An Exploration of Audiologist and Patient Communication during Adult Tinnitus Management Sessions in Gauteng, South Africa

Abstract

Introduction: Tinnitus is a prevalent symptom of hearing loss and can have a significant impact on quality of life. Recently a large body of research exploring patient-centred care and communication practices in audiology has emerged. However, there remains a paucity of research on communication in tinnitus management consultations. Aims: The aim of this study was to explore interactions between audiologists and patients in initial adult tinnitus management sessions. The objectives of this study were to observe the communication processes of audiologists in this setting, as well as explore how audiologists negotiate complexities such as patient expectations, emotions, decision-making and goal setting with patients. Methodology: This study implemented a multimethod exploratory qualitative design incorporating interactional analysis of video recorded audiological initial tinnitus consultations, triangulated with participant interviews. The research was conducted at two hospitals in the public healthcare sector of Gauteng, South Africa. The data comprised of seven video-recorded interactions between five audiologists and seven patients, supplemented with interviews with all 12 participants after the tinnitus consultations. The video-recorded interactions were analysed by means of a hybrid sociolinguistic analysis approach with principles of interactional sociolinguistics and theme-oriented discourse analysis. The video- recorded data was triangulated with the interview data in order to strengthen the analysis and overall confirmability of the study. Results: The findings of this study highlight six communicative actions that contribute to patient-centred communication in initial adult tinnitus management sessions, namely: agenda setting, breaking from a scripted approach, prioritisation of patient concerns, engaging in emotional and psychosocial topics, shared decision-making and expectation setting. The results of this study show that audiologists are not consistently implementing these 5 communicative actions within their adult tinnitus management consultations, which has implications for patient-centred care. Conclusions: The study provides insights into the current communication practices of audiologists in adult tinnitus management sessions in South Africa. The research highlights both the strengths and weaknesses of audiologists in their use of effective communication strategies and patient-centred care, specifically in information exchange, responsiveness to patients’ emotions and psychosocial stressors, and shared decision-making. Audiologists need to consider how they can transform the concepts of patient-centred care and effective communication into practical actions within their tinnitus management. These findings can raise awareness among audiologists about their communication practices in tinnitus management consultations. Additionally, they offer insights into practical communication strategies that can be implemented into tinnitus management consultations and provide valuable insights for future researchers, educators and policymakers.