Clinical experiences, current approaches, opinions and awareness of healthcare professionals regarding the audio-vestibular consequences of individuals with traumatic brain injury: a cross-sectional online survey study

• Published in: BMJ open 2024-07, Vol.14 (7), p.e078017
• Main Authors: Bölükbaş, Kübra, Edwards, Laura, Baguley, David M, Fackrell, Kathryn
• Format: Article
• Language: English
• Subjects: Adult; Adults; Attitude of Health Personnel; Audiology; brain injuries; Brain Injuries, Traumatic - complications; Brain Injuries, Traumatic - psychology; Brain research; Cross-Sectional Studies; Ear, Nose and Throat/Otolaryngology; Female; Health Knowledge, Attitudes, Practice; Health Personnel - psychology; Hearing loss; Humans; Inclusion; Male; Medical personnel; Medical research; Middle Aged; Participation; Patient-centered care; Patients; physicians; Polls & surveys; Professionals; Social networks; Surveys and Questionnaires; Tinnitus; Trauma; trauma management; Traumatic brain injury; Vestibular Diseases - etiology
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2023-078017

ObjectiveTo explore the experiences, current approaches, opinions and awareness of healthcare professionals (HCPs) caring for adults with traumatic brain injury (TBI) regarding the audio-vestibular consequences.Design/settingCross-sectional online survey study.ParticipantsHCPs with experience of caring for adults with TBI, who were not ENT (ear nose throat) specialists or audiologists.MethodsThe study was conducted from May 2022 to December 2022. The online survey consisted of 16 closed and open-text questions in English and Turkish about clinical experience, current approaches and awareness of audio-vestibular consequences following TBI. Frequencies of responses to closed questions and associations between variables were analysed using SPSS V.28. Open-text responses were summarised in Microsoft Excel.ResultsSeventy HCPs participated from 17 professions and 14 countries, with the majority from the UK (42.9%). HCPs stated that ‘some’ to ‘all’ of their patients had auditory problems such as ‘inability to understand speech-in-noise’ (66%), ‘tinnitus’ (64%), ‘hyperacusis’ (57%) and balance problems such as ‘dizziness’ (79%) and ‘vertigo’ (67%). Usually, HCPs asked about the balance status of patients at appointments and when they observed dizziness and/or balance disorder they used screening tests, most commonly finger-to-nose (53%). For auditory impairments, HCPs preferred referring patients with TBI to audiology/ENT services. However, 6% of HCPs felt that audio-vestibular conditions could be ignored on referral because patients with TBI struggled with many impairments. Additionally, 44% would suggest hearing aids to patients with TBI with hearing loss ‘if they would like to use’ rather than ‘definitely’.ConclusionsMany audio-vestibular impairments are observed by HCPs caring for patients with TBI. The assessment and intervention opinions and awareness of HCPs for these impairments vary. However, non-expert HCPs may not be aware of negative consequences of untreated audio-vestibular impairments following TBI. Therefore, developing a simple framework for screening and indications of audio-vestibular impairments for referral may be helpful for non-audiological specialists regularly seeing these patients.