Factors involved in access and utilization of adult hearing healthcare: A systematic review.
Factors involved in access and utilization of adult hearing healthcare: A systematic review.
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DOI：
10.1002/lary.26234
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发表时间：
2017-05
期刊：
影响因子：
--
通讯作者：
Bush ML
中科院分区：
文献类型：
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作者：
Barnett M;Hixon B;Okwiri N;Irungu C;Ayugi J;Thompson R;Shinn JB;Bush ML
听力损失是一个公共卫生问题，但听力保健差距的存在并影响康复服务的利用。本综述的目的是系统地分析已发表的关于影响成人患者获得和利用听力康复保健的动机、障碍和依从性因素的文献。应用计算机检索PubMed、心理信息、CINAHL、Web of Science等相关文章。符合条件的研究是那些包含原创的、同行评议的英文研究，涉及影响成人听力保健获得和助听器使用以及人工耳蜗植入的因素。搜索范围为1990-2015年。两名调查人员独立审阅了所有文章并提取了数据。从每项研究中提取了与获得护理的机会和对推荐护理的依从性有关的具体变量。对30篇文献进行综述。影响听力康复获得和利用的因素可分为激励因素、障碍和治疗或设备使用的依从性。寻求治疗的关键动机包括听力损失程度、自我效能、家庭支持和对听力损失的自我认识。护理的主要障碍是经济限制、听力设备的耻辱、不便、相互竞争的慢性健康问题以及不切实际的期望。遵从性受自我效能感、教育水平和参与康复过程的影响最大。获得听力保健服务受到多种因素的影响。考虑到当前医疗政策和立法中改善医疗服务可及性的环境，更深入地了解激励因素、障碍和合规因素有助于提供有效和高效的听力医疗服务。
Hearing loss is a public health concern yet hearing healthcare disparities exist and influence utilization of rehabilitation services. The objective of this review was to systematically analyze the published literature on motivators, barriers, and compliance factors affecting adult patient access and utilization of hearing rehabilitation healthcare. Pubmed, PsychINFO, CINAHL, Web of Science were searched for relevant articles. Eligible studies were those containing original, peer-reviewed research in English pertaining to factors affecting adult hearing healthcare access and utilization of hearing aids and cochlear implantation. The search encompassed 1990-2015. Two investigators independently reviewed all articles and extracted data. Specific variables regarding access to care and compliance to recommended care were extracted from each study. Thirty articles were reviewed. The factors affecting access and utilization of hearing rehabilitation could be classified into motivators, barriers, and compliance in treatment or device use. The key motivators to seek care include degree of hearing loss, self-efficacy, family support, and self-recognition of hearing loss. The primary barriers to care were financial limitations, stigma of hearing devices, inconvenience, competing chronic health problems, and unrealistic expectations. Compliance is most affected by self-efficacy, education level, and engagement in the rehabilition process. Accessing hearing healthcare is complicated by multiple factors. Considering the current climate in healthcare policy and legislation towards improved access of care, a deeper understanding of motivators, barriers and compliance factors can aid in delivery of effective and efficient hearing healthcare.