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在南非的医疗保健背景下,听力学家在早期听力检测和干预中采用了哪些当前的做法?

What are the current practices employed by audiologists in early hearing detection and intervention in the South African healthcare context?

机构信息

Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

Int J Pediatr Otorhinolaryngol. 2021 Feb;141:110587. doi: 10.1016/j.ijporl.2020.110587. Epub 2020 Dec 24.

Abstract

BACKGROUND

Universal access to early hearing detection and intervention (EHDI) forms part of the audiology community's goal. Evidence on current practices employed by South African audiologists in EHDI in order to ensure this universal access and success for children with hearing impairment is therefore required, hence this study.

METHODS

A quantitative survey research methodology with a cross-sectional design was employed. An online survey was completed by 49 qualified audiologists and dually qualified speech therapists and audiologists. Data were analysed using descriptive statistics.

RESULTS

Results identified gaps in the implementation of EHDI within the South African context. A total of 83.7% of the participants were involved in newborn hearing screening (NHS), with over half adopting the targeted screening approach instead of universal NHS services (UNHS). Capacity versus Demand challenges play a significant role in the lack of successful implementation of NHS with over 60% of the audiologists in the sample reporting that NHS is and should only be conducted by audiologists only; with minimal evidence of task shifting found. No standardised screening protocol was found, with challenges around budget allocation for EHDI revealed.

CONCLUSIONS

Although progress has been noted, a) gaps between public and private healthcare sector resources allocations and availability, b) limited contextually responsive strategic planning, as well as c) lack of translation of knowledge, policies and guidelines into practice, are glaring areas that require attention by the South African audiology community.

摘要

背景

普遍获得早期听力检测和干预(EHDI)是听力学界的目标之一。因此,需要了解南非听力学家长期听力障碍儿童的 EHDI 实践情况,以确保实现这一目标。

方法

本研究采用定量调查研究方法,采用横断面设计。49 名合格的听力学家和双重合格的言语治疗师和听力学家完成了在线调查。使用描述性统计数据对数据进行分析。

结果

结果确定了南非 EHDI 实施中的差距。总共 83.7%的参与者参与了新生儿听力筛查(NHS),超过一半的人采用了有针对性的筛查方法,而不是普遍的 NHS 服务(UNHS)。能力与需求的挑战在 NHS 成功实施方面发挥了重要作用,超过 60%的样本中的听力学家报告说 NHS 应由听力学家进行,并且只能由听力学家进行;发现任务转移的证据很少。没有发现标准化的筛查方案,EHDI 的预算分配也存在挑战。

结论

尽管已经取得了进展,但仍存在以下问题:a)公共和私营医疗保健部门资源分配和可获得性之间的差距;b)有限的针对具体情况的战略规划;c)知识、政策和指南转化为实践的缺乏。这些都是南非听力学界需要关注的明显领域。

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