In pursuit of preventive audiology: help-seeking behaviour patterns of adults with hearing impairment in a peri-urban community in South Africa

Abstract

Background: There is a wealth of research, globally, on the help-seeking behaviour patterns of individuals with a variety of medical conditions especially those that are chronic in nature. However, research related to help-seeking behaviour patterns with hearing impairment is limited and mostly found in high income countries (HICs). Purpose: The main aim of this study was to investigate the help-seeking behaviour patterns of adults with hearing impairment in a peri-urban community in South Africa. Specific subaims included (a) describing the pattern of presentation in relation to one’s culture and beliefs; (b) defining the process from onset of symptoms to accessing audiology services; and (c) examining elements in the participant’s environment that acted as barriers or facilitators towards hearing health seeking behaviour adopted. Method and Materials: A qualitative research design that was descriptive in nature was employed for this study. Semi-structured interviews using an open-ended interview guide were conducted with 23 participants selected through a non-probability purposive sampling method. A thematic analysis through a deductive approach was adopted to analyse the data. Results: Participants’ patterns of presentation indicated a belief in a Western bio-medical causation to explain their hearing impairment. First-time help-seekers sought help mostly from healthcare workers at all levels of care in the public and private healthcare sector, followed by a few participants consulting their social networks, with only one participant using a traditional health provider to resolve their hearing difficulties. The process from onset of symptoms to accessing audiology services was complex resulting in long as compared to short journeys. Socio-economic factors were the most significant barrier while structural and health system factors facilitated the help-seeking behaviours adopted. Conclusions: This study identified the help-seeking behaviour patterns of adults with hearing impairment from their contexts. In a low-and-middle-income (LAMI) country, like South Africa, the social determinants of health and the significant inequalities in healthcare influence where individuals seek help. These findings contribute to the dearth of literature on hearing help-seeking and can influence hearing healthcare policy, particularly in preventive audiology in South Africa. There is also a potential to facilitate more contextual relevancy in the way clinicians practise within the field of audiology by seeking to understand the perspectives of adults with hearing impairment in their environments.