Disagreements between clients and family members regarding clients’ hearing and rehabilitation within audiology appointments for older adults
Keywords:conversation analysis, audiology, hearing impairment, hearing rehabilitation, family members, misalignment
Family members are significantly affected by the consequences of hearing impairment and can potentially play an important role in a client’s hearing rehabilitation. This paper uses two types of interaction analysis (Roter Interaction Analysis System (RIAS) and Conversation Analysis (CA)) to examine family member participation in a corpus of 17 video-recorded initial audiology appointments. RIAS results demonstrated that family members’ primary active communication role in consultations involved information provision. The CA findings supported this, and additionally identified that when family members provided additional information,it was often in disaffiliation with clients’ descriptions. In particular, disaffiliation arose concerning the extent of the client’s hearing difficulties and the client’s hearing rehabilitation needs. These ‘disagreements’ between clients and family members are analysed in detail, including how they were typically responded to by the audiologist. The implications of these disagreements are discussed in relation to family-centred care and effective rehabilitation in audiology.
Beach, W. A. (1995) Preserving and Constraining Options: ‘Okays’ and ‘Official’ Priorities in Medical Interviews. In G. H. Morris and R. J. Cheneil (Eds), The Talk of the Clinic: Explorations in the Analysis of Medical and Therapeutic Discourse, 259–289. Hillsdale, NJ: Lawrence Erlbaum Associates Inc.
Beisecker, A. E., Brecheisen, M. A., Ashworth, J. and Hayes, J. (1997) Perceptions of the role of cancer patients’ companions during medical appointments. Journal of Psychosocial Oncology 14 (4): 29–45.http://dx.doi.org/10.1300/J077v14n04_03
Beisecker, A. E. and Moore, W. P. (1994) Oncologists’ perceptions of the effects of cancer patients’ companions on physician-patient interactions. Journal of Psychosocial Oncology 12 (1–2): 23–39. http://dx.doi.org/10.1300/J077V12N01_02
Brooks, D. N., Hallam, R. S. and Mellor, P. A. (2001) The effects on significant others of providing a hearing aid to the hearing-impaired partner. British Journal of Audiology 35 (3): 165–171.
Clark, M. S. and Smith, D. S. (1998) Factors contributing to patient satisfaction with rehabilitation following stroke. International Journal of Rehabilitation Research 21 (2): 143–154. http://dx.doi.org/10.1097/00004356-199806000-00003
Clark, P. C., Dunbar, S. B., Shields, C. G., Viswanathan, B., Aycock, D. M. and Wolf, S. L. (2004) Influence of stroke survivor characteristics and family conflict surrounding recovery on caregivers’ mental and physical health. Nursing Research 53 (6): 406–413. http://dx.doi.org/10.1097/00006199-200411000-00009
Clayman, M. L., Roter, D., Wissowc, L. S. and Bandeen-Roched, K. (2005) Autonomy-related behaviors of patient companions and their effect on decision-making activity in geriatric primary care visits. Social Science and Medicine 60 (7): 1583–1591. http://dx.doi.org/10.1016/j.socscimed.2004.08.004
Donaldson, N. A., Worrall, L. and Hickson, L. (2004) Older people with hearing impairment: A literature review of the spouse's perspective Australian and New Zealand Journal of Audiology 26 (1): 30–39. http://dx.doi.org/10.1375/audi.18.104.22.168991
Drew, P., Chatwin, J. and Collins, S. (2001) Conversation analysis: A method for research into interactions between patients and health-care professionals. Health Expectations 4 (1): 58-70. http://dx.doi.org/10.1046/j.1369-6513.2001.00125.x
Drew, P. and Heritage, J. (Eds). (1992) Talk at Work: Interaction in Institutional Settings. Cambridge: Cambridge University Press.
