Samuel R. Atcherson

Readability of patient-reported outcome questionnaires for use with persons with swallowing disorders.

The purposes of this study were to examine the readability of published patient-related outcome (PRO) questionnaires for persons with swallowing problems, and to compare the readability results to existing data about average reading levels of English-speaking adults living in the United States. A search was conducted to identify published PRO questionnaires related to swallowing problems that traditionally are completed by patients in a self-administered format. Reading grade levels were analyzed separately for four different swallowing-related PRO questionnaires using the Flesch Reading Ease, FOG, and FORCAST formulas as computed by a readability calculations software package. Descriptive statistics were also computed across the questionnaires. The results of this study demonstrate that all four PRO questionnaires exceeded the fifth- to sixth-grade reading levels recommended by health literacy experts regardless of the formula applied. In the demand for standardization of swallowing-related quality-of-life assessment tools, developers should consider readability as another testable construct, since poor readability may affect validity, reliability, and sensitivity. The swallowing clinician should consider the average reading level needed to understand a particular PRO questionnaire when administering it to a patient or his or her proxy. Developers of PRO questionnaires should consider the reading level of respondents and include information about this when reporting psychometric data.

Auditory N1 component to gaps in continuous narrowband noises.

Objectives: To determine whether (1) the auditory N1 component can be elicited to gaps in continuous narrowband noises, (2) psychophysical and electrophysiological gap thresholds (PGTs and EGTs) are similar to one another, and (3) EGTs are the same for all narrowband noise center frequencies. Design: PGTs and EGTs were obtained from 18 normal-hearing young-adult listeners to gaps in continuous narrowband noises with center frequencies of 0.5, 1, or 4 kHz. PGTs were obtained with a modified Békésy-type tracking paradigm, whereas EGTs were obtained to 2-, 5-, 10-, 20-, or 50-msec gaps presented every 2.2 sec. Results: (1) The auditory N1 component was recorded to gaps in narrowband noises, although they appeared morphologically different from cortical potentials obtained using the continuous broadband noise. (2) At center frequencies of 1 and 4 kHz, psychometric functions revealed close similarity between PGTs and EGTs. However, different results were present for the 0.5-kHz narrowband noise, attributed to stimulus artifact. (3) EGTs were approximately 10 msec for most participants at 1 and 4 kHz, but 20 msec at 0.5 kHz, corroborating other studies showing increases in gap threshold with lower center frequencies. Conclusions: The auditory N1 component can be recorded to gaps in continuous narrowband noises whose gap thresholds are grossly similar to those obtained psychophysically. The differences found between PGTs and EGTs with different narrowband noise center frequencies call for further investigation of narrowband noise stimuli for the study of temporal resolution.

Readability of Patient-Reported Outcome Questionnaires for Use With Persons With Dysphonia

OBJECTIVESnThe purpose of this study was to examine the readability of several published patient-reported outcome (PRO) questionnaires for persons with dysphonia, and to compare the readability results with existing data about average reading levels for English-speaking adults living in the United States.nnnDESIGNnA search was conducted to identify published PRO questionnaires related to dysphonia that are traditionally completed by patients in a self-administered format.nnnMETHODnReading grade levels were analyzed separately for 12 different voice-related PRO questionnaires using the Flesch Reading Ease, FOG, and FORCAST formulas as computed by a readability calculations software package. Descriptive statistics were also computed across the questionnaires.nnnRESULTSnThe results of this study demonstrate that most PRO questionnaires exceeded the fifth- to sixth-grade reading levels recommended by health literacy experts regardless of the formula applied.nnnCONCLUSIONSnIn the demand for standardization of voice-related quality of life assessment tools, developers should consider readability as another testable construct because poor readability may affect validity, reliability and sensitivity. The voice clinician should consider the average reading level needed to understand a particular PRO questionnaire when administering it to a patient or their proxy. Developers of PRO questionnaires should consider reading level of respondents and include information about this when reporting psychometric data.

Readability of patient-reported outcome questionnaires for use with persons with tinnitus.

