Elpers Julia, Lester Cathy, Shinn Jennifer B, Bush Matthew L
University of Kentucky College of Medicine, Lexington, KY, USA.
Cabinet for Health and Family Services Commission for Children with Special Health Care Needs, Louisville, KY, USA.
J Community Health. 2016 Apr;41(2):226-33. doi: 10.1007/s10900-015-0086-1.
Infant hearing loss has the potential to cause significant communication impairment. Timely diagnosis and intervention is essential to preventing permanent deficits. Many infants from rural regions are delayed in diagnosis and treatment of hearing loss. The purpose of this study is to characterize the barriers in timely infant hearing healthcare for rural families following newborn newborn hearing screening (NHS) testing. Using stratified purposeful sampling, the study design involved semi-structured phone interviews with parents/guardians of children who failed NHS testing in the Appalachian region of Kentucky between 2012 and 2014 to describe their experiences with early hearing detection and intervention program. Thematic qualitative analysis was performed on interview transcripts to identify common recurring themes in content. 40 parents/guardians participated in the study and consisted primarily of mothers. Demographic data revealed limited educational levels of the participants and 70 % had state-funded insurance coverage. Participants reported barriers in timely infant hearing healthcare that included poor communication of hearing screening results, difficulty in obtaining outpatient testing, inconsistencies in healthcare information from primary care providers, lack of local resources, insurance-related healthcare delays, and conflict with family and work responsibilities. Most participants expressed a great desire to obtain timely hearing healthcare for their children and expressed a willingness to use resources such as telemedicine to obtain that care. There are multiple barriers to timely rural infant hearing healthcare. Minimizing misinformation and improving access to care are priorities to prevent delayed diagnosis and treatment of hearing loss.
婴儿听力损失有可能导致严重的沟通障碍。及时诊断和干预对于预防永久性缺陷至关重要。许多农村地区的婴儿在听力损失的诊断和治疗方面存在延迟。本研究的目的是描述肯塔基州阿巴拉契亚地区2012年至2014年新生儿听力筛查（NHS）测试未通过的儿童的父母/监护人在农村家庭及时进行婴儿听力保健方面所面临的障碍。采用分层目的抽样法，研究设计包括对2012年至2014年期间在肯塔基州阿巴拉契亚地区NHS测试未通过的儿童的父母/监护人进行半结构化电话访谈，以描述他们在早期听力检测和干预项目中的经历。对访谈记录进行主题定性分析，以确定内容中常见的反复出现的主题。40名父母/监护人参与了该研究，主要为母亲。人口统计学数据显示参与者的教育水平有限，70%有国家资助的保险覆盖。参与者报告了在及时进行婴儿听力保健方面存在的障碍，包括听力筛查结果沟通不畅、难以获得门诊检测、初级保健提供者提供的医疗信息不一致、缺乏当地资源、与保险相关的医疗延误以及与家庭和工作职责的冲突。大多数参与者表示非常希望为他们的孩子及时获得听力保健，并表示愿意使用远程医疗等资源来获得这种保健。农村婴儿及时获得听力保健存在多种障碍。尽量减少错误信息并改善获得医疗服务的机会是预防听力损失延迟诊断和治疗的优先事项。
