: Peter Lang.
Sarangi, S. (2010a) Practising discourse analysis in healthcare settings. In I. Bourgeault, R. Dingwall and R. De Vries (eds) The SAGE Handbook of Qualitative Methods in Health Research, 397–416. London: Sage. https://doi.org/10.4135/9781446268247.n21
Sarangi, S. (2010b) The spatial and temporal dimensions of reflective questions in genetic counseling. In A. Freed and S. Ehrlich (eds) Why Do You Ask? The Function of Questions in Institutional Discourse, 235–255. Oxford: Oxford University Press.
Sarangi, S. and Candlin, C. N. (2003) Categorization and explanation of risk: A discourse analytical perspective. Health, Risk and Society 5 (2): 115–124. https://doi.org/10.1080/1369857031000123902
Schegloff, E. A. (2007) A tutorial on membership categorization. Journal of Pragmatics 39 (3): 462–482. https://doi.org/10.1016/j.pragma.2006.07.007
Schegloff, E. A. (2008) Transcript symbols for conversation analysis. Available online: http://www.sscnet.ucla.edu/soc/faculty/schegloff/TranscriptionProject/index.html
Silverman, D. (1997) Discourses of Counselling: HIV Counselling as Social Interaction. London: Sage.
Sjoblad, S. and Warren, B. W. (2011) Can you unbundle and stay in business? Audiology Today (September–October): 36–46.
Southall, K., Gagné, J. P. and Jennings, M. B. (2013) The sociological effects of stigma: Applications to people with an aquired hearing loss. In J. J. Montano and J. B. Spitzer (eds) Adult Audiologic Rehabilitation (2nd edition), 108–129. San Diego, CA: Plural Publishing.
Sweetow, R. W. (1999) Counseling: It’s the key to successful hearing aid fittings. The Hearing Journal 52 (3): 10–17. https://doi.org/10.1097/00025572-199903000-00002
Taylor, B. and Weinstein, B. (2015) Moving from product-centered to patient-centric care: Expanding treatment options using decision aids. Audiology Online. Available online: https://www.audiologyonline.com/articles/moving-from-product-centered-to-14473
Turner, R. G. (1998) The hearing aid expert: Audiologist, dealer, or otolaryngologist? American Journal of Audiology 7 (2): 5–20. https://doi.org/10.1044/1059-0889(1998/016)
Tye-Murray, N. (2004) Foundations of Aural Rehabilitation: Children, Adults, and their Family Members (2nd edition). Clifton Park, NY: Delmar Learning.
Wilson, D. H., Walsh, P. G., Sanchez, L. and Read, P. (1998) Hearing Impairment in an Australian Population: Centre for Population Studies in Epidemiology. Adelaide: Centre for Population Studies in Epidemiology, South Australian Department of Human Services.
Yin, R. K. (2009) Case Study Research: Design and Method. London: Sage.
Australian Broadcasting Association (2017) Hearing clinics: Had it up to hear. Television segment in The Checkout, series 5 episode 9. Available online: https://www.youtube.com/watch?v=9tVO-nvrIt4
Australian Broadcasting Corporation (2014) Have I got a hearing aid for you! Background Briefing, 30 November. Available online: http://www.abc.net.au/radionational/programs/backgroundbriefing/2014-11-30/5920176
Australian Competition and Consumer Commission (2017) Issues around the Sale of Hearing Aids: Consumer and Clinician Perspectives Available online: https://www.accc.gov.au/publications/issues-around-the-sale-of-hearing-aids
Bassett, E. (2007) Voicing as an Involvement Strategy in Decision Making in Oncology Consultations. Unpublished Masters thesis, Macquarie University, Sydney.
Brouwer, C. E. (2012) Talking ‘cognition’ in the audiology clinic. In G. Rasmussen, C. E. Brouwer and D. Day (eds) Evaluating Cognitive Comptences in Interaction, 189–211. Amsterdam: John Benjamins. https://doi.org/10.1075/pbns.225.09bro
Brouwer, C. E. and Day, D. (2012) WHO/ICF guidelines and compliance in a hearing aid consultation. In M. Egbert and A. Deppermann (eds) Hearing Aids Communication: Integrating Social Interaction, Audiology and User Centered Design to Improve Communication with Hearing Loss and Hearing Technologies, 125–137. Mannheim: Verlag für Gesprächsforschung.
Candlin, C. N. (1987) Explaining moments of conflict in discourse. In R. Steele and T. Treadgold (eds) Language Topics: Essays in Honour of Michael Halliday, 413–431. Amsterdam: John Benjamins.
Collingridge, L. (2009) Patient-Professional Interaction in Clinical Settings in Audiology. Unpublished PhD Thesis, Department of Linguistics, Macquarie University, Sydney.
