|Year : 2021 | Volume
| Issue : 2 | Page : 51-55
Public awareness and guidance of hearing care by questionnaire under “SHRAWAN SHAKTI ABHIYAN”
Mahendra Kumar Taneja
Editor Indian Journal of Otology
|Date of Submission||13-Nov-2021|
|Date of Acceptance||17-Nov-2021|
|Date of Web Publication||7-Dec-2021|
Mahendra Kumar Taneja
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Taneja MK. Public awareness and guidance of hearing care by questionnaire under “SHRAWAN SHAKTI ABHIYAN”. Indian J Otol 2021;27:51-5
Public awareness of hearing-related issues has been very scarcely evaluated globally. Health agencies are getting concerned to it even government of India has launched national program for prevention and control of deafness though it is in very preliminary stage. Hence, this preliminary study was conducted to measure awareness toward hearing care. A modified questionnaire was formulated on the basis of previous studies.
This preliminary study was conducted in south Delhi during a charitable ENT checkup camp. A total of one hundred and fifty-six patients were registered and out of which 120 participated in the questionnaire.
Thyroid hormone optimum levels are essential for optimal hearing as its β receptors initiate myelinogenesis of the cochlea and auditory nerve. The deficiency is said to enlarge intercellular spaces in stria vascularis, leading to degeneration of hair cells in cochlea due to deficient, protein synthesis, enzyme function, and myelin production. Deficiency also aggravates autoimmune diseases and precipitates sensorineural deafness.
For clinical and treatment purposes hearing impairment in prelingual and post lingual deafness. The Government of India has been working primarily on prelingual by providing support in terms of cochlear implant.
Most hearing loss in adults are slowly progressive, difficult to reverse and become permanent. This badly affects the mental health of senior citizen. There will be around 200 billion senior citizens by 2050 and almost 30% will be having disabling hearing loss, which is thirty dB in better ear. The WHO reports that the incidence of deafness will go high and expect one in ten person that is 10% population will be having hearing loss. Most of them will be deprived of getting job opportunity and if yes it will be in lower grade of employment. A person of 60 plus can expect another 20 years of enhanced life span and active working. We neglect higher cholesterol level or L. D. L. levels. Hyperlipidemia may lead to cochlear ischemia due to increase in blood viscosity.
Various studies have reported depression isolation due to hearing impairment and Shukla et al. have observed a significant negative effect in cognitive function in older adults and reported relieve in negative effect by social participation and exercise including better cognitive function.,
As we go for echocardiography and assess the coronary blood vessels, we can predict in future by brachial ankle pulse wave velocity, which is an indication of arterial stiffness, suggesting reduced blood and oxygen supply to cochlea, heart, and brain.
| Materials and Methods|| |
The study was conducted at south Delhi. A questionnaire containing 24 questions was prepared. It was divided in four parts. The first part was demographic and clinical characteristics of participants including age, gender, locality, previous history of deafness, or family history of hearing loss.
| Results|| |
A total of 120 ENT patients were the subject of study. The most common three correct answers were
First Question No.13 Sudden loss of hearing is an emergency and must seek medical opinion was correct (True) in 65%, second question otomycosis can be contracted at swimming pool was correct (True) also in 65% and third question age related hearing loss may affect behavior again was correct (True) in 65%. Age-related hearing loss leads to change in behavior all in 78 (65%). Noise due to D. J. at night leads to physical and mental health problem 42 (35%). The most unfortunate part was the questionnaire no. 9 slap on the ear may cause hearing loss was correct in 36 (30%), 57 (47.5%) answers were wrong and 27 (22.5%) were not sure. 72 (60%) were aware that lifestyle, Yoga, and Pranayama is beneficial in preventing and rehabilitation of deafness.
Majority of patients were of the middle age group (Min. 12 years and Max. 73 years) and the mean age was 47.7 years. [Table 1] illustrates the details of age. The attendance was predominantly of male. It may be reluctance to hearing health in females due to in house culture. None of the participants had attended or participated previously in hearing prevention and rehabilitation program.
