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ReseaRch // Family-Centered Hearing Care
be responsive to individual needs and will
always provide treatment that respects the
wishes of the patient.
Benefits for the Patient from Family-
Family-centered care has become
internationally recognized as a dimension
of high-quality health provision. While
most research has been conducted out-
side of audiology, the broad consensus is
that family-centered care results in supe-
rior health outcomes, particularly along
dimensions such as patient well-being
(less symptomology), adherence to treat-
ment recommendations, and satisfaction
with medical services19
(see Rathert et al20
for a review).
Similarly, research conducted in audi-
ology has demonstrated that outcomes
are improved when family is engaged.
For example, the family of patients with
hearing loss can encourage help-seeking
and advocate for the adoption of hear-
on the proper use and care of devices,
increase a person’s confidence that they
can manage their hearing loss,
hearing handicap when accompany-
ing patients to audiologic rehabilitation
and reinforce the importance
of adhering to treatment recommenda-
Correlational evidence also
suggests that the involvement of fam-
ily best differentiates successful users of
hearing aids from unsuccessful users of
and is the best predic-
tor of hearing aid satisfaction.
recent study, audiologists also identified
a number of benefits to involving family
members in audiological care, including:
increased family member input and sup-
port into rehabilitation decision-making,
improved provision of information to
both patients and family members, and
importantly, the provision of emotional
support for the patient.
Benefits for the Family from Family-
The literature suggests that there are
both direct and indirect benefits for family
and communication partners attending and
participating in audiology appointments.
Direct benefits include greater awareness
of the effect of hearing impairment for
10 Recommendations to Implement
1) Invite a family member along to audiologic appointments. When making appointments
say: “Our experience is that it is very helpful if you can bring a friend or a loved one along to the
appointment. Who would that be?” If patient asks for more information, you could say “There is a
lot to discuss and it helps to include family and friends in the process.” This information should be
reinforced in any written information provided to patients regarding appointments.
2) set up the physical environment so that family are comfortably included in the
consultation rather than being relegated to a seat at the back of the room. An inclusive physical
environment fosters a sense that everyone can equally provide their thoughts and perspectives.
3) start the appointment by letting the patient and the family member know that
input will be sought from both of them—patient first and then the family member. The
clinician could say “We are going to do a lot today. For the next 10 minutes, I want to find out about
your hearing and communication (directed to the patient) and then I want to find out about this from
your perspective [directed to the significant other].” The goal is to listen so as to attain an integrated
understanding of the patient’s and family’s physical, social, and emotional needs.
4) set joint hearing and communication goals with patient and family. Discuss what
they would both like to achieve (eg, TV at a lower volume, easier conversation) and prioritize together.
The Client Oriented Scale of Improvement (COSI)48 could be used or the Goal-Sharing Partnership
5) Present options for rehabilitation that address the needs and goals of both the
patient and the family. For example, whereas a hearing aid alone can address the problem of
communicating with one’s spouse at the dinner table, a hearing aid and a remote mic can be used
when trying to communicate across greater distances.
6) When developing the treatment plan, aim for shared decision-making, with patient,
family, and clinician as equal partners in the process. Use decision aids to guide discussions about options
for hearing rehabilitation (see Laplante-Lévesque, Hickson, and Worrall50). Decision aids provide a simple
summary of all options and the advantages and disadvantages of each. Confirm there is a mutual under-
standing of all communication goals.
7) Remember that the patient and the family are the experts. They live with the hearing
loss every day. For example, the patient and family could be asked “What do you want to do about
your hearing loss?”
8) actively encourage involvement of the family at all stages of the care process (eg,
history taking, rehabilitation planning, hearing aid fitting, follow up, and annual reviews).
9) Measure outcomes of interventions for both the patient and the family. You could
revisit the goals identified at the start by both patient and family and find out how much the treatment
has affected those goals. There are many outcome measures for patients and a smaller number for
family that could also be helpful: the Significant Other Scale–Hearing (SOS-HEAR)51 and the Hearing
Impairment Impact–Significant Other Profile (HII-SOP).52
10) Make the entire clinic family-centered with buy-in from all stakeholders (execu-
tives, managers, clinicians, and front office staff). Put family-centered care on the agenda of regular
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