Hearing aid use and adherence to treatment in a publicly-funded health service from the city of São Paulo, Brazil

Introduction Periodic follow-up appointments are important to ensure long-term effectiveness of rehabilitation with hearing aids. However, not all users are able to maintain adherence to recommendations prescribed during the fitting process and some do not attend those appointments, which compromises the effectiveness of treatment. Objective Compare hearing aid use after 1 year between subjects who did not attend a follow-up evaluation appointment at a publicly-funded health service (nonattenders) and those who attended the appointment (attenders). Reasons for nonuse of hearing aids and unscheduled appointments were also analyzed. Methods Prospective observational cross-sectional study. Nonattenders and attenders in a follow-up evaluation appointment were interviewed by telephone about hearing aid use, reasons for nonuse, and unscheduled appointments. Results The nonattenders group consisted of 108 subjects and the attenders group had 200 subjects; in both groups, most users kept bilateral use but the nonuse rate was higher in nonattenders. The main reason for nonuse of hearing aids among nonattenders was health problems; fitting problems was the main reason for nonuse in the attenders group. Health problems and issues like unavailable companion and transportation difficulties were the reasons for unscheduled follow-up appointments. Conclusion Nonattenders had a greater nonuse rate and were more likely to abandon hearing aid use. Measures to increase hearing aid use and adherence to prescribed recommendations are also necessary to ensure long-termeffectiveness of rehabilitation with hearing aids.

Resultado do uso da protese auditiva adaptada em servico publico de saude / Results of hearing aids use dispensed by a publicly-funded health service

O uso da prótese auditiva e a satisfação podem ser utilizados para determinar a efetividade da reabilitação auditiva, pouco investigada na população brasileira. OBJETIVO: Avaliar o uso da prótese auditiva em adultos atendidos num serviço público de saúde, as intervenções necessárias e a satisfação após um ano de adaptação. MÉTODO: Estudo prospectivo observacional transversal. Usuários de prótese auditiva foram convocados para avaliação formal do uso. RESULTADOS: Duzentos usuários de prótese auditiva compareceram à avaliação formal (perda de 47% da amostra inicial); 76,5% dos usuários avaliados mantiveram o uso bilateral, 10,5% unilateral e 13% nenhuma; 99,5% necessitaram de algum tipo de intervenção. Os usuários que mantiveram o uso foram considerados "satisfeitos". CONCLUSÃO: Os usuários de prótese auditiva atendidos no serviço público de saúde em questão apresentam dificuldade para comparecer às consultas de seguimento. A maioria dos indivíduos avaliados manteve o uso da prótese auditiva; entretanto, praticamente todos necessitaram de algum tipo de intervenção. Apesar do alto grau de satisfação, estes achados não contemplaram os indivíduos que não compareceram à avaliação formal, que poderiam representar os menos aderidos ao tratamento. Os dados evidenciaram a necessidade de seguimento periódico para garantir a efetividade do uso da prótese auditiva em longo prazo. .

Hearing aid use and satisfaction can be used to analyze the effectiveness of hearing rehabilitation, an issue few explored in Brazilian users. OBJECTIVE: Evaluate hearing aid use dispensed in a publicly-funded health service after one year, the interventions needed and users' satisfaction. METHOD: Prospective observational cross-sectional study. Hearing aid users were invited by telephone to participate in an evaluation of hearing aid use. RESULTS: 200 hearing aid users attended the evaluation (47% of sample loss); 76.5% of the subjects were using hearing aids bilaterally, 10.5% unilaterally and 13.0% none of them; 99.5% of users needed some kind of intervention. Users who kept wearing their hearing aids were considered "satisfied". CONCLUSION: Active search by telephone showed that hearing aid users who attend this publicly-funded health service have difficulties to attend follow-up appointments. Most of the users that came for evaluation kept using their hearing aids; non-use rate was 13%. Practically all hearing aid users needed some kind of intervention. Despite the high level of satisfaction, those findings did not include users who did not participate in evaluation, which could represent subjects less adhered to the treatment. Results highlighted the need of periodical follow-ups to ensure the effectiveness of auditory rehabilitation. .

