Dhanshree R. Gunjawate

Follow-up in newborn hearing screening – A systematic review

INTRODUCTION The quality and efficiency of newborn hearing screening programs (NHS) rely heavily on appropriate follow-up. The Joint Committee on Infant Hearing recommends a follow-up rate of more than 95% of infants who fail the initial hearing screening. However, a 70% benchmark is considered to be more feasible. This high loss to follow-up (LTF) rate acts as a threat to the overall success of NHS programs. The objective of the study was to identify and examine the reported rates of LTF, attributed reasons for LTF and strategies undertaken to reduce LTF. METHODS Using a systematic search, articles published between 2005 to December 2015 were identified from PubMed/Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Educational Resources Information Center (ERIC), Scopus, Ovid, ProQuest, and Cochrane Library. To be included in the review, the study should be exploring the loss to follow-up or drop-out rate in newborn hearing screening programs and be published in an indexed peer-reviewed journal in the English language. The main outcome measures were overall rate of LTF, factors leading to LTF and measures adopted to overcome LTF. RESULTS 53 articles were short-listed for data extraction. Out of these, 27 were single-centre studies, 19 were multi-centre, 3 compared multiple databases, and 4 used survey-based methods. Overall LTF rates of 20% in single-centre and 21% in multiple-centre studies were observed. Educational disparity and lack of adequate knowledge among parents were associated with LTF. The most commonly used strategy to overcome LTF suggested by studies was the use of an adequate data management system. CONCLUSION This review is a novel attempt to explore the LTF among NHS studies, reasons for LTF and strategies to reduce LTF. This review can act as a basis for planning and execution of effective NHS programs.

Knowledge and attitude (KA) survey regarding infant hearing loss in Karnataka, India

INTRODUCTION The support provided and the decisions taken by mothers determine the success of Universal Newborn Hearing Screening (UNHS). Attempts at exploring the existing knowledge-attitude among mothers is crucial to create/modify the existing screening programs. The present study attempts to explore the knowledge and attitude toward infant hearing loss (HL) among mothers of newborns in the Indian state of Karnataka. METHOD A cross-sectional survey was conducted among 219 mothers of newborns in Karnataka, India. The questionnaire was framed from existing literature and consisted of 19 questions assessing knowledge and attitude toward infant HL to be rated on a three-point scale (no, not sure, yes). Descriptive statistics and Cronbachs α were used to analyze the data. RESULTS Mothers exhibited good knowledge of risk factors; noise (70.3%) and ear discharge (54.3%). More than 75% agreed that treatment for HL is available and that these children can attend school. The questions of superstitions and cultural beliefs yielded mixed responses. A large number of mothers expressed desire to have their children tested at birth (84.9%) and were concerned about their childrens hearing (87.7%). Yet only 54.3% stated that they would allow their children to wear hearing aids. SUMMARY AND CONCLUSION The present study is an attempt to understand the knowledge and attitude of mothers toward infant HL in Karnataka and facilitate identification of potential areas of less knowledge as a reference for endeavors of enhancement. It further highlights the need for implementing public awareness programs to improve knowledge and attitude of mothers toward infant HL for better implementation of UNHS.

A national survey of knowledge, attitude and practices among pediatricians towards newborn hearing screening in India

INTRODUCTION Pediatricians have a key role in ensuring that infant has undergone hearing screening and required follow-up. Attempts in various countries and centers have been made at exploring their knowledge, attitude and practices towards universal newborn hearing screening. In India, such a program is at its preliminary stage, and hence a need was felt to study this aspect in pediatricians working in India. METHOD A cross-sectional online survey was carried out among 112 pediatricians working in India. The questionnaire was framed after reviewing the existing questionnaires. Descriptive statistics was used to summarize the findings. RESULTS A response rate of 7.99% (112/1402) was obtained of which only 20.5% reported of availability of screening program in their work set-up. The majority of the pediatricians (95%) were aware of the newborn hearing screening while 98.3% were affirmative about the importance of screening of all infants. Very few pediatricians reported of a screening program in their set-up or in their close locality. Overall the pediatricians were confident about their knowledge on this topic yet expressed a need to know more about several intricacies about hearing screening. The pediatricians also provided an input on the most preferred method of receiving more information. SUMMARY AND CONCLUSION The success of the universal newborn hearing screening program lies in the support and cooperation of health care providers such as pediatricians. The present study draws attention to the positive attitude and practices exhibited by them. It also sheds light on the knowledge gaps that are present and need the due attention of the policy makers. Further, it highlights the need for having more continuing medical education program and awareness drives for ensuring a better implementation of UNHS.