Objectives:The readability of 15 tinnitus-focused, patient-reported outcome (PRO) questionnaires was analyzed. Design:Reading grade levels were analyzed using the Flesch Reading Ease, FOG, and FORCAST formulas as computed by a readability calculations software package. Results:The results of this study demonstrate that the majority of questionnaires exceeded the fifth- to sixth-grade reading levels recommended by health literacy experts regardless of the formula applied. Conclusions:In the demand for standardization of tinnitus assessment tools, developers and clinicians should consider readability as another testable construct, as poor readability may affect both validity and reliability.

Contralateral noise has possible asymmetric frequency-sensitive effect on the 2F1-F2 otoacoustic emission in humans

Contralateral acoustic stimulation has been shown to produce a suppressive effect on the 2F1-F2 distortion-product otoacoustic emission (DPOAE). According to reports by other studies, there is a frequency-specific suppressive region between 1 and 2kHz when the contralateral broadband or narrowband noise stimulation contains energy close to or near the F2 frequencies in that region. In general the broader the bandwidth of the noise stimulation, the greater is the suppressive effect. A frequency-sensitive region between 1 and 2kHz has also been suggested as narrowband noises with center frequencies remote from the F2 frequency seems to produce suppression in the same defined region. In order to test this hypothesis, narrowband noises wide enough to elicit suppression with center frequencies unmatched to the F2 frequencies were employed in the present study. For the right ear, a strong frequency-sensitive suppressive region was noted for the F2 frequency at 2kHz, but not at 1 and 4kHz. The left ear had some suppression at 1kHz, but this effect was not as robust as seen in the right ear. The apparent suppressive differences between ears suggest a possible MOC reflex asymmetry that has not previously been described for DPOAEs. These results suggest that physiological differences between ears and possibly handedness must be taken into account when examining contralateral suppression to narrowband noises. Furthermore, the frequency contributions of the contralateral stimulus may have a greater complex interaction with the cochlear physiology than previously considered.

Quality of life for individuals with hearing impairment who have not consulted for services and their significant others: Same- and different-sex couples

UNLABELLEDnThe purpose of this exploratory study was to assess perceptions of quality of life for individuals with hearing impairment who have not consulted for services and their significant others who are in same-sex relationships vs. those who are in different-sex relationships. Data were collected on a total of 20 older couples: 10 in same-sex relationships and 10 in different-sex relationships. In each of the couples, one member self-identified as having hearing impairment. The couples completed an audiologic evaluation, a disease-specific quality of life questionnaire, and a short, structured interview (which served as a general measure of quality of life). No differences between the groups were found on demographic or audiologic variables. Differences between the groups and within the couples were found on the disease-specific and overall quality of life measures. Participants with hearing impairment in different-sex relationships reported significantly more total consequences of hearing impairment than those in the same-sex relationships. Differences were found in the rate of reporting for various contributors to overall quality of life and consequences of hearing impairment on quality of life. There was more congruity between same-sex couples than different-sex couples. There appear to be important differences in perceptions of both disease-specific and overall quality of life based on sexual orientation for older couples who have not consulted for hearing services. These differences can help inform clinical practice with this under-researched population.nnnLEARNING OUTCOMESnReaders will be able to: (1) Describe quality of life variables for individuals with hearing problems in same- and different-sex relationships, (2) understand the differences in quality of life variables between same- and different-sex couples, (3) consider the clinical implications of these quality of life variables.

Readability of patient-reported outcome questionnaires for use with persons who stutter

OBJECTIVEnThe purpose of this study was to examine the readability of several published patient-reported outcome (PRO) questionnaires for use with persons who stutter, and to compare the readability results to existing data about average reading levels for English-speaking adults living in the United States.nnnDESIGNnPublished PRO questionnaires were identified that are traditionally completed by persons who stutter in a self-administered format.nnnMETHODnReading grade levels were analyzed using the Flesch Reading Ease, FOG, and FORCAST formulas as computed by a readability calculations software package. Descriptive statistics were computed across the questionnaires.nnnRESULTSnThe results of this study demonstrate that many of the PRO questionnaires exceeded the fifth to sixth grade reading levels recommended by health literacy experts.nnnCONCLUSIONSnThe clinician should consider the average reading level needed to understand a particular PRO questionnaire when administering it to a patient or their proxy. Likewise, developers of PRO questionnaires should consider reading level of respondents and include information about this when reporting psychometric data.nnnEDUCATIONAL OBJECTIVESnThe reader will get an overview over the literature on patient-reported outcome (PRO) questionnaires and their use with persons who stutter and will be able to: (1) define readability, (2) describe how reading levels are determined for a given PRO questionnaire, (3) list the strengths and limitations of readability assessment in the evaluation of persons who stutter and (4) analyze the role of readability assessment in future PRO questionnaire development.

