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      Nursing training program in children’s hearing health: a proposal for interactive tele-education Translated title: Capacitação dos enfermeiros em saúde auditiva infantil: uma proposta de teleducação interativa Translated title: Capacitación de enfermeros en salud auditiva infantil: una propuesta de teleducación interactiva

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          Abstract

          ABSTRACT Objective: To verify the effectiveness of a nursing training program in the area of children’s hearing health using interactive tele-education. Methods: Interrupted time series with non-random control group pre-test/ post-test. A cohort of 41 nurses, with no previous formal training in hearing health. A “Children’s Hearing Health” Cybertutor was employed. The effectiveness of the nursing training was verified by comparing pre- versus post-training performance and by analyzing responses to an evaluation questionnaire. Results: Following training, the performance was significantly better in all domains assessed and in the total score. The evaluation questionnaire demonstrated that the Cybertutor was well accepted and the performance revealed in the pre-training phase demonstrated the need for children´s hearing health training. Conclusion: The effectiveness of the nursing training program in the area of Children’s Hearing Health using interactive tele-education could be proven, since there was an improvement in performance in all domains evaluated.

          Translated abstract

          RESUMO Objetivo: verificar a eficácia de um tutor eletrônico - cybertutor na capacitação de enfermeiros na área de saúde auditiva infantil. Métodos: séries temporais interrompidas com grupo controle pré-teste/pós-teste não randomizado. Participaram 41 enfermeiros que foram capacitados por meio de um Cybertutor denominado “Saúde Auditiva Infantil”. A eficácia da capacitação foi verificada a partir da comparação do desempenho dos enfermeiros, nos questionários pré e pós-capacitação, e a avaliação do Cybertutor foi investigada por meio de um formulário com perguntas fechadas e abertas. Resultados: O desempenho no questionário pré-capacitação demonstrou a necessidade da capacitação em saúde auditiva infantil. Houve diferença no desempenho após a capacitação em todos os domínios avaliados e no escore total. Conclusão: A eficácia do cybertutor na capacitação de enfermeiros na área de Saúde Auditiva Infantil pôde ser comprovada, uma vez que houve melhora no desempenho em todos os domínios avaliados.

          Translated abstract

          RESUMEN Objetivo: verificar la eficacia de un tutor electrónico - cybertutor en la formación de enfermeros en el área de salud auditiva infantil. Métodos: series temporales interrumpidas con grupo control pretest/posttest no aleatorio. Participaron 41 enfermeros, que fueron capacitados a través de un Cybertutor denomidado "Salud auditiva infantil". La eficacia de la capacitación se verificó comparando el desempeño de los enfermeros en los cuestionarios pre y post capacitación, y la evaluación del Cybertutor se investigó a través de un formulario con preguntas cerradas y abiertas. Resultados: El desempeño en el cuestionario precapacitación demostró la necesidad de capacitación en salud auditiva infantil. Hubo una diferencia en el desempeño después del entrenamiento en todos los dominios evaluados y en el puntaje total. Conclusión: La efectividad del cybertutor en la capacitación de enfermeras en el área de Salud Auditiva Infantil podría demostrarse, ya que hubo una mejora en el rendimiento en todos los dominios evaluados.

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          The role of community health workers in addressing the global burden of ear disease and hearing loss: a systematic scoping review of the literature

          Introduction Community health workers (CHWs) have the potential to improve access to ear and hearing services for people across low-income or middle-income countries, remote, underserved, or resource-poor areas of the world. We performed a systematic scoping review to identify evidence on how CHWs are currently deployed in the prevention, screening, diagnosis, treatment and management of ear disease and hearing loss; methods to train and support CHWs in this context; and cost-effectiveness of CHWs. Methods We performed a systematic search of the literature from September 1978 to 18 March 2018 from 11 major databases and the grey literature. Results We identified 38 original studies that met the inclusion criteria, taking place across South Asia (n=13), Oceania (n=7), North America (n=7), South America (n=6) and Africa (n=5). 23 studies showed CHWs can increase community participation in screening. They can conduct screening using whispered voice tests, noisemakers for neonatal screening, automated audiological tests and otoscopy. Eight studies focused specifically on the evaluation of programmes to train CHWs, and three provided a general programme description. Three studies documented a role of CHWs in the treatment of ear disease or hearing loss, such as performing ear washouts, instillation of topical antibiotics or fitting of hearing aids. Only one study provided an indepth cost-utility analysis regarding the use of CHWs to conduct hearing screening, and no studies commented on the role of CHWs in the prevention of hearing loss. Conclusion CHWs have been employed in diverse ways to address the global burden of ear disease and hearing loss. Future research needs to explore the role of CHWs in preventative strategies, identify optimum methods to train and support CHWs, and explore their cost-effectiveness.
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            The universal newborn hearing screening in Brazil: from identification to intervention.

