Addressing Hearing Health Care Disparities among Older Adults in a US-Mexico Border Community.
Addressing Hearing Health Care Disparities among Older Adults in a US-Mexico Border Community.
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DOI：
10.3389/fpubh.2016.00169
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发表时间：
2016
影响因子：
5.2
通讯作者：
Harris F
中科院分区：
文献类型：
--
作者：
Ingram M;Marrone N;Sanchez DT;Sander A;Navarro C;de Zapien JG;Colina S;Harris F
听力损失与日常生活活动中的认知衰退和损害有关。获得听力保健对美国人口的健康老龄化具有广泛的影响。这项定性研究调查了在美国-墨西哥边境社区中与听力健康的社会生态领域相关的因素，该社区在获得护理方面存在差异。一个多学科研究团队与联邦合格健康中心(FQHC)的社区卫生工作者(CHW)合作设计了这项研究。CHWS对听力损失患者(n = 20)和焦点小组及其家人/朋友(n = 27)和一般社区成员(n = 47)进行了访谈。研究小组采访了FQHC提供者和工作人员(n = 12)。个人经历了抑郁、悲伤和社会孤立，以及在沟通方面的沮丧甚至愤怒。家庭成员经历了沟通恶化的负面影响，但很少表达应对策略。各数据来源普遍同意，听力损失不是在初级保健中常规解决的问题，辅助听力技术通常负担不起。社区成员描述了与听力损失有关的耻辱，以及需要更多地获得听力保健和更广泛的社区教育。研究结果证实，由于社会经济条件和缺乏获得听力保健的机会，听力损害对生活质量的影响会加剧。听力损失需要在整个社会生态框架内采取全面和创新的公共卫生对策，其中既包括个人交流干预，也包括更多地获得听力卫生资源。社区卫生服务机构可以有效地针对社区特点制定干预策略。
Hearing loss is associated with cognitive decline and impairment in daily living activities. Access to hearing health care has broad implications for healthy aging of the U.S. population. This qualitative study investigated factors related to the socio-ecological domains of hearing health in a U.S.–Mexico border community experiencing disparities in access to care. A multidisciplinary research team partnered with community health workers (CHWs) from a Federally Qualified Health Center (FQHC) in designing the study. CHWs conducted interviews with people with hearing loss (n = 20) and focus groups with their family/friends (n = 27) and with members of the community-at-large (n = 47). The research team conducted interviews with FQHC providers and staff (n = 12). Individuals experienced depression, sadness, and social isolation, as well as frustration and even anger regarding communication. Family members experienced negative impacts of deteriorating communication, but expressed few coping strategies. There was general agreement across data sources that hearing loss was not routinely addressed within primary care and assistive hearing technology was generally unaffordable. Community members described stigma related to hearing loss and a need for greater access to hearing health care and broader community education. Findings confirm the causal sequence of hearing impairment on quality of life aggravated by socioeconomic conditions and lack of access to hearing health care. Hearing loss requires a comprehensive and innovative public health response across the socio-ecological framework that includes both individual communication intervention and greater access to hearing health resources. CHWs can be effective in tailoring intervention strategies to community characteristics.