New Study Analyzes Stages-of-Change in History-Taking
Fri May 20, 2016 01:21 PMBy Amanda Farah Cox
A recent study through the University of Queensland in Brisbane, Australia, looks at how the transtheoretical model of behavior change can help audiologists identify a person with hearing loss’s stage-of-change during the history-taking phase of their first appointment. The article, “Application of the transtheoretical model of behavior change for identifying older clients’ readiness for hearing rehabilitation during history-taking in audiology appointments,” was published in the International Journal of Audiology by Katie Ekberg, Caitlin Grenness and Ida Advisory Board Chairwoman Louise Hickson. The researchers videoed 62 initial hearing assessment appointments with clients aged 55 years and older and analyzed the clients’ language to determine how their readiness for change can be identified during the history-taking portion of the appointment. The researchers then compared the perceived readiness with the decisions the clients made later in the appointment regarding hearing aids and rehabilitation. Clients were identified as being in the pre-contemplation, contemplation, or preparation stages by their answers to questions during the history-taking phase based on how they described their hearing loss. For example, a referenced client who blames mumbling – even when describing actors on television – for the reason why she can’t hear, would be in the pre-contemplation stage. Conversely, a different client who cites “being deaf” as her reason for visiting the audiologist has a self-perceived hearing loss and is more likely to fall into the contemplation or preparation phase. Identifying the person with hearing loss’s stage-of-change became particularly useful late in the appointments. The study showed that who were in pre-contemplation were unlikely to seek further help, with 80% refusing hearing aids recommendations, compared with 71% in preparation who accepted them. As such, the researchers suggest that recommending hearing aids may not be an effective strategy with clients who are in pre-contemplation and that awareness-raising about age-related hearing loss or communication strategies might be more useful. The study emphasizes that though a person with hearing loss attends an audiology appointment, he or she is not necessarily ready to take action on their hearing, but that an audiologist can quickly gain an understanding of their readiness in the history-taking phase. Subsequently, the researchers stress the need for audiologists to be thorough when taking a client’s history in order to ensure that the PHL’s needs and wants are clear and recommend the use of open-ended questions. They also recommend the participation of communication partners in the appointment, and suggest using Ida’s Motivation Tools to get a fuller picture of the client’s readiness for change. You can read the article in full here.