What are the motivators, barriers, and compliance factors affecting adult patient access and use of hearing rehabilitation healthcare?
Motivators to accessing care included higher degree of hearing loss, difficulty understanding speech, and a high level of confidence in the ability to access care. Barriers included denial of the problem, inconvenience, lack of support from family, and financial means.
Background: Hearing impairment is a common, chronic condition affecting a large portion of the population in the United States.
In spite of the high prevalence of hearing loss, utilization of diagnostic and therapeutic hearing healthcare is limited. Even when patients undergo appropriate hearing screening and referral in primary care clinics, there is evidence indicating poor adherence to recommended treatment.
Untreated hearing loss causes a measurable impact to the social, occupational, and emotional well-being of adults. However, the factors affecting the access and utilization for adults seeking hearing rehabilitation are not well understood.
Study design: PubMed, PsycINFO, CINAHL, and Web of Science were searched for relevant articles. Eligible studies were those containing original, peer-reviewed research in English pertaining to factors affecting adult hearing healthcare access and utilization of hearing aids and cochlear implantation. The search encompassed 1990 to 2015.
Synopsis: The investigators reviewed all articles and extracted data. Specific variables regarding access to care and compliance to recommended care were extracted from each study. Thirty articles were reviewed.
The factors affecting access and utilization of hearing rehabilitation could be classified into motivators, barriers, and compliance in treatment or device use.
The key motivators to seek care include degree of hearing loss, self-efficacy, family support, and self-recognition of hearing loss. The primary barriers to care were financial limitations, stigma of hearing devices, inconvenience, competing chronic health problems, and unrealistic expectations. Compliance is most affected by self-efficacy, education level, and engagement in the rehabilitation process.
There are multiple limitations of this review, as well as of the articles included in the review. In spite of thorough search criteria, it is possible that relevant articles were excluded from this review.
Citation: Barnett M, Hixon B, Okwiri N, et al. Factors involved in access and utilization of adult hearing healthcare: A systematic review. Laryngoscope. 2017;127:1187–1194.