Revista CEFAC
https://revistacefac.org.br/article/doi/10.1590/1982-0216/20232518522
Revista CEFAC
Original Articles

Analysis of a hearing loss identification and intervention program in the first years of life in primary care

Análise de um programa de identificação e intervenção  da perda auditiva nos primeiros anos de vida na atenção primária

Maria Taiany Duarte de Oliveira; Kátia de Freitas Alvarenga; Alice Andrade Lopes Amorim; Lilian Cassia Bornia Jacob; Eliene Silva Araújo

Downloads: 0
Views: 215

Abstract

Purpose: to analyze the implementation and effectiveness of a hearing loss identification and intervention program in the first years of life in primary care.

Methods: an experimental study carried out in two Basic Health Units. Twenty-three Community Health Workers participated, trained through an online self-instructional course from the Ministry of Health. Subsequently, they followed the hearing and language of children from zero to two years old, referring them, if necessary, to audiological evaluation. For the analysis of pre and post online course knowledge, the Wilcoxon test was applied, and to compare the performance between the participants of the two Basic Health Units, the Mann Whitney test was used, adopting p<0.05. Additionally, the qualitative perception of participating community workers, the referrals, and the result of the audiological evaluation were analyzed.

Results: the online course was effective in improving the knowledge of the participants. A total of 102 children were monitored, 15 of them were referred for evaluation. From these, four underwent hearing screening and 11 underwent a complete hearing assessment, a case of conductive hearing loss being identified.

Conclusion: the implementation of a program for the identification and intervention of hearing loss, in the first years of life, in primary care, permeated by community health workers, is feasible.

Keywords

Hearing Loss; Community Health Workers; Inservice Training; Primary Health Care

Resumo

Objetivo: analisar a implantação e a eficácia de um programa de identificação e intervenção da perda auditiva nos primeiros anos de vida na atenção primária.

Métodos: estudo experimental realizado em duas Unidades Básicas de Saúde. Participaram 23 agentes comunitários de saúde, capacitados por meio de um curso autoinstrucional online do Ministério da Saúde. Posteriormente, acompanharam a audição e a linguagem das crianças de zero a dois anos, encaminhando-as, se necessário, para avaliação audiológica. Para análise do conhecimento pré e pós curso online foi aplicado o teste de Wilcoxon e para comparação do desempenho entre os participantes das duas Unidades Básicas de Saúde empregou-se o teste de Mann Whitney, com adoção de p<0,05. Adicionalmente, avaliou-se a percepção qualitativa dos agentes comunitários participantes, os encaminhamentos realizados e o resultado da avaliação audiológica.

Resultados: o curso online foi eficaz na melhoria do conhecimento dos participantes. Totalizaram-se 102 crianças acompanhadas, 15 delas encaminhadas para avaliação. Destas, quatro realizaram triagem auditiva e 11 realizaram a avaliação auditiva completa, sendo identificado um caso de perda auditiva condutiva.

Conclusão: a implantação de um programa de identificação e intervenção da perda auditiva nos primeiros anos de vida na atenção primária, permeada por agentes comunitários de saúde, mostrou-se viável.

Palavras-chave

Perda Auditiva; Agentes Comunitários de Saúde; Capacitação em Serviço; Atenção Primária à Saúde

References

1. Brasil. Ministério da Saúde. 2021. Relatório Anual de Gestão do Ministério da Saúde [homepage on the internet] [acessed 2022 nov 2]. Available at: https://bvsms.saude.gov.br/bvs/publicacoes/relatorio_anual_gestao_2021.pdf.

2. World Health Organization. The Report of the International Workshop on Primary Ear and Hearing Care - Cape Town [homepage on the internet] 1998. [accessed 2020 nov 2]. África do Sul. Available at: https://apps.who.int/iris/bitstream/handle/10665/66384/WHO_PBD_PDH_00.10.pdf?sequence=1&isAllowed=y

3. Brasil. Ministério da Saúde. Portaria nº 2.436, de 21 de novembro de 2017. Aprova a política Nacional de Atenção Básica [homepage on the internet]. 2017 [accessed 2022 nov 2]. Available at: http://bvsms.saude.gov.br/bvs/saudelegis/gm/2017/prt2436_22_09_2017.html

4. Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Ações Programáticas Estratégicas. Diretrizes de Atenção à Triagem Auditiva Neonatal [homepage on the internet]. Brasília: Ministério da Saúde, 2012, 32 p. [acessed 2023 jan 6]. Available at: https://bvsms.saude.gov.br/bvs/publicacoes/diretrizes_atencao_triagem_auditiva_neonatal.pdf

5. World Health Organization [homepage on the internet]. Deafness and hearing loss. 2021 [acessed 2022 nov 2]. Available at: https://www.who.int/news-room/fact-sheets/detail/deafness-and-hearing-loss.

6. O'Donovan J, Namanda AS, Hamala R, Winters N, Bhutta MF. Exploring perceptions, barriers, and enablers for delivery of primary ear and hearing care by community health workers: a photovoice study in Mukono District, Uganda. Int J Equity Health. 2020;19(1):62. https://doi.org/10.1186/s12939-020-01158-8. PMID: 32381090.