Eggly, S., Penner, L. A., Greene, M., Harper, F. W. K., Ruckdeschel, J. C. and Albrecht, T. L. (2006) Information seeking during ‘bad news’ oncology interactions: Question asking by patients and their companions. Social Science and Medicine 63 (11): 2974–2985. doi: http://dx.doi.org/10.1016/j.socscimed.2006.07.012
Ellingson, L. L. (2002) The role of companions in geriatric patient-interdisciplinary oncology team interactions. Journal of Aging Studies 16 (4): 361-382. doi: http://dx.doi.org/10.1016/S0890-4065(02)00071-3
Family Voices (2008) Guide to Using the Family-centered Care Self-assessment Tool. Albuquerque, NM: Family Voices.
Greene, M. G., Majerovitz, S. D., Adelman, R. D. and Rizzo, C. (1994) The effects of the presence of a third person on the physician-older patient medical interview. Journal of the American Geriatrics Society 42 (4): 413–419.
Grenness, C., Hickson, L., Laplante-Lévesque, A., Meyer, C. and Davidson, B. (in preparation) Communication patterns in audiological history-taking: Audiologists, patients and their companions.
Grenness, C., Hickson, L., Laplante Lévesque, A., Meyer, C. and Davidson, B. (in press) The nature of communication throughout diagnosis and management planning in initial audiologic rehabilitation consultations. Journal of the American Academy of Audiology.
Hallberg, L. R. M. (1999) Hearing impairment, coping, and consequences on family life. Journal of the Academy of Rehabilitative Audiology 32: 45–59.
Hallberg, L. R. M. and Barrenäs, M.-L. (1993) Living with a male with noise-induced hearing loss: Experiences from the perspective of spouses. British Journal of Audiology 27 (4): 255–261. http://dx.doi.org/10.3109/03005369309076702
Heritage, J. and Maynard, D. W. (2006) Communication in Medical Care: Interaction between Primary Care. Cambridge: Cambridge University Press. http://dx.doi.org/10.1017/CBO9780511607172
Heritage, J. and Sefi, S. (1992) Dilemmas of advice: Aspects of the delivery and reception of advice in interactions between health visitors and first time mothers. In P. Drew and J. Heritage (Eds), Talk at Work: Interaction in institutional settings, 359–419. Cambridge: Cambridge University Press.
Hétu, R., Jones, L. and Getty, L. (1993) The impact of acquired hearing impairment on intimate relationships: Implications for rehabilitation. Audiology and Neuro-Otology 32 (8): 363–381. http://dx.doi.org/10.3109/00206099309071867
Hétu, R., Riverin, L., Lalande, N., Getty, L. and St-Cyr, C. (1988) Qualitative analysis of the handicap associated with occupational hearing loss. British Journal of Audiology 22 (4): 251–264. http://dx.doi.org/10.3109/03005368809076462
Holt, E. (2007) 'I’m eyeing your chop up mind’: Reporting and enacting. In E. Holt and R. Clift (Eds), Reporting on Talk: Reported Speech in Interaction, 47–80. Cambridge: Cambridge University Press.
Ishikawa, H., Roter, D. L., Yamazakia, Y. and Takayamac, T. (2005) Physician–elderly patient–companion communication and roles of companions in Japanese geriatric encounters. Social Science and Medicine 60 (10): 2307–2320. doi: http://dx.doi.org/10.1016/j.socscimed.2004.08.071
Jefferson, G. (1993) Caveat Speaker: Preliminary Notes on Recipient Topic-Shift Implicature. Research on Language and Social Interaction 26 (1): 1–30. http://dx.doi.org/10.1207/s15327973rlsi2601_1
Jefferson, G. (2004) Glossary of transcript symbols with an introduction. In G. Lerner (Ed.), Conversation Analysis: Studies from the First Generation, 13–23. Philadelphia, PA: John Benjamins.
Jones, L., Kyle, J. and Wood, P. (1987) Words Apart: Losing your Hearing as an Adult. London: Tavistock Publications.
