Hearing Impairments and Prevention

Study Notes

Hearing impairment is a disability affecting quality of life, measured in Disability-Adjusted Life Years (DALYs). DALYs include Years Lived with Disability (YLD) and Years of Life Lost (YLL).
Globally, disabling hearing loss affects 430 million people (1 in 20) in 2019, projected to rise to 700 million (1 in 14) by 2050.
In the Netherlands, 1.3 million people experience hearing loss.
Hearing loss is assessed through an audiometry test, measuring the softest audible frequencies.
Symptoms of high-frequency hearing loss include difficulty understanding women's/children's voices, and words starting/ending with "s," "h," "f," or "th."

Primary prevention addresses causes before the onset of hearing loss. Prenatal causes include genetics and intra-uterine infections, perinatal difficulties (lack of oxygen, prematurity, low birth weight), and childhood/adolescent factors like chronic ear infections. Factors that increase risk in adulthood include smoking, drugs, noise exposure, and non-communicable diseases (NCDs) like diabetes and hypertension.
Secondary prevention involves early screening, starting in childhood to identify and address hearing loss when caught early.
Tertiary prevention aims to manage the consequences of hearing loss. This includes treatment options like hearing aids or cochlear implants, communications assistance strategies (speech reading, sign language), and occupational/vocational rehabilitation, thus mitigating reduced quality of life and improved physical health.

An intake tool, based on the International Classification of Functioning, Disability and Health (ICF), assesses patient needs and identifies 5 categories: no problem, possible problem, or problem (green, orange, red). This assessment informs the intervention design.
The Behavior Change Wheel (BCW) guides intervention design. This framework integrates factors like capability, opportunity, and motivation to develop targeted interventions.
The BCW involves 8 steps, moving from understanding behaviour to identifying interventions, modes of delivery and translated BCTs into intervention content. Factors including affordability, practicability, effectiveness, acceptability of side effects are crucial consideration factors.