Centre for Hearing and Balance Studies, University of Bristol, 8 Woodland Road, Bristol BS8 1TN, UK.
Age Ageing. 2012 Jan;41(1):40-6. doi: 10.1093/ageing/afr112. Epub 2011 Sep 1.
Hearing loss is common in older age. Research with older people in residential care settings has identified high prevalence of hearing loss and low uptake of hearing aids. Hearing loss in these settings is associated with reduced social engagement. Although hearing aids remain the default treatment for presbyacusic hearing loss, these are not well used. We do not know what other modifiable factors contribute to communication problems for older people with hearing loss living in residential care.
To explore the factors affecting communicating with a hearing loss in residential care.
An ethnographic study in two residential care homes comprised 19 sessions of observation, and in-depth interviews with 18 residents. Observations explored communication behaviour in everyday interactions, including mealtimes, structured groups and informal group activities. Interviews were informed by the observations and identified reasons for these behaviours and communication preferences. Observational data were recorded in field notes and interviews were audio-recorded and transcribed. Analysis was conducted using constant comparison methods.
Hearing loss affected whether residents were able to access social opportunities. Two key themes influenced this (i) contextual issues compounded communication difficulties and (ii) environmental noise restricted the residents' communication choices. Problems were observed at every mealtime and during formal and informal group activities. The use of hearing aids and access to hearing services did not improve social engagement.
Environmental and social factors are key to maximising communication opportunities. Improvements to communication in residential care settings could be based on changes in these with input from residents and staff. Further work is needed to develop effective communication strategies in residential care.
听力损失在老年人中很常见。在养老院环境中对老年人进行的研究表明，听力损失的发病率很高，而助听器的使用率却很低。这些环境中的听力损失与社交参与度降低有关。尽管助听器仍然是老年性听力损失的默认治疗方法，但这些助听器并没有得到很好的使用。我们不知道其他可改变的因素对居住在养老院的听力损失的老年人的沟通问题有何影响。
探讨影响居住在养老院的听力损失患者沟通的因素。
在两家养老院进行了一项人种学研究，包括 19 次观察和对 18 名居民的深入访谈。观察探索了日常生活互动中的沟通行为，包括用餐时间、结构化小组和非正式小组活动。访谈受观察结果的启发，确定了这些行为和沟通偏好的原因。观察数据记录在现场笔记中，访谈进行了录音和转录。分析采用了恒定比较法。
听力损失影响居民是否能够获得社交机会。有两个关键主题影响了这一点：（i）背景问题加剧了沟通困难，（ii）环境噪音限制了居民的沟通选择。问题在每餐时间以及正式和非正式小组活动中都有观察到。助听器的使用和听力服务的获取并没有改善社交参与度。
环境和社会因素是最大限度地提高沟通机会的关键。居住在养老院的环境中的沟通可以通过改变这些因素并得到居民和工作人员的投入来改善。需要进一步努力制定在养老院中有效的沟通策略。