Perception of quality of life for adults with hearing impairment in the LGBT community

UNLABELLEDnThe purpose of the this study was to examine the perception of both generic and disease-specific quality of life (QoL) in adults with hearing impairment who are members of the lesbian, gay, bisexual, and transgender (LGBT) community. Eighty-three adults who self-identified as having hearing impairment and as being members of the LGBT community and 80 adults with hearing impairment who do not self-identify as being members of the LGBT community (comparison group) participated in this study. The mean age of the participants in the LGBT group was 64.65 years, and the mean age for the comparison group was 63.26 years. Demographic information about the participants included: self-identification in the LGBT community, age, current and previous gender, relationship status, and hearing aid use. Participants received an audiometric evaluation and completed a disease-specific QoL instrument (Hearing Handicap Inventory for the Elderly/Adults) and a generic QoL instrument (Short-Form 36 Health Survey). The results from this study indicate that factors such as gender, relationship status, and hearing aid use are related to the perception of QoL for individuals with hearing impairment who are members of the LGBT community. Differences were found between the participants in the LGBT group and the comparison group.nnnLEARNING OUTCOMESnAfter reading this article, readers should be able to: (1) describe the disease-specific QoL affects of hearing loss on members of the LGBT community compared with a group of adults with hearing impairment who are not members of the LGBT community, (2) describe the gender diffferences in perception of QoL for members of the LGBT community and participants not in the LGBT community, and (3) discuss clinical implications of the findings.

Conceptual model for quality of life among adults with congenital or early deafness.

BACKGROUNDnA conceptual model of health-related quality of life (QoL) is needed to describe key themes that impact perceived QoL in adults with congenital or early deafness.nnnOBJECTIVEnTo revise University of Washington Center for Disability Policy and Researchs conceptual model of health promotion and QoL, with suggestions for applying the model to improving programs or services that target deaf adults with early deafness.nnnMETHODSnPurposive and theoretical sampling of 35 adults who were born or became deaf early was planned in a 1-year study. In-depth semi-structured interviews probed deaf adult participants perceptions about quality of life as a deaf individual. Data saturation was reached at the 17th interview with 2 additional interviews for validation, resulting in a total sample of 19 deaf adults. Coding and thematic analysis were conducted to develop the conceptual model.nnnRESULTSnOur conceptual model delineates the relationships between health status (self-acceptance, coping with limitations), intrinsic (functional communication skills, navigating barriers/self-advocacy, resilience) and extrinsic (acceptance by others, access to information, educating others) factors in their influence on deaf adult quality of life outcomes at home, college, work, and in the community.nnnCONCLUSIONSnFindings demonstrate the need for the programs and services to consider not only factors intrinsic to the deaf individual but also extrinsic factors in enhancing perceived quality of life outcomes among people with a range of functional hearing and language preferences, including American Sign Language.

Audiology Students’ Perception of Hybrid Simulation Experiences: Qualitative Evaluation of Debriefing Sessions

Simulation-based research is still new in the audiology field and requires more research to better understand students’ perspectives on standardized patients/parents (SPs) and manikins use. There is also limited research about debriefing practices in audiology. This qualitative study used a baby simulator and SPs to evaluate audiology students’ reflection during three debriefing sessions conducted at the University of Arkansas for Medical Science (UAMS) Simulation Center. Seventeen Doctor of Audiology (AuD) students participated in the simulation event, and the data were collected using the transcripts of videotaped debriefing sessions. The qualitative content analysis of the transcripts revealed eight sub-themes: support, compassion, respect, teamwork, limited academic knowledge and practice, insufficient communication skills, low self-confidence, and undesirable emotional reactions. These items, in turn, fell under two main themes of Qualification and Lack of Preparation. Both main themes were included in one core category named Professional Dispositions and Competencies. Study findings indicated that audiology students demonstrated both promising professional dispositions and competencies as well as characteristics that may hinder students from developing their professional abilities. Thus, audiology programs will benefit from simulation use, including debriefing sessions, to emphasize professional efficiency.