Kilmer, R. P., Cook, J. R. and Munsell, E. P. (2010) Moving from principles to practice: Recommended policy changes to promote family-centred care. American Journal of Community Psychology 46 (3–4): 332–341. http://dx.doi.org/10.1007/s10464-010-9350-9
Laplante-Lévesque, A., Hickson, L. and Worrall, L. (2010) Rehabilitation of older adults with hearing impairment: A critical review. Journal of Aging and Health 22 (2): 143–153. http://dx.doi.org/10.1177/0898264309352731
Luterman, D. M. (2008) Counseling Persons with Communication Disorders and Their Families. Austin Texas: Pro-ed.
Mahoney, C. F., Stephens, S. D. and Cadge, B. A. (1996) Who prompts patients to consult about hearing loss? British Journal of Audiology 30 (3): 153–158. http://dx.doi.org/10.3109/03005369609079037
Manchaiah, V. K. C., Stephens, D., Zhao, F. and Kramer, S. E. (2012) The role of communication partners in the audiological enablement/rehabilitation of a person with hearing impairment: an overview. Audiological Medicine 10 (1): 21–30. http://dx.doi.org/10.3109/1651386X.2012.655914
Meyer, C., Hickson, L. and Fletcher, A. (2014) Identifying the barriers and facilitators to optimal hearing aid self-efficacy. International Journal of Audiology 53 (S1): s28–s37. http://dx.doi.org/10.3109/14992027.2013.832420
Meyer, C., Hickson, L., Khan, A. and Walker, D. (2014) What is important for hearing aid satisfaction: Application of the expectancy-disconfirmation model. Journal of the American Academy of Audiology 53: s3–s17.
Meyer, C., Hickson, L., Lovelock, K., Lampert, M. and Khan, A. (2014) An investigation of factors that influence help-seeking for hearing impairment in older adults. International Journal of Audiology 53 (S1): S3–S17. http://dx.doi.org/10.3109/14992027.2013.839888
Miller, W. E. (1983) Research and family factors in aural rehabilitation of the elderly. Activities, Adaptation & Aging 3 (4): 17–29.
Muntigl, P. (2013) Resistance in couples counselling: Sequences of talk that disrupt progressivity and promote disaffiliation. Journal of Pragmatics 49 (1): 18–37. doi: http://dx.doi.org/10.1016/j.pragma.2013.01.003
Pilnick, A., Hindmarsh, J. and Gill, V. T. (2009) Beyond doctor and patient: Developments in the study of healthcare interactions. Sociology of Health and Illness 31 (6): 787–802. http://dx.doi.org/10.1111/j.1467-9566.2009.01194.x
Preminger, J. and Lind, C. (2012) Assisting communication partners in the setting of treatment goals: The development of the Goal-sharing for Partners Strategy. Seminars in Hearing 33 (1): 53–64. http://dx.doi.org/10.1055/s-0032-1304728
Preminger, J. and Meeks, S. (2010) The influence of mood on the perception of hearing-loss related quality of life in people with hearing loss and their significant others. International Journal of Audiology 49 (4): 263–271. http://dx.doi.org/10.3109/14992020903311396
Prohaska, T. R. and Glasser, M. (1996) Patients’ views of family involvement in medical care decisions and encounters. Research on Aging 18 (1): 52–69. http://dx.doi.org/10.1177/0164027596181004
Roter, D. and Larson, S. (2001) The relationship between residents’ and attending physicians’ communication during primary care visits: An illustrative use of the Roter Interaction Analysis System. Health Communication 13 (1): 33–48. http://dx.doi.org/10.1207/S15327027HC1301_04
Roter, D. and Larson, S. (2002) The Roter Interaction Analysis System (RIAS): Utility and flexibility for analysis of medical interactions. Patient Education and Counseling 46 (4): 243–251. doi: http://dx.doi.org/10.1016/S0738-3991(02)00012-5
Sacks, H. (1992) Lectures on Conversation. Oxford: Blackwell Publishing.
Scarinci, N., Meyer, C. and Hickson, L. (in preparation) Family-centred care in hearing rehabilitation: The perspective of older adults with hearing impairment and family members.