Prevalence and Influencing Risk Factors of Voice Problems in Priests in Kerala

OBJECTIVE Voice problems are commonly reported by professionals in occupations involving a large amount of voice loading. The aim of the present study was to investigate the prevalence of voice problems in Mar Thoma priests and identify possible risk factors responsible for voice problems. STUDY DESIGN This is a cross-sectional study. METHOD The study group consisted of 270 Mar Thoma priests with 1-35 years of professional experience. A self-reported questionnaire was used to collect the data. RESULTS Mar Thoma priests were found to have higher career (47.8%) and year prevalence (25.2%) of voice problems with 17.8% of them reporting frequent voice problems during their career. Asthma, allergy and frequent throat clearing behavior were found to have significant association with priests reporting frequent voice problems. Significantly higher number of priests with frequent voice problems missed their work. CONCLUSION The study results provide valuable preliminary information regarding the prevalence voice problems and associated risk factors in Mar Thoma priests. However, further investigations are required for in-depth understanding of the types of voice problems these priests experience and their impact on their quality of life.

Knowledge and attitude of parents/caregivers towards hearing loss and screening in newborns – a systematic review

Abstract Objective: The parents/caregivers of a newborn play a pivotal role in the process of hearing screening and intervention. The decisions taken by them depend on their knowledge and attitude. The purpose of this study was to review the literature systematically on knowledge and attitude of parents/caregivers towards infant hearing loss and newborn hearing screening. Design: A systematic search was conducted using electronic databases for the periods from 1990 to March 2016. Two authors scrutinized the studies and extracted the data based on predetermined criteria. Study sample: Ten studies. Results: Ear discharge was correctly identified as a risk factor for hearing loss along with measles, drugs/medication, family history, congenital causes and noise exposure. The studies revealed mixed results for knowledge about newborn hearing screening. Overall, the parents/caregivers showed positive attitudes towards hearing screening and intervention options. However, due to heterogeneity in the studies, it’s hard to derive a conclusion. Conclusions: The present review sheds light on the common areas of misconception among parents/caregivers about risk factors of infant hearing loss and newborn hearing screening. The review also draws attention to the need to have more studies exploring this knowledge and attitude of parents/caregivers among diverse populations.

Audiology occupational stress experienced by audiologists practicing in India

Abstract Objective: The aim of the present study is to identify the levels of occupational stress across different types of setting, years of experience, and age. Design: A questionnaire-based observational research design using the audiology occupational stress questionnaire (AOSQ) was used. Study sample: The sample comprised of audiologists registered under the Indian Speech and Hearing Association. The questionnaire was sent via personal email to 400 audiologists, of which 100 responded. Results: Descriptive statistics and chi-square analysis were carried out. Participants in both the groups experienced stress to some extent, with more stress reported in private practitioners. Conclusion: This study helps to identify certain factors that contribute towards work-related stress. These in turn have an impact on the overall professional output of a professional.

