SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS最新文献

Background:  Caregiver expectations have been shown to impact child outcomes. There is limited research regarding caregivers of non-verbal autistic children in rural South Africa. Autistic individuals form part of a larger environment, which they influence and which impacts them. Caregivers form part of this environment.

Objectives:  This study aims to explore caregivers' expectations of communication, education, social implications and intervention for their non-verbal autistic child in rural KwaZulu-Natal (KZN).

Method:  Bronfenbrenner's ecological and bioecological systems theory framed the study and allowed the child's interaction with their environment to be understood through the use of a qualitative study design via interviews. Eleven caregivers (pilot study: n = 1 and main study: n = 10) of non-verbal autistic children were selected and interviewed. Data were analysed thematically.

Results:  Caregivers had varied expectations. Grandparents were often the primary caregivers (microsystem). Relationships within the mesosystem (caregiver and therapist) and caregiver's understanding affected their feelings and expectations that changed over time (chronosystem). Education was the predominant expectation. The study highlighted limited resources (schools) within the exosystem. Caregivers reported both support and judgement from their communities.

Conclusion:  There is a need for public awareness, caregiver counselling and autism support groups in rural KZN and more specialised education options in order to improve caregivers' expectations.Contribution: This study contributes to the limited literature in the field of autism in South Africa, more specifically the rural context and communication disorders.

Background:  Limited research is available regarding the professional quality of life experiences of South African speech-language therapists and audiologists, despite the implications this has for wellbeing, quality of patient care, productivity and attrition from the professions.

Objectives:  This study explored levels of compassion satisfaction, burnout, and secondary traumatic stress, the relationships between these, differences on the basis of registration and years of experience and participants' perceptions of their professional quality of life.

Method:  A sample of 92 South African speech-language therapists and audiologists completed an online survey that included the Professional Quality of Life (ProQOL) scale. The data were analysed using descriptive statistics, analysis of variation (ANOVA), correlations and thematic analysis.

Results:  The findings indicated that participants experienced slightly higher levels of secondary traumatic stress and burnout and slightly lower levels of compassion satisfaction than international samples. There were significant inter-relationships between the three elements of professional quality of life, and no significant differences for these on the basis of registration or years of experience. Participants identified a range of factors that contributed to their experiences of compassion satisfaction and fatigue, as well as suggestions for improvement.

Conclusion:  Professional quality of life plays an important role in South African speech-language therapists and audiologists' professionalism, job performance and satisfaction and retention.Contribution: The data collected provide valuable insights into the professional quality of life experiences of South African speech-language therapists and audiologists, as well as those working in similar contexts. It also offers suggestions that may contribute to future research and interventions.

Background:  Continuing professional development (CPD), a compulsory requirement of the Health Professions Council of South Africa (HPCSA), is undertaken by healthcare professionals (HCPs), including audiologists, to remain up-to-date with the latest developments, technology and best practices within their discipline. However, the low compliance rates of audiologists engaging in CPD need to be investigated to establish the barriers that audiologists encounter as well as possible interventions to improve their participation.

Objectives:  This study aimed to explore the barriers that audiologists encounter when participating in CPD activities and to highlight their suggestions for improving its uptake.

Method:  The descriptive qualitative research design entailed the use of semi-structured online interviews with 11 audiologists practising within the private sector in the province of KwaZulu-Natal, South Africa, their responses being thematically analysed.

Results:  Three barriers were identified, namely: (1) personal, (2) financial and (3) structural barriers, with eight subthemes and nine recommendations provided by participants.

Conclusion:  It is anticipated that implementing the proposed strategies will address the barriers and allow active engagement of audiologists in their continued education.Contribution: Limited literature has been documented on the barriers that young, private sector audiologists encounter within the South African context while also providing suggestions to address these barriers.

Background:  There is a noticeable gap in access to audiology services in South Africa, and the gap is intensified in rural areas. Often, primary healthcare (PHC) facilities have an unequal ratio of audiologists to patients in need. Telehealth can expand the range of hearing healthcare services.

Objectives:  This study aimed to determine whether, for infants, tele-diagnostic Auditory Brainstem Response (ABR) assessment results conducted within a mobile clinic van are comparable to face-to-face diagnostic ABR results in rural Winterveldt, Pretoria North, South Africa.

Method:  The study utilised a quantitative, prospective cross-sectional comparative within-subject design. Each participant received both face-to-face and mobile tele-diagnostic ABR tests, which were then compared to evaluate the feasibility of mobile tele-diagnostic ABR testing. The Student's t-test was used to determine whether there was a difference between face-to-face and tele-diagnostic tests, and Bland -Altman plots were used to assess the level of agreement between the ABR testing results.

Results:  There was a strong correlation (p  0.001) between face-to-face and mobile tele-diagnostic ABR test results for both neurological and audiological ABR tests. The study found that there was no statistical significance between face-to-face and tele-diagnostic ABR measures; additionally, the results were within clinically acceptable and normative measures.

Conclusion:  Tele-diagnostic ABR offered within a mobile clinic van is feasible as it produces similar and clinically acceptable results when compared to the traditional assessment method.Contribution: This feasibility study is a positive indicator that tele-diagnostic ABR testing through a mobile clinic van may be considered to accelerate the delivery of hearing healthcare services to the infant population in rural communities.

Background:  South Africa shows a high prevalence of type 2 diabetes with reported association with auditory dysfunction.

Objectives:  To describe the audiological profile of adults with this metabolic condition.

Method:  Employing a descriptive research design, 35 individuals with type 2 diabetes, selected through purposive sampling, underwent a basic audiological assessment in addition to extended high-frequency (EHF) audiometry, distortion product otoacoustic emissions (DPOAE) testing and neurological auditory brainstem response (ABR) test.

