Decision-making following identification of an infant's unilateral hearing loss: Parent and professional perspectives
Ann Porter1, Nicola Sheeran1, Michelle Hood1
1School of Applied Psychology, Griffith University, Parklands Drive, Southport, QLD, 4222, Australia.
Insights
Parents deciding on unilateral hearing loss (UHL) management face uncertainty due to limited evidence. More research is needed to clarify long-term outcomes and guide informed decisions for children with UHL.
Area of Science:
- Audiology
- Pediatric Medicine
- Decision Science
Background:
- Infants diagnosed with unilateral hearing loss (UHL) require timely management decisions.
- Parents often lack sufficient evidence to guide these critical choices.
- Uncertainty exists regarding the need for additional support for infants with UHL.
Purpose of the Study:
- To examine the decision-making processes of parents and clinicians for managing UHL in infants post-newborn hearing screening.
- To understand the complexities and influencing factors in UHL management decisions.
Main Methods:
- Applied thematic analysis of semi-structured interviews.
- Recruited 15 parents of children under 4 with permanent UHL.
- Recruited 14 clinicians involved in UHL management.
Main Results:
- Decision-making is driven by motivation, limited evidence causing uncertainty, and available evidence building certainty.
- Parent and clinician perspectives reveal complex decision-making with contested opinions.
- No single best management option is consistently identified.
Conclusions:
- Parental choices for UHL management have lifelong implications.
- Further research is needed to evaluate short- and long-term consequences of UHL management options.
- Uncertainty poses challenges and risks cognitive biases in clinical and parental decision-making.
Background:
Parents of infants identified with unilateral hearing loss (UHL) make decisions about managing their infant's hearing loss based on limited evidence and before knowing whether their infant will require additional support.
Objectives:
The decision-making processes of parents and clinicians regarding the management of UHL following newborn hearing screening were examined.
Procedure:
Two convenience samples were recruited: 15 parents of children with permanent UHL aged under 4 years, and 14 clinicians. Applied thematic analysis of the semi-structured interviews elicited insight into the complexities surrounding decision-making from a parent and clinician perspective.
Results:
Three main themes captured the decision-making process: motivation for decision-making, limited evidence creates uncertainty, and available evidence builds certainty. The diverse experiences and opinions of parents and clinicians highlight the complexity of decision-making when there are contested opinions and no clear best management option.
Conclusions:
The choices parents make about the management of their child's UHL can have lifelong implications for their child. Many questions need answering before parents can effectively evaluate the short- and long-term consequences of their options and whether the advantages outweigh the disadvantages in the long-term. This uncertainty is challenging for professionals and parents and risks cognitive biases influencing clinical and parental decision-making.
