Sample History Paper on Needs Assessment for Hearing Services in Five Counties in Eastern Washington

Variations in a population’s age, size, gender balance, ethnicity, and race directly influence resources to be employed, and ultimately costs of healthcare provision as there are specific health risks associated closely with specific demographics. According to the NIDCD (National Institute on Deafness and Other Communication Disorders) (2019), presbycusis (age-related hearing loss) is a prevalent condition affecting a third of people between the ages of 65 to 74, and half of those older than 75.

On the opposite side of the spectrum, children are also quite susceptible to ENT (Ear, Nose, and Throat) infections (NIDCD, 2019). Ear infections, referred to as Otitis, are mostly caused by bacteria that cause inflammation of the middle ear by causing a build-up of fluids behind the eardrum. These infections affect five out of six children below three years. They are divided into 3.

  • Acute Otitis (AOM): This is the most common, where parts of the middle ear get infected, causing swelling due to the fluid being trapped behind the eardrum, causing earaches and in some cases a mild fever.
  • Otitis Media with Effusion (OME): This occurs after an ear infection, where the fluid trapped behind the eardrum fails to be discharged. It has no symptoms, but a doctor will be able to see the trapped fluid inside the ear of the affected person using specialized equipment.
  • Chronic Otitis Media with Effusion (COME): This is where the trapped fluid stays in place over a prolonged period or constantly recurs without there being an infection. COME affects hearing, and may also make it difficult for the child to fight off emerging infections.

Hearing difficulties may also be occasioned by lengthy exposures to harmful noise. This is referred to as Noise-Induced Hearing Loss (NIHL) and can occur at any age. Centre for Disease Control (CDC) studies conducted in 2011-2012 on hearing loss through tests and interviews had at least 6% of adults below 70 years experiencing hearing loss in one or both ears due to prolonged exposure to exceedingly loud noise, and 17% of teenagers experiencing a similar hearing loss (Lieberthal et., 2013).

Some of the other known but relatively rarer ear-related conditions and diseases, for example, Otosclerosis, and Usher Syndrome are also largely age-related according to the National Institute on Deafness and Other Communication Disorders.

Considering the above, age as a demographic plays a big role in susceptibility to different hearing problems and infections and would therefore be the most important demographic consideration in the determination of the need for hearing services.

Data Analysis

Using Timberline’s robust electronic health database, the data should be analyzed in the following main groups to help in determination of the community hearing services needs.

  • Age: As a demographic, age has been shown to be a strong contributing factor to various hearing problems and conditions. Analysing the data in terms of age will allow Timberline Health to be able to determine what percentages of the communities population are in the various age brackets and therefore be able to know what hearing complications and diseases may be prevalent considering which age bracket would be the biggest in terms of percentage of total population.
  • Gender: This combined with age will also help to identify which diseases and conditions may be prevalent in the population as some of them have a gender bias in addition to an age bias, for example Ostosclerosis, is more prevalent amongst white middle aged women.
  • Race: Race also combined with age and gender helps to identify which diseases and conditions may prove prevalent within certain groups. As is in the example given above, Ostosclerosis mainly affects white middle aged women.

 

Other Factors

Though not as prevalent as age, gender or race, there are other factors that may lead to or contribute to certain hearing conditions and diseases and, subsequently hearing loss.

  • Genetics: Gene mutations can also cause hearing problems. Enlarged Vestibular Aqueducts (EVA) is an example of such a hearing condition caused by a genetic mutation. Here, the vestibular aqueducts, the narrow bony canals that connect the inner ear to the Endolymphatic Sac, become enlarged. This is due to the mutation of the gene called SLC26A4 previously referred to as the PDS gene, with studies showing that most children with EVA end up developing some amount of hearing loss. Vestibular Schwannoma is another example although the specific genes that mutate resulting in this disease have not yet been fully understood.

Also, some of the hearing diseases may be genetically acquired, for example, Pendred Syndrome, and Usher Syndrome, which is believed to cause about 50% of all deaf-blindness cases. Ménière’s Disease is also believed to be so acquired as it runs in families.

  • Head trauma may also result in hearing complications and loss. Sudden Deafness can be caused by among other things physical injuries occasioned by a blow to the head.
  • Past diseases may also lead to hearing difficulties. Ostosclerosis for example is also believed by scientists to be related to previous measles infections.

References

Lieberthal, A. S., Carroll, A. E., Chonmaitree, T., Ganiats, T. G., Hoberman, A., Jackson, M. A., … & Schwartz, R. H. (2013). The diagnosis and management of acute otitis media. Pediatrics131(3), e964-e999.

National Institute of Deafness and Other Communication Disorders. (2019, August 8). Hearing, Ear Infections, and Deafness. https://www.nidcd.nih.gov/health/hearing-ear-infections-deafness

 

Questionnaire

Please answer the following questions keenly.

Tick where appropriate

Name: …………………………………………..

Gender:          Male….. Female…..

Date of Birth: …………………………………………..

Race: White…. African….Asian….Latino/Hispani…..Indian……..

Employment Status: Employed… Self Employed… Retired…Student….                                                                           Others(Please specify)………….

Is there anyone in your family with a hearing impairment? Yes….. No…..

If yes, who, and how is he/she related to you?

………………………………………………………………………………………………..

………………………………………………………………………………….

Do you sometimes feel embarrassed because you struggle to hear when you meet new

people? Yes….. No…..

 

Do you, or have you ever had tinnitus (buzzing, ringing or whistling sounds in your

ears)? Yes….. No…..

If yes, when did you have it and how long did it last?

……………………………………………………………………………………..

Have you had any ear diseases, Infections or Conditions?

….Yes Painfully acute ear inflammation as a child with some discharge.

…..Yes painfully acute ear inflammation as an adult with discharge

…..Yes Chronic ear inflammation with tympanic membrane perforation and a feeling of

deafened ear with discharge.

……No

……Do not know

Have you had any ear operations? Yes….. No…..

If yes, do you know what was done?

…………………………………………………………………………………….

Have you ever felt frustrated when talking to someone because you can’t hear them

clearly? Yes….. No…..

Do you work in a noisy environment? Yes….. No…..

If yes, explain:……………………………………………………………………………………………

How often do you get exposed to very noisy environments?…………………………

Do you wear any hearing protection at work? Yes….. No…..

Have you ever hurt your head in an accident? Yes….. No…..

Have you ever used a hearing aid? Yes….. No…..