Bakgrund: Attityder gentemot funktionsnedsättning grundar sig historiskt sett i samhällets förändring och kunskap. Attitydbegreppet utgår i examensarbetet från Theory of planned behavior, där bakomliggande faktorer leder handling. En hörselnedsättning är en dold oftast kronisk funktionsnedsättning. Svensk lagstiftning reglerar rättigheter och skyldigheter i arbetslivet för inblandade aktörer. Personen med hörselnedsättning bearbetar sin situation i tre skeenden i en livsomställningsprocess. Syfte: Genom integrativ litteraturstudie kartlägga attityder personer med hörselnedsättning möter i arbetslivet och personens eget förhållande till sin hörselnedsättning. Metod: Innehållsanalys av 13 skandinaviska undersökningar, där hörselnedsättning ingår. Attityderna delas upp i 12 kategorier utifrån område. Vilka aktörer (Arbetsgivare, kollegor och personen med hörselnedsättning) attityden framkommer vid redovisas. Resultat: Attityder framkommer jämt fördelat mellan positivt och negativt i kategorierna. Vid Hänsyn vid kommunikation och Användande av tekniska hörhjälpmedel framkommer attityder mest frekvent. I fyra kategorier, Frånvaro vid raster på arbetet, Synlig hörhjälpmedel, Öppenhet om hörselnedsättning och Mötesdisciplin, är det framförallt personen med hörselnedsättning som är den som har attityder gentemot sin hörselnedsättning och dess konsekvenser. Slutsatser: När attityderna i kategorierna sammanbinds med Theory of planned behavior framkommer att kunskap och information påverkar den slutliga handlingen. Livsomställningsprocessen påverkar hur personen med hörselnedsättning förhåller sig till hörselnedsättningen och dess konsekvenser.

Diss. Linköping : Universitetet, 2005.

No description available.

Central auditory processing is complex and can not be evaluated by a single method. This thesis focuses on assessment of some aspects of central auditory functions by the use of dichotic speech tests and cognitive tests that tax functions important for speech processing. Paper A deals with the cognitive effects in dichotic speech testing in elderly hearing-impaired subjects. It was found that different listening tasks in the dichotic tests put different demands on cognitive ability, shown by a varying degree of correlation between cognitive functions and dichotic test parameters. Age-related cognitive decline was strongly connected with problems to perceive stimuli presented to the left ear. Paper B presents a new cognitive test battery sensitive for functions important for speech processing and understanding, performed in text, auditory and audiovisual modalities. The test battery was evaluated in four groups, differing in age and hearing status, and has proven to be useful in assessing the relative contribution of different input-modalities and the effect of age, hearingimpairment and visual contribution on functions important for speech processing. In Paper C the test battery developed in Paper B was used to study listening situations with different kinds of background noise. Interfering noise at +10 dB signal-to-noise ratio has significant negative effects on performance in speech processing tasks and on the effort perceived. Hearing-impaired subjects showed poorer results in noise with temporal variations, and elderly subjects were more distracted by noise with temporal variations, especially by noise with meaningful content. In noise, all subjects, particularly those with impaired hearing, were more dependent upon visual cues than in the quiet condition. Hearing aid benefit in speech processing with and without background noise was studied in Paper D. The test battery developed in Paper B was used together with a standard measure of speech recognition. With hearing aids, speech recognition was improved in the background condition without noise and in the background condition of ordinary speech. Significantly less effort was perceived in the cognitive tests when hearing aids were used, although only minor benefits of hearing aid amplification were seen. This underlines the importance of considering perceived effort as a dimension when evaluating hearing aid benefit, in further research as well as in clinical practice. The results from the studies contribute to the knowledge about speech processing but also to the search for more specific evaluation of speech understanding, incorporating both sensory and cognitive factors. / The ISBN 91-85297-49-6 in the printed verison is incorrect. The correct ISBN is 91-85297-93-3.

Bakgrund: Monaurala lågredundanta taltester används, tillsammans med andra tester i testbatterier, för att undersöka centrala auditiva funktioner. Testgrupper som ingår i monaurala lågredundanta taltester är: lågpassfiltrerade taltester, tal-i-brus tester och tidskomprimerade taltester. Syfte: Syftet var att ta reda på vilka monaurala lågredundanta taltester som finns och vilka resultat man kan få på dessa. Metod: Litteraturstudie där experimentella studier har använts. Resultat: De monaurala lågredundanta taltester som har använts i de studerade artiklarna är filtrerat tal, meningar-i-brus, ord-i-brus, taluppfattning-i-brus, tal-i-brus, SPIN, R-SPIN, SSI/MCI, SSI/ICM, SIN, tidskomprimerade ord med olika kompressionsgrader, hackat tal, The Compressed Sentence Test och SCAN-A, SCAN-C med undertesterna Auditory Figure Ground och filtrerade ord. Försökspersoner med hörselnedsättning får signifikant sämre resultat än normalhörande på många av testerna. Barn får sämre resultat på flera av testerna jämfört med vuxna. Slutsatser: Det finns många olika monaurala lågredundanta taltester. De valda artiklarna tar upp fler monaurala lågredundanta taltester än vad som nämns i använd referenslitteratur.