In history of present illness incidence of hearing loss was reported in 12.5% which was quite high in urban population since the study was in ENT patients hence this incidence was not significant. There was family history of deafness in 15%, smoking 20%, and tobacco chewing in 17.5%. Smoking may potentiate the aging hearing loss by two folds firstly by reducing the cognition power and secondly affecting the respiratory tract resulting to sinusitis, Eustachian tube More Details dysfunction. This leads to mixed hearing loss hence this public awareness will be of great help. Again, tobacco chewing leads to sensorineural deafness. In the history there was incidence of diabetes in 22.5%, hypertension in 27.5%, dizziness in 20%, tinnitus in 10% vide [Table 2], all these potentiate aging deafness.
The demographic revealed that majority were from urban area, 50% were from middle-income group, 47.5% from lower income group, only 2.5% from upper income group, because it was a free ENT checkup camp. The general knowledge and acquaintance with hearing prevention was almost the same in both the groups; [Table 3] shows the true/false answers of each question. [Table 4] depicts the correct answer in different four areas of questionnaire; the percentage of correct answer was comparatively better in diagnostic delay section (62.5%). It depicts better awareness toward seeking medical care.
| Discussion|| |
We have updated, modified the table, and added more question making it a table of 24 questions.
Perhaps, this is the only study conducted about awareness of prevention and rehabilitation of hearing impairment in ENT patients. Most studies have been conducted on college students.,, Lass & colleagues observed the correct answer 97.5% that tinnitus can be caused by exposure to loud sound while in the present study correct answer was in 57 (47.5%) only hearing aids needs to fit accurately to provide maximum benefit was answered correctly in 90 (75%) while Lass and colleagues observed correct answer in 43 (35.8%) university college students.
It was disheartening that 36 (30%) of ENT patients were not aware of neonatal hearing programme inspite of best locality of India. 63 (52.5%) participants in our study were aware that hearing loss may cause attention deficit thus reducing school performance. A study by Di Berardino et al. observed that hearing impairment will affect the performance of their child in 24.8%. It again proves public is gradually getting awareness.
In our study women were less aware and their answers were incorrect while William et al observed more correct answers. Noise exposure leads to deafness also and its importance should be highlighted to public.
Question cotton buds are necessary for ear cleaning and are the safest mean which was (false) was rightly answered in only 25 (20.8%). The author has observed, cotton bud left and forgotten in the ear canal is one of the cause of unilateral deafness next to wax, which is curable and provide immediate relief. The public should be made aware not to use cotton bud or negligently leave or forget in the ear.
The question no. 14 age related hearing loss was correct (True) in 78 (65%) in our study while this score was quite high in previous studies.,
Majority were not knowing that consanguinity may lead to deafness. Exposure to chemical at fuel filling station, oil in chemical industry may potentiate deafness. Ototoxicity of drugs, insecticides/mosquito coil, chlorhexidine and noise pollution may also potentiate deafness., For the first time author has added two more questions of public awareness, high cholesterol and hypertension treatable cause of deafness.
| Conclusion|| |
The present study prompt to continue and do a larger survey. Apart from finding the loop hole in further management, it will be an educational activity to paramedics and sensitize the media to enlighten the importance of preventive and rehabilitative,, measures. Majority of old age purchase hearing aid from the shop or online without going for hearing test (audiometry), programming and proper fitting. This leads to generation of noise more than better quality of perceived sound hence non acceptance of hearing aid. Child specialist or gynecologist should be trained with behavioral observation audiometry and chart should be displayed in reception area.
This is the first study with question enquiring and prompting senior citizen to involve in physical, socialization, Yoga, and Pranayama activities, which activates the cerebral cortex, increased conductivity in neurons, and regeneration of the spiral ganglion cells. Ischemia of cochlea, auditory nerve and cerebral cortex is the etiological factor of deafness can be prevented by those activities. Shukla et al has observed positive results and author by modified bhramari pranayama that is holding the breath out to maximum duration after humming.
| References|| |
Mahafzah MT, Mahafza T, Omari H, Al Hawari HH. Investigating the possible audiological effects of hypothyroidism. J Phonet Audiol 2018;4:137.
