LM302 - Listening for the Unspoken: Strategies for More Empathetic Counseling

Abstract:
Research in other healthcare fields shows patients of empathetic providers have better outcomes than patients seen by less empathetic providers. In hearing healthcare, empathy often requires understanding and responding to the source of a patient’s stigma or anxiety surrounding hearing healthcare. Audiologists often counsel on device-related stigma during the hearing aid selection process, yet patients presenting to a hearing clinic experience stigma from other sources, such as hearing loss and aging, as well. In this session, literature on stigma(s) experienced by the typical patient will be reviewed in the context of providing empathetic counseling to patients during hearing aid selection.

Summary:
The stigmas attached to hearing loss, aging, and hearing aid use are well documented in the literature. These sources of stigma are a frequent topic of counseling in the hearing clinic; although the audiologist might wish for a patient to make a purely data-driven decision regarding hearing aid adoption, it is impossible for the patient to ignore their own biases and the sociologic influences that introduced them.

Audiologists focus a great deal of their counseling during the hearing aid selection process on contrasting the look and feel of modern hearing aids with those of the past. While this may be an effective counseling strategy to assuage device-related stigma or anxiety, it does little to address the many other sources of stigma the patient might experience. According to a 2002 article in American Journal of Audiology by Erler and Garstecki, patients tend to associate more stigma with hearing loss than with hearing aids. Although hearing aid related stigma should not be ignored in the hearing aid selection and counseling process, it is not sufficient to counsel on hearing aid stigma at the expense of the other potential sources of stigma, particularly because those other sources may be a greater contributor to the patient’s overall reluctance toward hearing aid use.

Empathy is the act of “understanding and sharing the feelings of another” (Oxford English Dictionary); as such, understanding and anticipating the sources of stigma for a patient is core to displaying empathy in the hearing clinic. Although it is presently unknown how or if empathetic counseling may influence hearing aid uptake or outcomes, data from other healthcare fields provide a clear indication that patients benefit from empathetic providers. For example, in one study, diabetic patients in the care of physicians who scored high on a scale of empathy had lower (i.e., better) A1c (Hojat, et al., 2011). In another study, patient anxiety was lower for a group of patients seen by nurses who had participated in an empathy training program compared to patients seen by nurses who had participated in a sham training (La Monica, et al., 1987).

In this session, current research on stigma related to hearing loss, hearing aid use, and aging will be reviewed. Additionally, literature from other healthcare fields on the role of provider empathy in improving patient outcomes will be discussed. Strategies for applying the current evidence on sources of stigma in the clinic will be introduced, with a particular focus on providing more empathetic hearing healthcare.

References:

Erler, S. and Garstecki, D. (2002). Hearing Loss- and Hearing Aid-Related Stigma: Perceptions of Women with Age-Normal Hearing. American Journal of Audiology 11: 83-91.

Hojat M, Louis DZ, Markham FW, Wender R, Rabinowitz C, Gonnella JS. (2011). Physician empathy and clinical outcomes for diabetic patients. Acad Med 86: 359-364.

La Monica, E., Wolf, R., Madea, A., and Oberst, M. (1987). Empathy and Nursing Care Outcomes. Scholarly Inquiry for Nursing Practice 1(3).

Oxford English Dictionary Online. Oxford University Press. Available online: http://oxforddictionaries.com/definition/English/empathyq=empathy (accessed on 7 October, 2022).