            The objective of the study is to investigate the results of the newborn hearing screening program carried out in a Public Hospital in Brazil, in the first 3 years regarding: (1) the prevalence of hearing impairment; (2) the influence of the universal hearing screening program on the age at which the diagnosis of hearing loss is defined; (3) the cost effectiveness of the program; (4) the outcomes, in terms of the age in which the hearing rehabilitation started. A descriptive study of the first 3 years after starting the universal newborn hearing screening in a Public Hospital of Bauru, São Paulo state, Brazil. The screening method consists of a two-stage screening approach with transient otoacoustic emissions (TOAE), conducted by an audiologist. If the outcome in the second-stage screening is REFER, the infant is submitted to diagnostic follow-up testing and intervention at the Audiology and Speech Pathology Clinic at the University of São Paulo, campus of Bauru. The evaluation of the costs of the universal newborn hearing screening program per each screened newborn (around 4000/year) was done based on a proposal by the National Center for Hearing Assessment and Management, of the Utah State University, United States of America. 11,466 newborns were submitted to hearing screening, corresponding to 90.52% of the living newborns. The prevalence of sensorineural hearing loss was 0.96:1000. Of the 11 children with sensorineural hearing loss, eight children received hearing aids and five started the therapeutic process before the age of 1. Currently, four children between the ages of 11 months and 2 years old were submitted to cochlear implant surgery. The cost of hearing screening was US$7.00 and the annual cost of the universal newborn hearing screening program was US$26,940.47. The hospital-based universal newborn hearing screening carried out through the Brazilian National Health System is viable, with promising results. However, in a country such as Brazil, which presents large socio-economic differences, the same type of analyses should be performed in several regions, so as to take into account specific aspects, to implement the newborn hearing screening along with the Public System. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.
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              Identification of hearing loss after age 18 months is not early enough.

              The general development of 40 deaf and hard of hearing infants was analyzed. The infants were placed into one of two groups according to age at which hearing loss was identified: (a) before age 6 months and (b) after age 18 months. The mean age at testing was 40 months. Developmental quotients (DQs) were used to compare results regardless of the infants' age at time of testing. Infants were evaluated on the basis of their DQ scores on the Minnesota Child Development Inventory (MCDI; Ireton & Thwing, 1972). MCDI subtests include general development, gross motor, fine-motor, expressive language, comprehension-conceptual, situation-comprehension, self-help, and personal-social. Infants whose hearing loss was identified before age 6 months scored significantly higher than those whose hearing loss was identified after age 18 months in the expressive language and comprehension-conceptual subtests. The performance of the earlier-identified group supports the earliest identification of hearing loss and encourages implementation of universal hearing screening.
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                Author and article information

                Journal
                rgenf
                Revista Gaúcha de Enfermagem
                Rev. Gaúcha Enferm.
                Universidade Federal do Rio Grande do Sul. Escola de Enfermagem (Porto Alegre, RS, Brazil )
                0102-6933
                1983-1447
                2020
                : 41
                : spe
                : e20190446
                Affiliations
                [1] Bauru orgnameUniversidade de São Paulo orgdiv1Faculdade de Odontologia de Bauru Brazil
                [3] São Paulo São Paulo orgnameHospital Samaritano Brazil
                [4] São Paulo São Paulo orgnamePontifícia Universidade Católica de São Paulo Brazil
                [2] Natal Rio Grande do Norte orgnameUniversidade Federal do Rio Grande do Norte orgdiv1Centro de Ciências da Saúde Brazil
                Article
                S1983-14472020000200442 S1983-1447(20)04100000442
                10.1590/1983-1447.2020.20190446
                886c6bbe-504c-4360-8cf5-f9444f8a6544

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 01 December 2019
                : 12 February 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 19, Pages: 0
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                SciELO Revista de Enfermagem


                Distance learning,Health education,Education, nursing,Audiology,Educación a distancia,Educación en salud,Educación en enfermería,Audiología,Educação à distância,Educação em saúde,Educação em enfermagem,Audiologia

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