METHODS: Phase I involves three steps: (a) translating the intervention manual into Malay, (b) systematically adapting its content for cultural relevance, and (c) piloting the intervention. Phase II is a 4-month randomized controlled feasibility trial involving chronic tinnitus patients (n = 20), stratified by severity and randomly assigned to either (a) the adapted intervention delivered by a trained provider or (b) standard care. Feasibility outcomes include a 10% recruitment rate among eligible patients, a 65% eligibility rate within the target population, and 80% retention. Primary outcomes assess tinnitus severity via the Tinnitus Functional Index, while secondary outcomes measure psychological distress using the Depression Anxiety Stress Scale-42. Assessments occur at baseline, post-intervention (1 month), and at a 3-month follow-up. At follow-up, semi-structured interviews guided by the Theoretical Framework of Acceptability will explore participants' perceptions of the intervention.
DISCUSSION: This feasibility trial evaluates the practicality and acceptability of a culturally adapted, audiologist-delivered psychological intervention for chronic tinnitus patients in Malaysia. Unlike direct translations, it incorporates systematic cultural adaptation to ensure relevance for the target population. Findings will inform the viability of a future large-scale trial and the potential for expanding psychologically informed tinnitus care in audiology settings.
TRIAL REGISTRATION NUMBER: ACTRN12624001048572.
METHOD: This is a qualitative research design where focus group discussions among audiologists were held. The interview data were analyzed using reflexive thematic analysis to identify patterns and reconstruct meaning.
STUDY SAMPLE: Ten audiologists with at least 1 year of work experience in providing remote hearing aid adjustment services to adult patients were recruited.
RESULTS: Even though there has been an increased utilization of remote fine-tuning among audiologists in Malaysia due to the coronavirus disease 2019 pandemic, its use among audiologists remains limited at present. Five thematic areas were identified: "Adoption of Practice," "Challenges and Limitations," "Benefits and Opportunities," "Satisfaction," and "Recommendations for Improvement." The TedAP challenges (T-technical challenges: e-ease of use, d-digital competency; A-abuse of system, and P-physical examinations) have been identified under the "Challenges and Limitations" theme. Suggestions for improvement include integrating the applications and video calls on a common platform, assigning a "standby" trained audiologist, and incorporating remote fine-tuning into audiology education.
CONCLUSION: Challenges and limitations associated with the provision of tele-audiology have been documented based on the views and experiences of audiologists in Malaysia. Despite the barriers, audiologists acknowledged the benefits associated with remote systems and recommendations were provided to improve the services. The results of this study could contribute to the increase in the use of tele-audiology in Malaysia. This would be instrumental in developing further the audiology profession in terms of the adoption of tele-audiology and telehealth in Malaysia.
DESIGN: Searches were performed in electronic databases MEDLINE, EMBASE, CINAHL, PsycInfo, Web of Science, PubMed and Google Scholar. The Crowe Critical Appraisal Tool and Melnyk Levels of Evidence were used to assess quality and level of evidence of eligible studies. Behaviours of hearing healthcare professionals were summarised descriptively.
STUDY SAMPLE: 17 studies met the inclusion criteria.
RESULTS: Twelve studies described behaviours of audiologists and five studies were intervention studies. Audiologists were typically task- or technically-oriented and/or dominated the interaction during hearing aid consultations. Two intervention studies suggested that use of motivational interviewing techniques by audiologists may increase hearing aid use in patients.
CONCLUSIONS: Most studies of clinicians' behaviours were descriptive, with very little research linking clinician behaviour to patient outcomes. The present review sets the research agenda for better-controlled intervention studies to identify which clinician behaviours better promote patient hearing aid outcomes and develop an evidence base for best clinical practice.
DESIGN: An online survey exploring current practice, skills and confidence of audiologists, and the infrastructure and facilities available in their workplaces, was distributed to audiologists in Malaysia via professional associations and social media.
STUDY SAMPLE: A total of 111 audiologists, 84.7% female and 15.3% male (range = 23-44 years), participated in the study.
RESULTS: Although audiologists in Malaysia reported addressing all of the ICF domains, less than 26% of them assessed the patients' speech perception, carried out real-ear measurements, or used outcome measures routinely. The majority of the audiologists reported feeling confident in managing adult patients. However, 83% of the audiologists indicated they wanted to improve their skills related to management of adult patients, particularly in the areas of counselling and auditory training.
CONCLUSIONS: Inadequate infrastructure, resources and facilities in the workplace may have contributed to the gaps in service provision and influenced the current practice of audiological management for adult patients in Malaysia.
DESIGN: Scoping review.
STUDY SAMPLE: 1261 studies from 4 databases (PubMed, CINAHL, Embase and Scopus) and 7 studies from grey literature were identified. After removing duplicates, 647 studies were screened for title and/or abstract, and five studies met the criteria and were included.
RESULTS: Audiologists reported offering a range of diagnostic assessment and rehabilitation services, including hearing aids, assistive listening devices, auditory training, and counselling. However, the uptake of hearing services was low; rates of hearing aid use among people with at least mild hearing loss were around 2.7%-4.4%; 6.5%-7.3% for those with at least moderate loss. There were no data on the outcomes from hearing services.
CONCLUSIONS: This scoping review highlighted the limited uptake of hearing services among adults in Malaysia, despite the existence of services. Furthermore, it revealed a lack of information about the factors contributing to this limited uptake. To address the burden of hearing loss, there is an urgent need to identify barriers to access, improve access and uptake, and evaluate the benefits of adult hearing services in Malaysia.