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Equity and person-centeredness in provision of tinnitus services in UK National Health Service audiology departments
Abstract
Rationale, aim and objective: Chronic tinnitus is a prevalent condition broadly managed using individualised sound-based interventions, individualised or group education, counselling, or cognitive therapies. In the UK, therapy is largely delivered by audiologists or hearing therapists and, where available, clinical psychologists and physicians. Changes in the structure of the health service necessitate ongoing evaluation to monitor equity and person-centeredness of care. The purpose of the current evaluation was to describe provision and explore diversities in the services provided for tinnitus patients across the four countries of the UK and consider these relative to current commissioning and clinical practice guidelines.
Method: A 37 item questionnaire was devised and distributed via email and social media to reach audiology departments in the UK and 147 valid responses were acquired during the 3 month period of the evaluation.
Results: The structure and provision of tinnitus services varies widely across the four countries of the United Kingdom in terms of which clinicians provide the services. Outside of England there was no report of clinical psychology or audiovestibular physician involvement in services. There is also variability in access to psychological therapy or support (little training in CBT in Scotland and none in Northern Ireland), self-help groups (little involvement but interest from clinicians) and devices (e.g., one quarter of departments do not currently offer combination hearing aid devices for tinnitus). Clinicians are increasingly using validated questionnaires to evaluate the effectiveness of tinnitus management in their departments.
Conclusions: Training in and the provision of psychological support for tinnitus patients by audiologists is particularly a concern for Scotland and Northern Ireland and has implications for the person-centeredness of audiology services. Capacity and need for research in paediatric tinnitus, combination devices, non-ear level sound devices and audiologist-delivered psychological therapy, are noted.
Keywords
References
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DOI: http://dx.doi.org/10.5750/ejpch.v3i3.984
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