Adaptation and Validation of the Kannada Version of the Singing Voice Handicap Index

OBJECTIVE The present study aimed to adapt and validate the Singing Voice Handicap Index (SVHI) into Kannada language using standard procedures. STUDY DESIGN This is a cross-sectional study. METHODS The original English version of SVHI was translated into Kannada. It was administered on 106 Indian classical singers, of whom 22 complained of voice problems. Its internal consistency was determined using Cronbachs alpha coefficient (α), test-retest reliability using Pearsons product moment correlation and paired t test, and the difference in mean scores by independent sample t test. RESULTS The results revealed that the Kannada SVHI exhibited an excellent internal consistency (α = 0.96) with a high item-to-total correlation. Further, excellent test-retest reliability (r = 0.99) and significant differences in SVHI scores were also obtained by singers with and without a voice problem (t = 12.93, df = 104, P = 0.005). CONCLUSION The Kannada SVHI is a valid and reliable tool for self-reported assessment of singers with voice problems. It will provide a valuable insight into the singing-related voice problems as perceived by the singers themselves.

Exploring Attitudes of Indian Classical Singers Toward Seeking Vocal Health Care.

OBJECTIVE The attitude of Indian classical singers toward seeking vocal health care is a dimension yet to be explored. The current study was aimed to determine the attitudes of these singers toward seeking vocal health care and further understand the influence of age and gender. STUDY DESIGN Cross-sectional. METHOD A 10-item self-report questionnaire adapted from a study on contemporary commercial music singers was used. An additional question was added to ask if the singer was aware about the profession and role of speech-language pathologists (SLPs). The questionnaire was administered on 55 randomly selected self-identified trained Indian classical singers who rated the items using a five-point Likert scale. Demographic variables were summarized using descriptive statistics and t test was used to compare the mean scores between genders and age groups. RESULTS Of the singers, 78.2% were likely to see a doctor for heath-related problems, whereas 81.8% were unlikely to seek medical care for voice-related problems; the difference was statistically significant (P < 0.001). Responses for the questions assessing the attitudes toward findings from medical examination by a specialist revealed a statistically significant difference (P = 0.02) between the genders. Age did not have a significant influence on the responses. Only 23.6% of the respondents were aware about the profession and the role of SLPs. CONCLUSION The findings are in tune with western literature reporting hesitation of singers toward seeking vocal health care and draws attention of SLPs to promote their role in vocal health awareness and management.

Knowledge and Perceptions of Teleaudiology Among Audiologists: A Systematic Review

Background and Objectives The knowledge and perception of teleaudiology among audiologists will determine the acceptance and success of teleaudiology practice. This systematic review was conducted to review the published literature on knowledge and perceptions of teleaudiology application among audiologists. Materials and Methods Five studies exploring knowledge and perceptions of teleaudiology application among audiologists published in the English language up to May 2017 were included. Results Positive attitudes was observed across the studies regarding acceptance towards application of teleaudiology. The most common sources of knowledge were on the job, graduate studies, and continuing education programs. The major barriers to the uptake of application of teleaudiology were in terms of limitations in infrastructure, reimbursement, and licensure. Conclusions The study sheds light on the existing knowledge and perceptions of teleaudiology applications among audiologists. This will help in improving the existing teleaudiology services as well as overcome the challenges faced.

Adaptation and Validation of the Kannada Singing Voice Handicap Index-10

OBJECTIVE The aim of the present study was to adapt and validate the English version of the Singing Voice Handicap Index-10 (SVHI-10) into Kannada language. STUDY DESIGN Cross-sectional Comparitive study design. METHODS The English version of SVHI-10 was translated into Kannada using standard procedure. A total of 115 singers participated in the study, including 90 singers with no voice problems (control group) and 25 singers with voice problems. The internal consistency, test-retest reliability, clinical validity, and cutoff points were calculated. RESULTS Kannada SVHI-10 has excellent internal consistency and test-retest reliability. The singers with voice problems scored significantly higher than the singers with no voice problems (t = -14.67, df = 113, P < 0.001). The optimal cutoff point of the SVHI-10 was 9.5 with a sensitivity of 96% and specificity of 84%. CONCLUSION The Kannada SVHI-10 is a reliable and clinically valid tool to assess the self-reported singing voice handicap among singers. It can also be used as a quick screening tool for distinguishing singers with and without voice problems as per clients perception.