Santos KT, Dias NH, Mazeto GM, Carvalho LR, Lapate RL, Martins RH. Audiologic evaluation in patients with acquired hypothyroidism. Braz J Otorhinolaryngol 2010;76:478-84.
Thornton AR, Jarvis SJ. Auditory brainstem response findings in hypothyroid and hyperthyroid disease. Clin Neurophysiol 2008;119:786-90.
World Health Organization Seventieth World Health Assembly Provisional Agenda Item 15.8, Prevention of Deafness and Hearing Loss. Report by Secretariat, A70/34; May 04, 2017. who.int/iris/bitstream/handle/10665/274920/A70_34-en.pdf?sequence=1&isAllowed=y.
Lee JS, Kim DH, Lee HJ, Kim HJ, Koo JW, Choi HG, et al.
Lipid profiles and obesity as potential risk factors of sudden sensorineural hearing loss. PLoS One 2015;10:e0122496.
Mick P, Kawachi I, Lin FR. The association between hearing loss and social isolation in older adults. Otolaryngol Head Neck Surg 2014;150:378-84.
Shukla A, Reed NS, Armstrong NM, Lin FR, Deal JA, Goman AM. Hearing loss, hearing aid use, and depressive symptoms in older adults-findings from the Atherosclerosis Risk In Communities Neurocognitive Study (ARIC-NCS). J Gerontol B Psychol Sci Soc Sci 2021;76:518-23.
Sun J, Li H, Jin L, Luo H. Does hearing impairment affect mental health among Chinese older adults? Evidence from the Chinese longitudinal healthy longevity survey. Risk Manag Healthc Policy 2021;14:629-41.
Di Berardino F, Forti S, Iacona E, Orlandi GP, Ambrosetti U, Cesarani A. Public awareness of ear and hearing management as measured using a specific questionnaire. Eur Arch Otorhinolaryngol 2013;270:449-53.
Crandell C, Mills TL, Gauthier R. Knowledge, behaviors, and attitudes about hearing loss and hearing protection among racial/ethnically diverse young adults. J Natl Med Assoc 2004;96:176-86.
Chung JH, Des Roches CM, Meunier J, Eavey RD. Evaluation of noise-induced hearing loss in young people using a web-based survey technique. Pediatrics 2005;115:861-7.
Lass NJ, Woodford CM, Lundeen C, Lundeen DJ, Everly-Myers DS. The prevention of noise-induced hearing loss in the school-aged population: A school educational hearing conservation program. J Aud Res 1986;26:247-54.
Alshehri KA, Alqulayti WM, Yaghmoor BE, Alem H. Public awareness of ear health and hearing loss in Jeddah, Saudi Arabia. S Afr J Commun Disord 2019;66:e1-6.
Taneja MK, Varshney H, Taneja V, Varshney J. Ototoxicity, drugs, chemicals, mobile phones and deafness. Indian J Otol 2015;21:161-4. [Full text]
Taneja MK. Diwali-fire crackers and deafness. Indian J Otol 2004;10:3-5.
Taneja MK. Prevention and rehabilitation of old age deafness. Indian J Otolaryngol Head Neck Surg 2020;72:524-31.
Taneja MK, Taneja V. Role of vitamin D in prevention of deafness. Indian J Otol 2012;18:55-7. [Full text]
Taneja MK, Taneja V. Vitamin D deficiency in e.N.T. Patients. Indian J Otolaryngol Head Neck Surg 2013;65:57-60.
Taneja MK. National deafness program and behavioral enforcement audiometry. Indian J Otol 2012;18:1-2. [Full text]
Taneja MK. Modified Bhramari pranayama in infection. Indian J Otolaryngol Head Neck Surg 2020;72:395-7.
[Table 1], [Table 2], [Table 3], [Table 4]