BAA MAGAZINE SUMMER 2017 DRAFT 4

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FEATURE ‘Being Heard’ - Lived Experience of Adults with Mild Hearing Loss: Qualitative Research into the Diversity of Experience and Impact of Mild Hearing Loss SARA COULSON Senior Lecturer Audiology DeMontfort University KATE CHAPMAN Lecturer Drama Studies DeMontfort University BACKGROUND According to the World Health Organisation (2002), by 2030, hearing loss will be in the top 10 disease burdens in the UK, above cataracts and diabetes. In 2015, the Department of Health published its Action Plan on Hearing Loss which made a number of proposals. One of these was to encourage early awareness, diagnosis and management of hearing loss. With most health problems, you are strongly encouraged to be assessed as soon as you feel any symptoms. This is because it is widely accepted that early interventions tend to result in better outcomes (Claire et al, 2007; Moniz-Cook et al, 2010; National Institute on Aging, 2013; Bowel Cancer UK, 2017). Early interventions in mental health can prevent its escalation (Claire et al, 2007). Early interventions in dementia can delay its progression, and has also shown a beneficial effect for carers (Moniz-Cook et al, 2010). The combined economic costs to the UK for these conditions both directly from care, and indirectly from lost productivity and reduced quality of life, have been estimated at £131 billion per year (Centre for Mental Health, 2014; Alzheimer’s Society, 2014). Studies have shown links between unaddressed hearing loss and social isolation and depression (Tambs, 2004; WHO, 2017). Other studies have shown links with the incidence of hearing loss and cognitive decline (Wayne and Johnsrude, 2015). One could, therefore, conclude that early intervention in hearing loss would have resulting positive impacts on the outcomes or prognosis for people with dementia or mental health problems. The majority of hearing loss is progressive and due to aging or exposure to noise. According to Sheild, (2006) developed countries consistently report that approximately 22% of their population has some form of hearing loss, and for 16% of the population the hearing loss is categorised as mild (average pure tone thresholds of the best ear at 0.5, 1, 2 & 4 kHz between 20 and 40 dB (BSA, 2015)). In a national US survey between 1999 and 2004, Agrawal et al (2008) found that over 8% of adults between the ages of 20 – 29 reported hearing loss, and that the prevalence increased in this time. The World Health Organisation has linked increasing hearing loss in young people with the ubiquitous use of phones as personal audio systems (WHO, 2017). A different study by Honeycutt et al (2003) looked at the economic costs of disability including both medical treatment and lost productivity due to illness or inability to access education and work. For hearing loss, the lifetime cost in US dollars was $330 000 per person, of which 4/5 of that was lost productivity. Given the high projected disease burden of hearing loss, increasing prevalence of hearing loss among younger adults, and the financial implications of supporting people with dementia, mental health problems and difficulties accessing education and work, it seems prudent to provide early assessment and rehabilitation for hearing loss. This means providing reasonable adjustments in work and education, counselling and support, and hearing aids and assistive listening devices for people with mild hearing loss. Hearing aids are free to patients on the NHS and provide huge benefits to people with hearing loss at a small cost to the NHS of less than £100 each (AoHL, 2015). THE ‘BEING HEARD’ PROJECT Research and statistics are important tools providing evidence for best practice. It is also important to understand the implications of best practice on individuals. ‘Being Heard’ began as a collaborative project seeking to explore and reveal the experiences of people with mild hearing loss. This category has become the focus of debate since North Staffordshire Clinical Commissioning Group withdrew the provision of hearing aids to people with mild hearing loss in order to save money (AoHL, 2017). AIM: to capture and disseminate the experiences of people diagnosed as having mild hearing loss in order to define the parameters of this categorisation and to understand the diversity of experience within it. OBJECTIVES: 1. To pilot an interdisciplinary research relationship which uses the methodologies of theatre and performance to disseminate research, engage stakeholders and create impact. 2. To build a wider partnership (beyond HE) to facilitate advocacy and dissemination of research. 3. To undertake 15 interviews with contributors with the aim of gaining a picture of their experiences and the ways in which mild hearing loss impacts on their lives, the strategies they use and the ways in which their hearing is changing. 4. To curate material from the interviews to use in a verbatim theatre performance which will reflect the diversity and detail of the experience of mild hearing loss and its treatment. 5. To present the performance to audiences of health professionals, commissioners of hearing rehabilitation services, and those with hearing loss as a stimulus for debate and discussion. 6. To disseminate research by sharing the performance as a film and to evaluate its impact as an advocacy and awareness raising tool. RESEARCH QUESTION How does mild hearing loss impact on the lived experience of adults in the UK? STUDY DESIGN Recruitment Participants were self-selected volunteers recruited through Action on Hearing Loss, Leicester Aging Together and De Montfort BAA MAGAZINE / SUMMER 2017 / 12