Collins, S. (2005) Communicating for a clinical purpose: Strategy in interaction in healthcare consultations. Communication & Medicine 2 (2): 111–122. https://doi.org/10.1515/come.2005.2.2.111
Crowe, S., Cresswell, K., Robertson, A., Huby, G., Avery, A. and Sheikh, A. (2011) The case study approach. BMC Medical Research Methodology 11 (1): 100. https://doi.org/10.1186/1471-2288-11-100
Duchan, J. F. (2004) Maybe audiologists are too attached to the medical model. Seminars in Hearing 25 (4): 347–354. https://doi.org/10.1055/s-2004-836136
Egbert, M. (2012) Technology and social interaction in the multimodal, multispace setting of audiometric testing. In M. Okumura, D. Bekki and K. Satoh (eds) New Frontiers in Artificial Intelligence: JSAI-isAI 2011. Lecture Notes in Artificial Intelligence 7258: 240–252. Berlin: Springer. https://doi.org/10.1007/978-3-642-32090-3_22
Ekberg, K., Grenness, C. and Hickson, L. (2014) Addressing patients’ psychosocial concerns regarding hearing aids within audiology appointments for older adults. American Journal of Audiology 23 (3): 337–350. https://doi.org/10.1044/2014_AJA-14-0011
English, K. (2005) Get ready for the next big thing in Audiologic Counseling. The Hearing Journal 58 (7): 10–15. https://doi.org/10.1097/01.HJ.0000286416.66547.47
Erber, N. P., Lamb, N. L. and Lind, C. (1996) Factors that affect the use of hearing aids by older people: A new perspective. American Journal of Audiology 5 (2): 11–18. https://doi.org/10.1044/1059-0889.0502.11
Gill, V. T. and Maynard, D. W. (2006) Explaining illness: Patients’ proposals and physicians’ responses. In J. Heritage and D. Maynard (eds) Communication in Medical Care: Interaction between Primary Care Physicians and Patients. 115–150. Cambridge: Cambridge University Press.
Goffman, E. (1967) Interaction Ritual: Essays on Face to Face Behavior. New York: Doubleday Anchor.
Goldsmith, D. J. (1999) Content-based resources for giving face sensitive advice in troubles talk episodes. Research on Language & Social Interaction 32 (4): 303–336. https://doi.org/10.1207/S15327973rls3204_1
Grenness, C., Hickson, L., Laplante-Lévesque, A. and Davidson, B. (2014a) Patient-centred audiological rehabilitation: Perspectives of older adults who own hearing aids. International Journal of Audiology 53 (S1): S68–S75. https://doi.org/10.3109/14992027.2013.866280
Grenness, C., Hickson, L., Laplante-Lévesque, A. and Davidson, B. (2014b) Patient-centred care: A review for rehabilitative audiologists. International Journal of Audiology 53 (S1): S60–S67. https://doi.org/10.3109/14992027.2013.847286
Grenness, C., Hickson, L., Laplante-Lévesque, A., Meyer, C. and Davidson, B. (2015a) Communication patterns in audiologic rehabilitation history-taking: Audiologists, patients, and their companions. Ear & Hearing 36 (2): 191–204. https://doi.org/10.1097/AUD.0000000000000100
Grenness, C., Hickson, L., Laplante-Lévesque, A., Meyer, C. and Davidson, B. (2015b) The nature of communication throughout diagnosis and management planning in initial audiologic rehabilitation consultations. Journal of the American Academy of Audiology 26 (1): 36–50. https://doi.org/10.3766/jaaa.26.1.5
Heritage, J. and Sefi, S. (1992) Dilemmas of advice: Aspects of delivery and reception of advice between health visitors and first-time mothers. In P. Drew and J. Heritage (eds) Talk at Work, 359–417. Cambridge: Cambridge University Press.
Hetu, R. (1996) The stigma attached to hearing impairment. Scandinavian Audiology 25 (Suppl. 43): S12–S24.
Holland, A. (2007) Counseling in Communication Disorders: A Wellness Perspective. San Diego: Plural Publishing.
Leppänen, V. (1998) The straightforwardness of advice: Advice giving in interactions between Swedish district nurses and patients. Research on Language & Social Interaction 31 (2): 209–239. https://doi.org/10.1207/s15327973rlsi3102_3
McCarthy, P. A. and Alpiner, J. G. (2013) History of adult audiologic rehabilitation: A map for the future. In J. J. Montano and J. B. Spitzer (eds) Adult Audiologic Rehabilitation (2nd edition), 3–21. San Diego: Plural Publishing.
Meyer, C., Barr, C., Khan, A. and Hickson, L. (2017) Audiologist-patient communication profiles in hearing rehabilitation appointments. Patient Education and Counseling 100 (8): 1490–1498. https://doi.org/10.1016/j.pec.2017.03.022
Montano, J. J. (2011) Building relationships: An important component to the aural rehabilitation process. ENT and Audiology 204 (4): 91–92.
