Lillemor R.-M. Hallberg

Living with a male with noise-induced hearing loss: Experiences from the perspective of spouses

The aim of this inductive study was to describe, from the perspective of the spouses, their experiences of living close to a male with severe noise-induced hearing loss. An additional aim was to generate the first step of a theory of how these spouses managed their daily life. The study sample consisted of 10 strategically selected females who differed in age, educational status, number of children and years of marital relationship. Verbatim transcribed thematized interviews were analysed according to a method influenced by the constant comparative method for grounded theory. Two main variables, or core concepts, were identified: the husbands reluctance to acknowledge hearing difficulties and the impact of hearing loss on the intimate relationship. Combinations of these main variables were related to four qualitatively different strategies used by the spouses: co-acting, minimizing, mediating and distancing strategies. It is suggested that the type of strategy chosen by the spouse influences the outcome of the audiological rehabilitation.

Hearing impairment, coping and perceived hearing handicap in middle-aged subjects with acquired hearing loss

Coping strategies are presumed to be modifying factors between a hearing impairment and the perceived handicap. The focus of this investigation was to explore audiological and psychological factors affecting the perceived handicap in hearing-impaired middle-aged subjects. The Hearing Measurement Scale, supplemented by a subjective estimation of the perceived handicap, was used as the dependent variable in a study of 62 subjects, heterogeneous as to type and severity of hearing loss and to hearing aid use. In a stepwise regression analysis, maladaptive communication strategies as well as active and constructive coping behaviours were found to increase the self-perception of hearing handicap. Other significant variables were severity of hearing loss and years of education. Tinnitus symptoms did not contribute to the explained variance in the perceived handicap, which was an unexpected finding. A conclusion that may be drawn from the present study is that active coping strategies tend to focus attention on disability and thereby increase perceived handicap.

Activity limitation and participation restriction in adults seeking hearing aid fitting and rehabilitation

Purposes: We first aimed to describe demographic and audiological characteristics of adults referred to a university hospital for hearing aid (HA) fitting and rehabilitation. Our second aim was to employ an inventory that assesses life consequences of hearing impairment (HI) in terms of perceived activity limitation and participation restriction for the first time in a Norwegian adult outpatient population. A third aim was to study life consequences by audiological and demographic characteristics. Subjects and methods: During one year consecutive patients (n = 343) were requested to answer the Hearing Disability and Handicap Scale (HDHS) assessing activity limitation and participation restriction in relation to an audiological examination and medical consultation. The mean threshold of hearing (MTH) was ascertained by pure tone thresholds at 0.5 – 1 – 2 – 4 kHz in the better ear. Results: Activity limitation and participation restriction were both higher for HA experienced than HA naïve subjects ( p < 0.01). In a multivariable model, the explained adjusted variance of activity limitation (R2) was 43.4% with MTH, perceived duration, and severity of hearing problems as predictor variables. Correspondingly, the explained adjusted variance of participation restriction was 28.4% for a model with MTH, age, gender and perceived severity of hearing problems as predictors. Conclusions: As a standard supplement to audiometric tests, HDHS may be successfully applied as a clinical tool among similar hearing impaired outpatients in order to assess activity limitation and participation restriction as part of audiological rehabilitation.

To Be Stricken with Acute Myocardial Infarction: A Grounded Theory Study of Symptom Perception and Care-seeking Behaviour.

The process of perceiving symptoms of illness is complex, and many patients delay seeking care when symptoms of acute myocardial infarction occur. However delayed treatment can have great consequences for the prognosis. This article reports on a grounded theory study, the aim of which was to increase our understanding of the individual’s thoughts, feelings and actions at the onset of an acute heart attack. Qualitative analysis of semi-structured interviews revealed four different ways of perceiving the onset of symptoms: understanding, misinterpretation, amazement and disregard. The symptom perception categories were related to two core categories labelled health beliefs and acute reactions. Some persons were aware of risks for coronary heart disease and were ready to seek care immediately. Several others had illusions of invulnerability. Such illusions caused people to delay seeking care at the onset of symptoms of myocardial infarction.

Anxiety and coping in patients with chronic work-related muscular pain and patients with fibromyalgia.

The aims of this study were: (1) to compare two groups of patients with chronic pain conditions (work‐related muscular pain, mainly low back pain, and fibromyalgia) in general coping and pain‐specific coping; (2) to examine the relationship between general and pain‐specific coping and, (3) to examine the influence of state‐trait anxiety on general and pain‐specific coping. The sample included 80 individuals (range = 19–70 years; mean = 47; SD = 9.9), who were patients at two pain management clinics for examination of their physical and psychosocial health conditions and consideration on disability pension. The patients were asked to respond to the Strategies to Handle Stress Questionnaire, the Coping Strategies Questionnaire and the State‐Trait Anxiety Inventory. Patients with fibromyalgia scored significantly higher on T‐anxiety and adopted ‘problem‐solving’ (p<0.01) and ‘catharsis’ (p<0.05) less often and ‘religion’ more often (p<0.01) than patients with work‐related muscular pain in coping with stressful situations in general. No differences were revealed in pain‐related coping between the groups. T‐anxiety was positively correlated to pain‐related “catastrophizing” (p<0.001) and negatively to abilities to control and reduce pain (p<0.05 and p<0.01, respectively). The correlation between general and pain‐specific coping was weak to moderate. In conclusion, patients with fibromyalgia scored significantly higher on trait‐anxiety and seem to interpret stressful situations as more threatening than patients with work‐related muscular pain. Anxiety seems to be of central importance for coping with chronic pain. Anxiety‐prone patients with fibromyalgia might benefit from psychological support in the process of coping with pain.

