Convery Elizabeth, Hickson Louise, Keidser Gitte, Meyer Carly
HEARing Cooperative Research Centre, Melbourne, Australia.
National Acoustic Laboratories, Sydney, Australia.
Semin Hear. 2019 Feb;40(1):7-25. doi: 10.1055/s-0038-1676780. Epub 2019 Feb 5.
Hearing health care is biomedically focused, device-centered, and clinician-led. There is emerging evidence that these characteristics-all of which are hallmarks of a health care system designed to address acute, rather than chronic, conditions-may contribute to low rates of help-seeking and hearing rehabilitation uptake among adults with hearing loss. In this review, we introduce audiologists to the Chronic Care Model, an organizational framework that describes best-practice clinical care for chronic conditions, and suggest that it may be a viable model for hearing health care to adopt. We further introduce the concept of chronic condition self-management, a key component of chronic care that refers to the knowledge and skills patients use to manage the effects of a chronic condition on all aspects of daily life. Drawing on the chronic condition evidence base, we demonstrate a link between the provision of effective self-management support and improved clinical outcomes and discuss validated methods with which clinicians can support the acquisition and application of self-management skills in their patients. We examine the extent to which elements of chronic condition self-management have been integrated into clinical practice in audiology and suggest directions for further research in this area.
听力保健以生物医学为重点，以设备为中心，并由临床医生主导。越来越多的证据表明，这些特征——所有这些都是旨在解决急性而非慢性疾病的医疗保健系统的标志——可能导致听力损失成年人寻求帮助和接受听力康复的比例较低。在本综述中，我们向听力学家介绍慢性病护理模式，这是一个描述慢性病最佳实践临床护理的组织框架，并建议它可能是听力保健采用的可行模式。我们进一步介绍慢性病自我管理的概念，这是慢性病护理的一个关键组成部分，指的是患者用来管理慢性病对日常生活各个方面影响的知识和技能。借鉴慢性病证据基础，我们展示了提供有效的自我管理支持与改善临床结果之间的联系，并讨论了临床医生可以用来支持患者获得和应用自我管理技能的经过验证的方法。我们研究了慢性病自我管理要素在听力学临床实践中的整合程度，并提出了该领域进一步研究的方向。