Results:  This study revealed a 31.4% prevalence of hearing loss with 81.8% being sensorineural in nature. Poor hearing thresholds were observed at 16 kHz (n = 19; 54.3%), 18 kHz (n = 24; 68.6%) and 20 kHz (n = 30; 85.7%) in the right ear and at 16 kHz (n = 20; 57.1%), 18 kHz (n = 24; 68.6%) and 20 kHz (n = 30; 85.7%) in the left ear. Absent DPOAEs were observed at 6 kHz (n = 20; 51.7%) and 8 kHz (n = 24; 68.6%) in the right ear and at 6 kHz (n = 17; 48.6%) and 8 kHz (n = 29; 82.9%) in the left ear, possibly indicating that type 2 diabetes specifically targets higher frequency hearing. The ABR results revealed a delayed absolute latency of wave III bilaterally (right ear -69%; left ear - 51%), suggesting an impact of this metabolic disease on retro-cochlear pathways.

Conclusion:  Hearing loss should be recognised as a comorbidity accompanying type 2 diabetes, which indicates the need for routine comprehensive audiological assessments to facilitate early detection and intervention.Contribution: The present findings have implications for audiology clinical protocols; diabetes related health policies and patient education.

Background:  Young adults are exposed to high noise levels in leisure venues, which increases their risk of hearing loss, and can affect their quality of life.

Objectives:  The aim of this study was to describe the young adults' awareness, attitudes and perceptions towards leisure noise at a university in South Africa.

Method:  A descriptive cross-sectional study design with quantitative methods of data was considered for this study. Students from first to fourth years in the Education Department of a local university in Durban, South Africa, who were aged 18 years old - 25 years old were invited to participate in an online survey.

Results:  Of the 462 participants, most had a general awareness on noise and hearing loss but lacked knowledge on the negative effect of loud noise, with 95.2% using personal listening devices, followed by visiting restaurants and gyms, and 48.3% being unsure if noise can damage hearing permanently. They were unaware of methods to reduce their exposure to noise. A significant relationship between awareness of noise and attitudes (p = 0.029) indicated that the higher the level of awareness regarding leisure noise, the better their attitude and behaviour, thus the lower the risk of hearing loss.

Conclusion:  The results highlight the need for implementing the World Health Organization (WHO) noise regulations and providing education for this age group to prevent irreversible hearing loss through exposure to leisure noise.Contribution: A national study is recommended to increase research evidence.

Background:  Hearing impairment is an invisible disability affecting one in five people globally. Its ability to affect participation in activities of daily living means that it requires prompt identification and intervention.

Objective:  This article aims to define the process of accessing audiologists from the onset of symptoms for adults with hearing impairment in a peri-urban community in South Africa.

Method:  Twenty-three participants were recruited through purposive sampling from an audiology department of a public hospital. Semi-structured interviews were conducted using an interview guide, and data were mapped according to the participants' responses from the onset of ear and hearing symptoms to the point of audiologist consultation for analysis.

Results:  Seventeen (74%) participants had long journeys to accessing the audiologist after seeking help from multiple providers, with those with short journeys (26%) being referred mostly by public healthcare providers. Despite participants being from one peri-urban community, their journeys were influenced by socio-economics, health illiteracy and other structural factors. Finally, Ear-Nose-Throat specialists linked participants with audiology services.

Conclusion:  Accessing audiology services is a complex process in some contexts. The disparities in the social environment, lifestyle factors and pluralistic healthcare models influence access to audiologists. Healthcare providers must take cognisance of the journeys of adults with hearing impairment in their clinical interventions. Universal health coverage, in the form of the planned National Health Insurance (NHI) for all South African citizens, will play an important role in addressing the societal inequalities in accessing healthcare. Factors leading to long journeys should be addressed to facilitate early intervention.Contribution: The study raises implications for the planned NHI in South Africa, suggesting that universal health coverage could play a vital role in addressing societal inequalities in accessing healthcare, including audiology services.

Background:  The South African Noise Induced Hearing Loss (NIHL) Regulations, mandates employers to conduct a noise risk assessment, which records specific variables for determining the status of exposure and the need for implementation of control measures.

Objectives:  The study evaluated company noise risk assessment practices for alignment with legal requirements and specific risk assessment guidelines.

Method:  Convenience sampling was used to select the four manufacturing and utilities companies that participated in the study. The participating companies submitted latest noise risk assessment records for evaluation through the READ approach.

Results:  The noise risk assessment records of three of the four companies omitted the recording of factors such as the reasonable deterioration in or failure of control measures, adequate control and formalisation of hearing conservation programmes (HCPs). When evaluated against the South African National Standard 31000 Risk Assessment guidelines, the risk assessment processes of the respective companies were lacking in addressing aspects related to establishing communication and consultation, evaluation, adapting, continually improving, leadership and commitment, and integration.

Conclusion:  The recorded information on the noise risk assessment reports from the four participating companies were incomplete, negatively affecting subsequent HCP management processes and decision-making. Future studies should investigate other aspects such as the implementation status of recommended noise controls as well as their effectiveness as recorded in the noise risk assessment records.Contribution: This study provided firsthand insights of company noise risk assessment practices, specifically identifying functional and technical areas requiring improvement to enhance current efforts directed towards the minimisation of NIHL within HCPs. The study highlighted that the current practices on recording noise risk assessment information remain incomplete, adversely diminishing the impact of the assessment as an important decision-making tool. The identified technical issues specifically, when addressed, will increase trust on the decisions derived from noise risk assessments.

No abstract available.