Coping strategies used by middle-aged males with noise-induced hearing loss, with and without tinnitus

Abstract The aim of this study was to examine the relationship between general coping strategies and specific communication strategies, adopted by males with noise-induced hearing loss (NIHL) in order to deal with stressful events and demanding auditory situations. The sample included 72 males with NIHL; 22 without tinnitus, 26 with mild tinnitus, and 24 with severe tinnitus. The following variables were measured: “active coping” “escape coping” and “passive acceptance” (general coping strategies), and “maladaptive behaviours”, “verbal strategies” and “nonverbal strategies” (specific communication strategies). The results showed that males without tinnitus or with mild tinnitus combined “active coping” and “passive acceptance”, whereas males with severe tinnitus supplemented these strategies with “escape coping”. The relationship between general coping and specific communication strategies was weak, although giving a significant correlation between “escape coping” and “maladaptive behaviours”. The results...

Psychological functioning in women with fibromyalgia : a grounded theory study

The aim of this study was to elucidate psychological functioning and psychological processes in women with fibromyalgia. Twenty-one females with fibromyalgia (aged 26–72 years) were interviewed in-depth. The interviews were analysed in line with grounded theory. A core concept, “unprotected self,” mirroring childhood conditions and adult psychological functioning, was identified. Intense activity or hypomanic helpfulness often was used as self-regulation in adult life. Later an increased exposure to mental load is accompanied by reduction of cognitive functioning and generalised pain. The phase of persistence of fibromyalgia is marked by reduction of cognitive functions, unprotected psychological functioning, and increased mental load as from crisis and somatic symptoms.

Dental auscultation for nursing personnel as a model of oral health care education: development, baseline, and 6-month follow-up assessments

Oral health care has been shown to have low priority in nursing and has been only partly successful. To create more positive effects than those achieved through traditional oral health care education, this project tested an educational model for nursing staff personnel. In addition to traditional oral health care education, some of the nursing staff members passed an additional dental auscultation period and served as oral care aides. The aides were responsible for the oral health care of the residents at their nursing facilities (intervention group). The intervention nursing facilities were compared with facilities where nursing personnel only received a traditional oral health care education program. Assessments were made at baseline and at a 6-month follow-up. At follow-up it was shown that the nursing staff in the intervention group gave higher priority to the oral health care work than the nursing staff in the control group.

Ambivalence in Coping with Dental Fear and Avoidance: A Qualitative Study:

Dental phobia is a widespread problem, which can have significant impact on the individual’s health and daily life. This grounded theory study aims to explore the situation of dental phobic patients: how dental phobia interferes with their normal routines and functioning, social activities and relationships, what factors contribute to the maintenance of dental fear and how they cope with their fear. In the qualitative analysis of thematized in-depth interviews four main categories were developed: threat to self-respect and well-being, avoidance, readiness to act and ambivalence in coping. The results show that several psychological and social factors interact in determining how dental phobic individuals cope with their fear, and demonstrate in what way dental fear affects their daily lives.

Calibrating and adjusting expectations in life: A grounded theory on how elderly persons with somatic health problems maintain control and balance in life and optimize well-being

Aim: This study aims at exploring the main concern for elderly individuals with somatic health problems and what they do to manage this. Method: In total, 14 individuals (mean = 74.2 years; range = 68–86 years) of both gender including hospitalized and outpatient persons participated in the study. Open interviews were conducted and analyzed according to grounded theory, an inductive theory-generating method. Results: The main concern for the elderly individuals with somatic health problems was identified as their striving to maintain control and balance in life. The analysis ended up in a substantive theory explaining how elderly individuals with somatic disease were calibrating and adjusting their expectations in life in order to adapt to their reduced energy level, health problems, and aging. By adjusting the expectations to their actual abilities, the elderly can maintain a sense of that they still have the control over their lives and create stability. The ongoing adjustment process is facilitated by different strategies and result despite lower expectations in subjective well-being. The facilitating strategies are utilizing the network of important others, enjoying cultural heritage, being occupied with interests, having a mission to fulfill, improving the situation by limiting boundaries and, finally, creating meaning in everyday life. Conclusion: The main concern of the elderly with somatic health problems was to maintain control and balance in life. The emerging theory explains how elderly people with somatic health problems calibrate their expectations of life in order to adjust to reduced energy, health problems, and aging. This process is facilitated by different strategies and result despite lower expectation in subjective well-being.