University using posters and email requests. Data Collection Method and Tools Volunteers to the study had their hearing tested using pure tone audiometry to confirm a mild hearing loss before being included in the study. They were then interviewed using a list of structured questions. Topics of relationships and social interactions, employment, education, community engagement, and mental health were explored. As we are looking to understand the individual’s lived experience, the questions were open-ended to allow a wide variety of responses. The interviews were audio recorded and then reviewed for themes and key messages. Analysis The volunteers’ words formed the basis of the script of a verbatim performance in the style of Augusto Boul. Verbatim theatre is a documentary style of performance, in which actors perform only using words that were uttered by ‘real’ people. However, the identities of the hard of hearing contributors were not used in the performance. The collected data was curated for themes, and a script created. Themes identified included: - first signs of hearing loss - family - work - social life - hearing aids - strategies Dissemination Actors have performed the verbatim script and a film, ‘Being Heard’, has been produced. The film was shown to the research contributors on May 19th 2017 for comment, in which it was well received. ‘Being Heard’ is now available to use as tool for advocacy and awarenessraising around mild hearing loss. The outcomes of the research will also be shared in a live performance for health professionals, commissioners, and other stakeholders. For further information, please contact Sara Coulson at sara.coulson@dmu.ac.uk. REFERENCES Action on Hearing Loss (2015). Hearing Matters. [Online] Available at: https:// www.actiononhearingloss.org.uk/~/media/ Documents/Policy%20research%20 and%20influencing/Research/Hearing_ Matters_2015/Hearing%20Matters%20 Report.ashx (Accessed 2.6.17) Action on Hearing Loss (2017). North Staffordshire Hearing Aid proposals. [Online] Available at: https://www. actiononhearingloss.org.uk/get-involved/ campaign/hearing-aid-cuts/northstaffordshire.aspx (Accessed 2.6.17) Agrawal, Y, Platz, E A, Niparko, J K (2008). Prevalence of Hearing Loss and Differences by Demographic Characteristics Among US Adults. Data From the National Health and Nutrition Examination Survey, 1999-2004. Arch Intern Med. 2008;168(14):1522-1530 Alzheimer’s Society (2014). Dementia UK: update. [Online] Available at https:// www.alzheimers.org.uk/download/ downloads/id/2323/dementia_uk_update. pdf (Accessed 2.6.17) Bowel Cancer UK (2017) #STOPBOWELCANCER [Online] Available at https://www.bowelcanceruk. org.uk/campaigning/early-diagnosis/ (Accessed 19.05.17) British Society of Audiology (2015). Recommended Procedure Pure-tone air-conduction and bone conduction threshold audiometry with and without masking. [Online] Available at: http:// www.thebsa.org.uk/wp-content/ uploads/2011/04/Pure-Tone- Audiometry-1.pdf (Accessed 2.6.17) Centre for Mental Health (2014). Economic and social costs of mental health problems. [Online] Available at https://www.centreformentalhealth.org. uk/economic-and-social-costs. (Accessed 2.6.17) Claire M Kelly, CM, Jorm, AF and Wright, A (2007). Improving mental health literacy as a strategy to facilitate early intervention for mental disorders. Med J Aust; 187 (7): 26. NHS England and Department of Health (2015). Action Plan on Hearing Loss. 23 March 2015, Department of Health. Honeycutt, A A, Grosse, S, Dunlap, L J, Schendel, D E, Chen, H, Brann, E, al Homsi, G (2003), ECONOMIC COSTS OF MENTAL RETARDATION, CEREBRAL PALSY, HEARING LOSS, AND VISION IMPAIRMENT, in Barbara M. Altman, Sharon N. Barnartt, Gerry E. Hendershot, Sheryl A. Larson (ed.) Using Survey Data to Study Disability: Results from the National Health Survey on Disability (Research in Social Science and Disability, Volume 3) Emerald Group Publishing Limited, pp.207 – 228 Moniz-Cook, E, Agar, S, Gibson, G, Win, T & Wang, M (2010). A preliminary study of the effects of early intervention with people with dementia and their families in a memory clinic. Aging and Mental Health, p199 – 211. National Institute on Aging (2013). 2012 – 2013 Alzheimer’s Disease Progress Report: Seeking the Earliest Interventions. [Online] Available at: https://www.nia.nih.gov/alzheimers/ publication/2012-2013-alzheimersdisease-progress-report. (Accessed 18.05.2017) Sheild, B (2006). Evaluation of the social and economic costs of hearing impairment: A report for Hear-It. [Online] Available at: http://www.hear-it.org/sites/ default/files/multimedia/documents/ Hear_It_Report_October_2006.pdf (Accessed 2.6.2017) Tambs, K (2004). Moderate Effects of Hearing Loss on Mental Health and Subjective Well-Being: Results From the Nord-Trøndelag Hearing Loss Study. Psychosomatic Medicine: September/ October 2004 - Volume 66 - Issue 5 - pp 776-782 Wayne, R V, Johnsrude, I S (2015). A review of causal mechanisms underlying the link between age-related hearing loss and cognitive decline. Ageing research reviews, 23: 154 – 166. Wingfield, A, Tun, P A, McCoy, S L (2005). Hearing loss in older adulthood. What it is and how it interacts with cognitive performance. Current directions in psychological science: a journal of the American Psychological Society 14(3); 144 – 148. World Health Organisation. (2002) Prevention of deafness and hearing impairment. [Online] Available at: www. who.org World Health Organisation (2017) Prevention of deafness and hearing loss. BAA MAGAZINE / SUMMER 2017 / 13
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Page 3 and 4: Contents: General: 3 Editorial 4 Pr
Page 5 and 6: Power Your Senses Oticon NHS Study
Page 7 and 8: FEATURE To Assess the Effect of Che
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Page 19 and 20: Thursday 16th November Solent Hall
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Page 23 and 24: FEATURE Development of the Spatial
Page 25 and 26: INFORMATION BAA Members - Education
Page 27 and 28: TRAINEES Deafness in Low and Middle
Page 29 and 30: INDUSTRY UPDATES The future is now:
Page 31 and 32: British Academy of Audiology 14th A

BAA MAGAZINE SUMMER 2017 DRAFT 4

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