No AccessAmerican Journal of AudiologyResearch Article1 Dec 2015

“This Is a Partnership Between All of Us”: Audiologists' Perceptions of Family Member Involvement in Hearing Rehabilitation


    The purpose of the study was to explore the perceptions of audiologists about the role of family members in hearing rehabilitation for older adults with hearing impairment (HI), the influence of family member involvement on outcomes, and factors affecting family members' involvement.


    A qualitative descriptive research study was undertaken. Using a purposeful sampling strategy, 9 audiologists were recruited. Audiologists participated in individual semistructured interviews. Interview transcripts were analyzed using thematic analysis, and a process of member checking was used to enhance the trustworthiness of findings reported.


    The importance of promoting partnership emerged as the overarching theme. Audiologists valued promoting partnership with family members so that a shared understanding could be established, family members could be active participants with distinct roles in hearing rehabilitation, and the rehabilitation outcomes for the person with HI could be improved. Audiologists generally reported low attendance rates of family members to appointments and identified 5 major factors affecting family participation.


    There is growing recognition among audiologists of the importance of promoting partnership with family members during the hearing rehabilitation process. More research is needed to develop and evaluate a family-centered model of hearing health care that considers the service-level barriers identified by audiologists in the present study.


    • Arango, P. (2011). Family-centered care.Academic Pediatrics, 11, 97–99. doi:10.1016/j.acap.2010.12.004
    • Bamm, E. L., & Rosenbaum, P. (2008). Family-centered theory: Origins, development, barriers, and supports to implementation in rehabilitation medicine.Archives of Physical Medicine and Rehabilitation, 89, 1618–1624.
    • Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology.Qualitative Research in Psychology, 3, 77–101. doi:10.1191/1478088706qp063oa
    • Brown, K., Worrall, L., Davidson, B., & Howe, T. (2011). Living successfully with aphasia: Family members share their views.Topics in Stroke Rehabilitation, 18, 536–548. doi:10.1310/tsr1805-536
    • Chia, E. M., Wang, J. J., Rochtchina, E., Cumming, R. R., Newall, P., & Mitchell, P. (2007). Hearing impairment and health-related quality of life: The Blue Mountains Hearing Study.Ear and Hearing, 28, 187–195.
    • Dalton, D. S., Cruickshanks, K. J., Klein, B. E., Klein, R., Wiley, T. L., & Nondahl, D. M. (2003). The impact of hearing loss on quality of life in older adults.The Gerontologist, 43, 661–668.
    • Dillon, H., James, A., & Ginis, J. (1997). Client Oriented Scale of Improvement (COSI) and its relationship to several other measures of benefit and satisfaction provided by hearing aids.Journal of the American Academy of Audiology, 8, 27–43.
    • Dunst, C. J., Trivette, C. M., & Hamby, D. W. (2007). Meta-analysis of family-centered helpgiving practices research.Mental Retardation and Developmental Disabilities Research Reviews, 13, 370–378. doi:10.1002/mrdd.20176
    • Ekberg, K., Meyer, C., Scarinci, N., Grenness, C., & Hickson, L. (2014). Disagreements between clients and family members regarding clients' hearing and rehabilitation within audiology appointments for older adults.Journal of Interactional Research in Communication Disorders, 5, 217–244.
    • Ekberg, K., Meyer, C., Scarinci, N., Grenness, C., & Hickson, L. (2015). Family member involvement in audiology appointments with older people with hearing impairment.International Journal of Audiology, 54, 70–76. doi:10.3109/14992027.2014.948218
    • Ellingson, L. L. (2002). The roles of companions in geriatric patient–interdisciplinary oncology team interactions.Journal of Aging Studies, 16, 361–382. doi:10.1016/S0890-4065(02)00071-3
