Evaluation and diagnosis: Understanding, communication, and shared decision making

As described in the previous chapters, after becoming aware of hearing loss and having taken action to seek information, the person with hearing loss (PHL) may decide to start the journey of consultation and possible intervention with hearing healthcare professionals. As a part of this journey, audiological services and procedures provide an evaluation of hearing and related difficulties, followed by a diagnosis and the development of a plan for the management of the difficulties. The main purpose of this is to facilitate improved communication in PHLs, which will in turn improve health-related quality of life (HRQoL) by reducing the psychological, social, and emotional effects of hearing loss (Gagné et al., 2009). According to the modern audiological rehabilitation concept developed on the basis of the World Health Organization’s (WHO) International Classification of Functioning, Disability and Health (ICF; World Health Organization, 2001), using the biopsychosocial model, audiological services are expected to go beyond the traditional approach in order to adopt a more holistic, person-centered orientation in hearing healthcare. Decisions in the management of hearing loss should not only consider functional hearing deficits, but also the effects on the psychological, social, and socio-economic status of the person, as well as the overall effect on HRQoL (Gagné et al., 2009). Using a biopsychosocial approach to implement audiological management, it is important for hearing health professionals (HHPs) to adopt person-centered audiological rehabilitation (PCAR) by using effective patient-centered communication, together with a consideration of patients’ values and the contributions they are able to make to the process. The key steps of PCAR at the phase of diagnosis are summarized in the following table.