Parliament of the Commonwealth of Australia (2017) Still Waiting to be Heard… Report on the Inquiry into the Hearing Health and Wellbeing of Australia. Canberra: Commonwealth of Australia. Available online: https://www.aph.gov.au/Parliamentary_Business/Committees/House/Health_Aged_Care_and_Sport/HearingHealth/Report_1
Ridgway, J., Hickson, L. and Lind, C. (2015) Autonomous motivation is associated with hearing aid adoption. International Journal of Audiology 54 (7): 476–484. https://doi.org/10.3109/14992027.2015.1007213
Roberts, C. and Sarangi, S. (2005) Theme-oriented discourse analysis of medical encounters. Medical Education 39 (6): 632–640. https://doi.org/10.1111/j.1365-2929.2005.02171.x
Sacks, H. (1974) On the analyzability of stories by children. In R. Turner (ed.) Ethnomethodology, 216–232. Harmondsworth, UK: Penguin.
Sarangi, S. (2000) Activity types, discourse types and interactional hybridity: The case for genetic counselling. In S. Sarangi and M. Coulthard (eds) Discourse and Social Life, 1–27. New York: Longman.
Sarangi, S. (2008) Other-orientation in patient-centred healthcare communication: Unveiled ideology or discoursal ecology? In G. Garzone and S. Sarangi (eds) Discourse, Ideology and Specialized Communication. Special issue of Linguistic Insights 33: 39–71. Berlin: Peter Lang.
Sarangi, S. (2010a) Practising discourse analysis in healthcare settings. In I. Bourgeault, R. Dingwall and R. De Vries (eds) The SAGE Handbook of Qualitative Methods in Health Research, 397–416. London: Sage. https://doi.org/10.4135/9781446268247.n21
Sarangi, S. (2010b) The spatial and temporal dimensions of reflective questions in genetic counseling. In A. Freed and S. Ehrlich (eds) Why Do You Ask? The Function of Questions in Institutional Discourse, 235–255. Oxford: Oxford University Press.
Sarangi, S. and Candlin, C. N. (2003) Categorization and explanation of risk: A discourse analytical perspective. Health, Risk and Society 5 (2): 115–124. https://doi.org/10.1080/1369857031000123902
Schegloff, E. A. (2007) A tutorial on membership categorization. Journal of Pragmatics 39 (3): 462–482. https://doi.org/10.1016/j.pragma.2006.07.007
Schegloff, E. A. (2008) Transcript symbols for conversation analysis. Available online: http://www.sscnet.ucla.edu/soc/faculty/schegloff/TranscriptionProject/index.html
Silverman, D. (1997) Discourses of Counselling: HIV Counselling as Social Interaction. London: Sage.
Sjoblad, S. and Warren, B. W. (2011) Can you unbundle and stay in business? Audiology Today (September–October): 36–46.
Southall, K., Gagné, J. P. and Jennings, M. B. (2013) The sociological effects of stigma: Applications to people with an aquired hearing loss. In J. J. Montano and J. B. Spitzer (eds) Adult Audiologic Rehabilitation (2nd edition), 108–129. San Diego, CA: Plural Publishing.
Sweetow, R. W. (1999) Counseling: It’s the key to successful hearing aid fittings. The Hearing Journal 52 (3): 10–17. https://doi.org/10.1097/00025572-199903000-00002
Taylor, B. and Weinstein, B. (2015) Moving from product-centered to patient-centric care: Expanding treatment options using decision aids. Audiology Online. Available online: https://www.audiologyonline.com/articles/moving-from-product-centered-to-14473
Turner, R. G. (1998) The hearing aid expert: Audiologist, dealer, or otolaryngologist? American Journal of Audiology 7 (2): 5–20. https://doi.org/10.1044/1059-0889(1998/016)
Tye-Murray, N. (2004) Foundations of Aural Rehabilitation: Children, Adults, and their Family Members (2nd edition). Clifton Park, NY: Delmar Learning.
Wilson, D. H., Walsh, P. G., Sanchez, L. and Read, P. (1998) Hearing Impairment in an Australian Population: Centre for Population Studies in Epidemiology. Adelaide: Centre for Population Studies in Epidemiology, South Australian Department of Human Services.
Yin, R. K. (2009) Case Study Research: Design and Method. London: Sage.
Published
2018-12-31
Issue
Section
Articles
License
Equinox Publishing Ltd.
How to Cite
Collingridge, L., & Bassett, E. (2018). Patient-centredness in advice delivered during audiology consultations. Journal of Applied Linguistics and Professional Practice, 13(1-3), 56-77. https://doi.org/10.1558/japl.31838