    • Epley, P., Summers, J. A., & Turnbull, A. (2010). Characteristics and trends in family-centered conceptualizations.Journal of Family Social Work, 13, 269–285. doi:10.1080/10522150903514017
    • Goldenberg, H., & Goldenberg, I. (2013). Family therapy: An overview (8th ed.). Belmont, CA: Brooks/Cole.
    • Grawburg, M., Howe, T., Worrall, L., & Scarinci, N. (2013). A qualitative investigation into third-party functioning and third-party disability in aphasia: Positive and negative experiences of family members of people with aphasia.Aphasiology, 27, 828–848.
    • Grenness, C., Hickson, L., Laplante-Lévesque, A., Meyer, C., & Davidson, B. (2015a). Communication patterns in audiologic rehabilitation history-taking: Audiologists, patients, and their companions.Ear and Hearing, 36, 191–204. doi:10.1097/AUD.0000000000000100
    • Grenness, C., Hickson, L., Laplante-Lévesque, A., Meyer, C., & Davidson, B. (2015b). The nature of communication throughout diagnosis and management planning in initial audiologic rehabilitation consultations.Journal of the American Academy of Audiology, 26, 36–50.
    • Hickson, L., Meyer, C., Lovelock, K., Lampert, M., & Khan, A. (2014). Factors associated with success with hearing aids in older adults.International Journal of Audiology, 53, S18–S27.
    • Howe, T., Davidson, B., Worrall, L., Hersh, D., Ferguson, A., Sherratt, S., & Gilbert, J. (2012). “You needed to rehab … families as well”: Family members' own goals for aphasia rehabilitation.International Journal of Language and Communication Disorders, 47, 511–521. doi:10.1111/j.1460-6984.2012.00159.x
    • Ishikawa, H., Roter, D. L., Yamazaki, Y., & Takayama, T. (2005). Physician–elderly patient–companion communication and roles of companions in Japanese geriatric encounters.Social Science & Medicine, 60, 2307–2320. doi:10.1016/j.socscimed.2004.08.071
    • Jansen, J., van Weert, J. C., Wijngaards-de Meij, L., van Dulmen, S., Heeren, T. J., & Bensing, J. M. (2010). The role of companions in aiding older cancer patients to recall medical information.Psycho-Oncology, 19, 170–179. doi:10.1002/pon.1537
    • Kalischuk, R. G., Nowatzki, N., Cardwell, K., Klein, K., & Solowoniuk, J. (2006). Problem gambling and its impact on families: A literature review.International Gambling Studies, 6, 31–60.
    • Kramer, S. E., Kapteyn, T. S., Kuik, D. J., & Deeg, D. J. (2002). The association of hearing impairment and chronic diseases with psychosocial health status in older age.Journal of Aging and Health, 14, 122–137. doi:10.1177/089826430201400107
    • Kuhlthau, K. A., Bloom, S., Van Cleave, J., Knapp, A. A., Romm, D., Klatka, K., … Perrin, J. M. (2011). Evidence for family-centered care for children with special health care needs: A systematic review.Academic Pediatrics, 11, 136–143. doi:10.1016/j.acap.2010.12.014
    • Laplante-Lévesque, A., Hickson, L., & Worrall, L. (2010). A qualitative study of shared decision making in rehabilitation audiology.Journal of the Academy of Rehabilitative Audiology, 43, 27–43.
    • Laplante-Lévesque, A., Pichora-Fuller, M. K., & Gagné, J. P. (2006). Providing an Internet-based audiological counselling programme to new hearing aid users: A qualitative study.International Journal of Audiology, 45, 697–706.
    • Manchaiah, V. K. C., Stephens, D., Zhao, F., & Kramer, S. E. (2012). The role of communication partners in the audiological enablement/rehabilitation of a person with hearing impairment: An overview.Audiological Medicine, 10, 21–30. doi:10.3109/1651386X.2012.655914
    • Martire, L. M., Schulz, R., Helgeson, V. S., Small, B. J., & Saghafi, E. M. (2010). Review and meta-analysis of couple-oriented interventions for chronic illness.Annals of Behavioral Medicine, 40, 325–342.
    • Meyer, C., Hickson, L., & Fletcher, A. (2014). Identifying the barriers and facilitators to optimal hearing aid self-efficacy.International Journal of Audiology, 53, S28–S37.
