Wie können Menschen mit einer Hörbehinderung über eine Hörsystemversorgung hinaus unterstützt werden?

Zusammenfassung

Ziel Menschen mit Hörbehinderungen wenden zahlreiche Strategien an, um Schwierigkeiten im Zusammenhang mit der eigenen Höreinschränkung bewältigen zu können – dieser Prozess wird als Selbstmanagement bezeichnet. Während die Förderung von Selbstmanagement in fremdsprachigen Rehabilitationsprogrammen fest verankert ist, gibt es in Deutschland bisher keinerlei Empfehlungen hierzu. Deshalb besteht das Ziel dieses systematischen Reviews zunächst darin, einen Überblick bestehender Selbstmanagement-Interventionen für Menschen mit Hörbehinderungen zu geben und anschließend Einsatzmöglichkeiten im deutschen Versorgungssystem anzureißen.

Methodik Eine systematische Literaturrecherche wurde auf PubMed durchgeführt, um Studien mit entsprechenden Interventionsansätzen zu identifizieren. Wenn die vordefinierten Einschlusskriterien erfüllt werden konnten, wurden Informationen zur Publikation, Intervention und Evaluation aus den einzelnen Studien extrahiert und qualitativ zusammengefasst. Die methodische Qualität der Studien wurde bewertet.

Ergebnisse Insgesamt konnten 23 Artikel eingeschlossen werden. Die einzelnen Interventionen verfolgten verschiedenste Ziele, thematisierten ein breites Spektrum von Inhalten (Informationsvermittlung, Aspekte zur Kommunikationsverbesserung, psychosoziale, technische oder spezifische Aspekte) und wurden entweder gruppenbasiert, individuumsbasiert oder selbstangeleitet implementiert. Im Rahmen der Evaluationen konnten, mit Ausnahme weniger Studien, positive Interventionseffekte bezüglich des wahrgenommenen Hörhandicaps, des psychosozialen Wohlbefindens und der Kommunikation der Interventionsteilnehmer*innen festgestellt werden.

Diskussion Die eingeschlossenen Studien wiesen eine starke Heterogenität bezüglich der methodischen Qualität, der durchgeführten Intervention und des Evaluationsdesigns auf. Eine Zusammenfassung der Befunde war deshalb nur qualitativ möglich. Möglichkeiten der Anpassung bestehender Interventionsprogramme sowie Chancen und Grenzen einer Implementierung im deutschen Versorgungssystem sind im Weiteren zu diskutieren.

Schlussfolgerung Insgesamt scheint es sich bei Interventionen zur Unterstützung des Selbstmanagement um eine gewinnbringende Ergänzung zur alleinigen technischen Geräteversorgung und -anpassung zu handeln, die auch im deutschsprachigen Raum weiter forciert werden sollte.

Abstract

Objective People with hearing handicap have to use a whole range of strategies to cope with everyday challenges – they have to self-manage their hearing impairment. While the support of self-management is well established in foreign language audiological rehabilitation programs, there are no recommendations in Germany yet. Therefore, the aim of this systematic review is first to give an overview of existing self-management interventions for people with hearing handicap and then to suggest possible applications in the German care system.

Methods A systematic literature search was conducted on PubMed. The articles dealt with self-management interventions for people with hearing impairment. This eligibility criterion was applied to titles, abstracts, and full texts. If eligible, information on the publication, intervention, and evaluation were extracted and qualitatively summarized. The methodological quality of studies was investigated using the NIH assessment tool for interventional studies.

Results 23 papers could be included and show a high heterogeneity regarding methodological quality, applied intervention, and design of evaluation. The interventions pursuing various goals include a wide range of content (e. g., communication improvement or psychosocial aspects) and have been implemented on a group-based, individual-based, or self-administered level. Despite a few studies that failed to demonstrate intervention effects, most evaluations found positive ef-fects of the intervention on hearing impairment, psychological well-being, and communication.

Discussion The included studies present a high heterogeneity with regard to methodological quality, the intervention conducted, and the evaluation design. Therefore, a summary of the findings was only possible in a qualitative manner. Possibilities of adapting existing intervention programs as well as chances and limits of an implementation in the German health care system are to be discussed in the following.

Conclusion Overall, interventions including self-management support seem to be a profitable complement to sole technical device supply and should be further fostered in German-speaking countries as well.

Schlüsselwörter

Hörbehinderung - Selbstmanagement - Hörrehabilitation

Keywords

hearing handicap - self-management - hearing rehabilitation

Publication History

Received: 31 May 2023

Accepted: 13 May 2024

Article published online:
12 July 2024

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