Protocolo de seleção e adaptação de prótese auditiva para indivíduos adultos e idosos / Hearing aid fitting protocols for adults and elderly individuals

Introdução: A prótese auditiva é uma das alternativas utilizadas no processo de reabilitação auditiva que visa auxiliar a comunicação e minimizar as limitações causadas pela deficiência auditiva. Mesmo com o avanço da tecnologia, a seleção e adaptação da prótese auditiva exigem um processo criterioso para maximizar o desempenho, benefício e satisfação do usuário. Objetivo: Descrever o protocolo de seleção e adaptação de prótese auditiva para candidatos adultos e idosos utilizado em um centro de audiologia, cuja elaboração foi embasada em protocolos validados e descritos previamente na literatura científica específica e complementada por informações de evidências clínicas do serviço. Comentários Finais: O protocolo fonoaudiológico de seleção e adaptação da prótese auditiva para adultos e idosos demonstra que um maior número de informações coletadas propicia melhor orientação da expectativa real e maior efetividade no aconselhamento ao uso da prótese auditiva, favorecendo, desta maneira, o desempenho auditivo, a satisfação e o benefício do indivíduo.

Introduction: The hearing aids are one of the options used in auditory rehabilitation with the objective to improve communication and to minimize the limitations caused by hearing loss. Despite the development of technology, the selection and fitting processes demand specific procedures which goal is to maximize performance, benefit and user' satisfaction. Aim: To describe the hearing aid selecting and fitting protocol for adults and the elderly in an audiological center, which development was based on previously described and validated protocols from the specific literature and information based on clinical practice. Conclusions: The Hearing Aid Selecting and Fitting Protocol for adults and elder subjects showed that a greater amount of collected information provides better expectations for the patients' real life and greater effectiveness in counseling about hearing aids use, promoting maximum auditory performance, satisfaction and benefit to users.

Estudo do perfil audiológico de indivíduos atendidos em um serviço de diagnóstico brasileiro / Study of the audiological' profile of individuals attended in a brazilian diagnostic service

Introdução: A perda auditiva pode afetar a saúde e qualidade de vida do indivíduo. O levantamento do perfil audiológico torna-se importante ferramenta epidemiológica para a definição de novas políticas de saúde, medidas efetivas de prevenção, auxílio no diagnóstico médico e o aprimoramento de técnicas para a reabilitação auditiva. Objetivo: Avaliar o perfil audiológico dos indivíduos atendidos em um serviço de diagnóstico audiológico descrevendo a idade, sexo, principais queixas além de caracterizar os limiares audiométricos dos indivíduos segundo grau, tipo e configuração. Método: Estudo retrospectivo, por meio de análise de prontuários de 217 indivíduos, ambos os sexos, atendidos no setor privado de um serviço de diagnóstico audiológico brasileiro entre janeiro e junho de 2009. Para o estudo foram analisadas as queixas seguindo da avaliação da audiometria tonal. Resultados: As principais queixas apresentadas foram: 110 (50,7%) indivíduos relataram zumbido, 48 (22,1%) tontura e 116 (53,4%) disacusia. O perfil audiológico dos indivíduos foi caracterizado por: 36,4% de indivíduos com audição normal, 45,6% com Disacusia bilateral e 18% unilateral. Ao considerar ambos os grupos com disacusia, houve predomínio do tipo neurossensorial e do grau leve. Conclusão: As principais queixas encontradas foram zumbido, tontura e disacusia. A Audiometria demonstrou predomínio de disacusia bilateral, tipo neurossensorial e de grau leve para o estudo formado por indivíduos adultos e idosos atendidos no setor.

Introduction: Hearing loss can affect the health and quality of life of the individual. The finding of the audio logical profile becomes important epidemiological tool for the explanation of new health policies, effective prevention measures, aid in medical diagnosis and improvement of techniques for the auditory rehabilitation. Objective: To evaluate the audio logical profile of the individuals treated in a service of audio logical diagnosis describing the age, gender, chief complaints and to characterize the audiometric thresholds of individuals second degree, type and configuration. Method: A retrospective study, through analysis of medical records of 217 individuals of both genders in the private sector attended in a Brazilian service of diagnostic audiology between January and June 2009. For the study were analyzed the complaints following the evaluation of tonal audiometry. Results: The main complaints were 110 (50.7%) individuals reported tinnitus, 48 (22.1%) dizziness, and 116 (53.4%) dysacusis. The audio logical profile of the individuals was characterized by 36.4% of individuals with normal hearing, 45.6% with dysacusis bilateral and unilateral 18%. When considering both groups with dysacusis there was predominance of the sensory neuro type and of mild grade. Conclusion: The main complaints founded were tinnitus, dizziness, and dysacusis. The Audiometry showed the predominance of bilateral dysacusis of type sensory neuro and of mild grade for the study constituted by adults and seniors individuals attended in the sector.