    • Meyer, C., Hickson, L., Lovelock, K., Lampert, M., & Khan, A. (2014). An investigation of factors that influence help-seeking for hearing impairment in older adults.International Journal of Audiology, 53, S3–S17.
    • Nund, R. L., Ward, E. C., Scarinci, N., Cartmill, B., Kuipers, P., & Porceddu, S. V. (2014). Carers' experiences of dysphagia in people treated for head and neck cancer: A qualitative study.Dysphagia, 29, 450–458.
    • O Mahoney, C. F., Stephens, S. D. G., & Cadge, B. A. (1996). Who prompts patients to consult about hearing loss?.British Journal of Audiology, 30, 153–158.
    • Patton, M. Q. (2015). Qualitative research & evaluation methods: Integrating theory and practice (4th ed.). Thousand Oaks, CA: Sage.
    • Preminger, J. E. (2003). Should significant others be encouraged to join adult group audiologic rehabilitation classes?.Journal of the American Academy of Audiology, 14, 545–555. doi:10.3766/jaaa.14.10.3
    • Preminger, J. E., & Lind, C. (2012). Assisting communication partners in the setting of treatment goals: The development of the goal sharing for partners strategy.Seminars in Hearing, 33, 53–64.
    • Preminger, J. E., & Meeks, S. (2012). The hearing impairment impact-significant other profile (HII-SOP): A tool to measure hearing loss-related quality of life in spouses of people with hearing loss.Journal of the American Academy of Audiology, 23, 807–823.
    • Scarinci, N., Meyer, C., Ekberg, K., & Hickson, L. (2013). Using a family-centered care approach in audiologic rehabilitation for adults with hearing impairment.Perspectives on Aural Rehabilitation and Its Instrumentation, 20, 83–90.
    • Scarinci, N., Meyer, C., & Hickson, L. (2015). Family-centered care in audiological rehabilitation: The perspective of older adults with hearing impairment and family members. Manuscript in preparation.
    • Scarinci, N., Worrall, L., & Hickson, L. (2008). The effect of hearing impairment in older people on the spouse.International Journal of Audiology, 47, 141–151.
    • Scarinci, N., Worrall, L., & Hickson, L. (2009). The ICF and third-party disability: Its application to spouses of older people with hearing impairment.Disability and Rehabilitation, 31, 2088–2100.
    • Schilling, L. M., Scatena, L., Steiner, J. F., Albertson, G. A., Lin, C. T., Cyran, L., … Anderson, R. J. (2002). The third person in the room: Frequency, role, and influence of companions during primary care medical encounters.Journal of Family Practice, 51, 685–690.
    • Stark, P., & Hickson, L. (2004). Outcomes of hearing aid fitting for older people with hearing impairment and their significant others.International Journal of Audiology, 43, 390–398.
    • Street, R. L., & Gordon, H. S. (2008). Companion participation in cancer consultations.Psycho-Oncology, 17, 244–251. doi:10.1002/pon.1225
    • Thoren, E., Svensson, M., Tornqvist, A., Andersson, G., Carlbring, P., & Lunner, T. (2011). Rehabilitative online education versus Internet discussion group for hearing aid users: A randomized controlled trial.Journal of the American Academy of Audiology, 22, 274–285. doi:10.3766/jaaa.22.5.4
    • van den Brink, R. H., Wit, H. P., Kempen, G. I., & van Heuvelen, M. J. (1996). Attitude and help-seeking for hearing impairment.British Journal of Audiology, 30, 313–324.
    • Wolff, J., & Roter, D. (2008). Hidden in plain sight: Medical visit companions as a resource for vulnerable older adults.Archives of Internal Medicine, 168, 1409–1415. doi:10.1001/archinte.168.13.1409
    • Wolff, J., & Roter, D. (2012). Older adults' mental health function and patient-centered care: Does the presence of a family companion help or hinder communication?.Journal of General Internal Medicine, 27, 661–668. doi:10.1007/s11606-011-1957-5
    • World Health Organization. (2001). International classification of functioning, disability and health (ICF). Geneva, Switzerland: Author.

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