Audiologisk rehabilitering är en komplicerad process som ska innehålla olika insatser byggda på ett holistisk synsätt med medicinska, tekniska och beteendevetenskapliga aspekter involverade. Historiskt har dock den tekniska och medicinska delen ofta fått ta större plats än psykosociala bitar i rehabiliteringen. Syftet med studien var att undersöka likheter och skillnader angående audiologisk rehabilitering utifrån ramverket, ideologin samt praktiken i Danmark, Norge, Sverige och på Island. Metod: För att kunna uppnå syftet och få en mer helhetlig inblick i ämnet delades studien i två delar (litteraturstudie och enkätstudie). Litteraturstudien berörde ramverket i samtliga länder samt ideologin. Enkätstudien berörde praktiken i form av audionomens egen syn på audiologisk rehabilitering samt deras uppfattning av tillvägagångssättet på arbetsplatsen. Resultat: En röd tråd går genom ramverket, ideologin och praktiken i varje land. Vad gäller dessa huvudpunkter visade studien att det fanns både likheter och skillnader länderna emellan. I det stora hela visar resultatet av studien att tankesättet inom audiologisk rehabilitering är något mer holistiskt i Sverige än i de övriga länderna. Slutsats: Trycket om en kostnadseffektiv vård står i kontrast till sjukvårdslagarna då en kortsiktigt planerad hörselvård riskerar att motverka en holistisk audiologisk rehabilitering. / Audiological rehabilitation is a complicated process entailing different aspects from medical, technical and behaviour science forming a holistic treatment. Historically more emphasis has been placed on the technical and medical facets of the treatment compared to the psychosocial. Purpose: The study´s purpose was to inspect similarities and differences regarding audiological rehabilitation by examining the framework, ideology and practice in Denmark, Norway, Sweden and Iceland. Method: To be able to achieve the purpose and to get a holistic insight the study was divided into two parts, namely litterature study and questionnaires. The litterature study reviewed the countries framework and ideology. The questionnaire analyzed the audiologists thoughts on audiological rehabilitation as well as the workplace approach. Results: There is a fine thread within each country that goes through the framework, ideology and practice. Furthermore, the study showed that there are both similarities and differences between the different countries. In general the study proved that the mindset in Sweden is more holistic compared to the other countries. Conclusion: The pressure for cost-effective care is in contrast with health care laws as short-term planned health care can counteract an holistic audiological rehabilitation

Noise exposure is one of the most prevalent causes of irreversible occupational disease in Sweden and in many other countries. In hearing conservation programs, aimed at preventing noise-induced hearing loss, audiometry is an important instrument to highlight the risks and to assess the effectiveness of the program. A hazardous working environment and persons affected by it can be identified by monitoring the hearing thresholds of individual employees or groups of employees over time. However, in order to evaluate the prevalence of occupational noise-induced hearing loss, relevant reference data of unexposed subjects is needed. The first part of this dissertation concerns the changes in hearing thresholds over three decades in two occupational environments with high noise levels in the province of Östergötland, Sweden: the mechanical and the wood processing industries. The results show a positive trend, with improving median hearing thresholds from the 1970s into the 1990s. However, the hearing loss present also in the best period, during the 1990s, was probably greater than if the occupational noise exposure had not occurred. This study made clear the need for a valid reference data base, representing the statistical distribution of hearing threshold levels in a population not exposed to occupational noise but otherwise comparable to the group under study. In the second part of the dissertation, reference data for hearing threshold levels in women and men aged from 20 to 79 years are presented, based on measurements of 603 randomly selected individuals in Östergötland. A mathematical model is introduced, based on the hyperbolic tangent function, describing the hearing threshold levels as functions of age. The results show an age-related gender difference, with poorer hearing for men in age groups above 50 years. The prevalence of different degree of hearing loss and tinnitus is described for the same population in the third part of the dissertation. The overall prevalence of mild, moderate, severe or profound hearing loss was 20.9% collectively for women and 25.0% collectively for men. Tinnitus was reported by 8.9% of the women and 17.6% of the men. Approximately 2.4% of the subjects under study had been provided with hearing aids. However, about 7.7% were estimated to potentially benefit from hearing aids as estimated from their degree of hearing loss. Noise-induced hearing loss primarily causes damage to the outer hair cells of the inner ear. The fourth and last part of the dissertation evaluates the outer hair cell function, using otoacoustic emission measurements (OAE). Prevalence results from three different measuring techniques are presented: spontaneous otoacoustic emissions (SOAE), transient evoked otoacoustic emissions (TEOAE) and distortion product otoacoustic emissions (DPOAE). Gender and age effects on the recorded emission levels were also investigated. Women showed higher emission levels compared to men and for both women and men the emission levels decreased with increasing age. The results from the OAE recordings were shown to be somewhat affected by the state of the middle ear. The study included tympanometry, and the relation of the outcome ofthis test to the otoacoustic emissions is described, where high middle ear compliance resulted in low emission level. Reference data for the tympanometric measurements are also presented. The results of this project form an essential part of the important work against noiseinduced hearing loss, which needs continuous monitoring. The reference data presented here will provide a valid and reliable data base for the future assessment of hearing tests performed by occupational health centres in Sweden. This data base will in turn prove useful for comparison studies for Sweden as a responsible fellow EU member country setting high standards for work force safety. The statistical distribution of hearing threshold levels as a function of age for men and women in tabulated form is available on the Swedish Work Environment Authority (Arbetsmiljöverket) web site: http://www.av.se/publikationer/bocker/fysiskt/h293.shtm.