Pre COVID, a study was conducted to determine how eHealth can help address the hearing and communication needs of adults with hearing impairment and their families. At that time, our rationale was that eHealth, defined by the World Health Organization 1 as “the cost-effective and secure use of information and communication technologies (ICT) in support of health and health-related fields,” provides a unique opportunity for clinicians to implement patient and family-centered care (PFCC). Our previous work had suggested it was challenging in clinical settings to be able to address the broad-ranging implications of hearing impairment for the daily lives of patients and their families. 2–6 eHealth could mean new opportunities, such as videoconferencing into patients’ homes, using patient web portals to share information before or between appointments, and online social networking for peer support. 7–10 Our aim was to find out how stakeholders (adults with hearing impairment, families, clinicians) thought eHealth could help meet the needs of people with hearing impairment and their significant others.
How did we find out the views of stakeholders?
We involved 123 people (39 adults with hearing impairment, 28 significant others, and 56 hearing care professionals) across the different phases of this study. First, participants were asked to respond to the statement, “One way I would like to use ICTs to address the hearing and communication needs of adults with hearing loss and their family and friends is to….” Data collection was predominantly online, and we used a video to explain what ICTs were and what PFCC was to provide context.
All ideas were collated, then we asked participants to 1) group similar ideas together (e.g., educate speakers to speak slowly and educate people who have no hearing loss that patience may be required to get responses); and 2) rate how helpful all the ideas would be for them on a five-point scale from 1 (not at all helpful) to 5 (extremely helpful).
We used a process called Group Concept Mapping to collect and analyze the data, supported by Concept System® Global MAX™ software (Version 2016.046.12; http://www.conceptsystemsglobal.com).
What ideas did participants have about how eHealth could help them?
A total of 123 different ideas were generated in response to the prompt statement. These ideas were organized in three main areas (Figure 1):
- Educate and involve others
- Support aural rehabilitation
- Educate about and demonstrate the impacts of hearing impairment and the benefits of hearing rehabilitation
Did all stakeholders have the same views about what would be most helpful?
No! There were different perspectives. For example, adults with hearing impairment perceived the use of eHealth to “educate about and demonstrate the impacts of hearing impairment and benefits of hearing rehabilitation” as significantly less helpful, compared to significant others. In a similar way, clinicians perceived the use of eHealth to “support hearing loss self-management using multi-media platforms” as significantly more helpful, compared to adults with hearing impairment.
However, all stakeholder groups agreed that “educate and involve significant others” and “educate about and demonstrate the impacts of hearing impairment and benefits of hearing rehabilitation” would be among the most helpful.
All stakeholder groups also agreed that using eHealth to “actively engage family members in hearing rehabilitation” and “empower adults with hearing impairment to manage their hearing impairment from home” would be the least helpful.
What was most interesting about the results?
We found the contrast between using eHealth to educate and involve significant others and actively engage family members in hearing rehabilitation to be most interesting. Both these clusters emphasized the potential use of eHealth to involve significant others in the hearing rehabilitation journey. The former, however, which focused on how eHealth could support the person with hearing impairment and their significant others by generating a shared understanding of the impacts of hearing impairment and providing communication education, was perceived as much more helpful than the latter. The reasons for this are unclear, but given that active involvement frequently referenced the use of video conferencing, it might reflect a low use of video conferencing software (particularly among adults with hearing impairment) or simply a preference for in-person family involvement. Further research is needed to explore this.
What does this mean for hearing health care?
The general consensus was that eHealth could be used to supplement existing face-to-face services, not replace them. Interestingly the eHealth ideas generated went well beyond merely supporting device use; they included many suggestions for how to educate significant others and the broader community about the impact of hearing impairment and how to use communication strategies to help people with hearing impairment.
In this research we identified opportunities to broaden the range of services currently offered, to better meet the hearing and communication needs of people with hearing impairment and their families and friends, without putting further pressure on clinical time. As we emerge from the COVID-19 pandemic, there is enormous potential to rethink how we provide services to people with hearing impairment and how eHealth could be better utilized to promote patient and family-centered hearing care.