Scarinci, N., Worrall, L. and Hickson, L. (2008) The effect of hearing impairment in older people on the spouse. International Journal of Audiology 47 (3): 141–151. http://dx.doi.org/10.1080/14992020701689696
Scarinci, N., Worrall, L. and Hickson, L. (2009a) The effect of hearing impairment in older people on the spouse: Development and psychometric testing of the Significant Other Scale for Hearing Disability (SOS-HEAR). International Journal of Audiology 48 (10): 671–683. http://dx.doi.org/10.1080/14992020902998409
Scarinci, N., Worrall, L. and Hickson, L. (2009b) The ICF and third-party disability: Its application to spouses of older people with hearing impairment. Disability and Rehabilitation 31 (25): 2088–2100. http://dx.doi.org/10.3109/09638280902927028
Scarinci, N., Worrall, L. and Hickson, L. (2012) Factors associated with third-party disability in spouses of older people with hearing impairment. Ear and Hearing 33 (6): 698–708. http://dx.doi.org/10.1097/AUD.0b013e31825aab39
Schegloff, E. (2007) Sequence Organization in Interaction. New York: Cambridge University Press. http://dx.doi.org/10.1017/CBO9780511791208
Schilling, L. M., Scatena, L., Steiner, J. F., Albertson, G. A., Lin, C. T., Cyran, L., Ware, L. and Anderson, R. J. (2002) The third person in the room: Frequency, role, and influence of companions during primary care medical encounters. Journal of Family Practice 51 (8): 685–690.
Shields, C., Epstein, R., Fiscella, K., Franks, P., McCann, R., McCormick, K. and Mallinger, J. (2005) Influence of accompanied encounters on patient-centredness with older patients. The Journal of the American Board of Family Practice 18 (5): 344–354. http://dx.doi.org/10.3122/jabfm.18.5.344
Stark, P. and Hickson, L. (2004) Outcomes of hearing aid fitting for older people with hearing impairment and their significant others. International Journal of Audiology 43 (7): 390–398. http://dx.doi.org/10.1080/14992020400050050
Stivers, T. (2005) Parent resistance to physicians’ treatment recommendations: One resource for initiating a negotiation of the treatment decision. Health Communication 18 (1): 41–74. http://dx.doi.org/10.1207/s15327027hc1801_3
Street, R. L. and Gordon, H. S. (2008) Companion participation in cancer consultations. Psycho-Oncology 17 (3): 244–251. http://dx.doi.org/10.1002/pon.1225
van den Brink, R. H. S., Wit, H. P., Kempen, G. I. J. M. and van Heuvelen, M. J. G. (1996) Attitude and help-seeking for hearing impairment. British Journal of Audiology 30 (5): 313–324. http://dx.doi.org/10.3109/03005369609076779
Visser-Meily, A., Post, M., Gorter, J. W., Berlekom, S. B. V., Bos, T. V. D. and Lindeman, E. (2006) Rehabilitation of stroke patients needs a family-centred approach. Disability and Rehabilitation 28 (24): 1557–1561. http://dx.doi.org/10.1080/09638280600648215
Wallhagen, M. I., Strawbridge, W. J., Shema, S. J. and Kaplan, G. A. (2004) Impact of self-assessed hearing loss on a spouse: A longitudinal analysis of couples. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences 59B (3): S190–S196. http://dx.doi.org/10.1093/geronb/59.3.S190
Wolff, J., and Roter, D. (2011) Family presence in routine medical visits: A meta-analytical review. Social Science and Medicine 72: 823-831. http://dx.doi.org/10.1016/j.socscimed.2011.01.015
Worrall, L., Brown, K., Cruice, M., Davidson, B., Hersh, D., Howe, T. and Sherratt, S. (2010) The evidence for a life-coaching approach to aphasia. Aphasiology 24 (4): 497–514. http://dx.doi.org/10.1080/02687030802698152
Zayts, O. and Schnurr, S. (2011) Laughter as medical providers’ resource: Negotiating informed choice in prenatal genetic counseling. Research on Language & Social Interaction 44 (1): 1–20. http://dx.doi.org/10.1080/08351813.2011.544221
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