7. World Health Organization. World report on hearing. Geneva: World Health Organization [homepage on the internet] 2021. [acessed 2023 jan 6]. Available at: https://www.who.int/publications/i/item/9789240020481.

8. Brasil. Ministério da Saúde. Secretaria de Gestão do Trabalho e da Educação na Saúde. Departamento de Gestão da Educação na Saúde. Política Nacional de Educação Permanente em Saúde: o que se tem produzido para o seu fortalecimento? 1. ed. rev. [homepage on the internet]. Brasília: Ministério da Saúde, 2018. 73 p. [acessed 2023 jan 6]. Available at: https://bvsms.saude.gov.br/bvs/publicacoes/politica_nacional_educacao_permanente_saude_fortalecimento.pdf

9. Alvarenga KF, Bevilacqua MC, Martinez MAN, Melo TM, Blasca WQ, Taga MFDL. Training proposal for community health agents in hearing health. Pró-Fono R. Atual. Cient. 2008;20(3):171-6. https://doi.org/10.1590/s0104-56872008000300006. PMID: 18852964.

10. Melo TMD, Alvarenga KDF, Blasca WQ, Taga MFDL. Community health agents training on hearing health: effectiveness of videoconference. Pró-Fono R. Atual. Cient. 2010;22(2):139-44. https://doi.org/10.1590/S0104-56872010000200012. PMID: 20640378.

11. Araújo ES, Jacob-Corteletti LCB, Abramides DVM, Alvarenga K de F. Community health workers training on infant hearing health: information retention. Rev. CEFAC. 2015;17(2):445-53. https://doi.org/10.1590/1982-0216201511913.

12. Araújo ES, Alvarenga KF, Urnau D, Pagnossin DF, Wen CL. Community health worker training for infant health: effectiveness of distance learning. Int J Audiol. 2013;52(9):636-41. https://doi.org/10.3109/14992027.2013.791029. PMID: 23711174.

13. Oliveira MTD, Alvarenga KF, Costa KTLD, Regini VBG, Balen SA, Jacob-Corteletti LCB et al. Effectiveness of an online continuing education course in infant hearing health for primary care professionals. Int J Audiol. 2022;62(5):453-61. https://doi.org/10.1080/14992027.2022.2050821. PMID: 35343871.

14. Sánchez D, Adamovich S, Ingram M, Harris FP, de Zapien J, Sánchez A et al. The potential in preparing community health workers to address hearing loss. J Am Acad Audiol. 2017;28(6):562-574. https://doi.org/10.3766/jaaa.16045. PMID: 28590899.

15. Araújo ES, Lima FS, Alvarenga KDF. Monitoring of children with risk indicators for hearing loss. Rev. CEFAC. 2013;15(2):305-13. https://doi.org/10.1590/S1516-18462012005000077.

16. O'Donovan J, Verkerk M, Winters N, Chadha S, Bhutta MF. The role of community health workers in addressing the global burden of ear disease and hearing loss: a systematic scoping review of the literature. BMJ Glob Health. 2019;4(2):e001141. https://doi.org/10.1136/bmjgh-2018-001141. PMID: 30899572.

17. Suen JJ, Bhatnagar K, Emmett SD, Marrone N, Robler SK, Swanepoel W et al. Hearing care across the life course provided in the community. Bull World Health Organ. 2019;97(10):681-90. https://doi.org/10.2471/BLT.18.227371. PMID: 31656333.

18. Alvarenga KF, Araújo ES, Melo TMD, Martinez MAN, Bevilacqua MC. Questionnaire for monitoring auditory and language development in the first year. Codas. 2013;25(1):16-21. https://doi.org/10.1590/s2317-17822013000100004. PMID: 24408165.

19. Frankenburg WK, Dodds J, Archer P, Shapiro H, Bresnick B. The Denver II: a major revision and restandardization of the Denver Developmental Screening Test. Pediatrics. 1992;89(1):91-7. https://doi.org/10.1542/peds.89.1.91. PMID: 1370185.

20. Coplan J, Gleason JR. Test-retest and interobserver reliability of the Early Language Milestone Scale. J Pediatr Health Care. 1993;7(5):212-9. https://doi.org/10.1016/0891-5245(93)90006-4. PMID: 8410587.

21. Lima MCMP, Barbarini GC, Gagliardo HGRG, Arnais MADO, Gonçalves VMG. Observation of language, visual and hearing function development in infants. Rev Saúde Públ. 2004;38(1):106-12. https://doi.org/10.1590/S0034-89102004000100015. PMID: 14963549.

22. Hall JW. Crosscheck principle in pediatric audiology today: a 40-year perspective. J Audiol Otol. 2016;20(2):59-67. https://doi.org/10.7874/jao.2016.20.2.59. PMID: 27626077.

23. Comitê Gestor da Internet no Brasil, editor [homepage on the internet]. ICT in health 2021: survey on the use of information and communication technologies in Brazilian health care facilities. São Paulo, 2021 - [acessed 2023 feb 6]. Available at: https://cetic.br/media/docs/publicacoes/2/20211130124545/tic_saude_2021_livroeletronico.pdf.

24. Brasil. Ministério da Saúde [homepage on the internet] Portaria nº 2.983, de 11 de novembro de 2019. [acessed 2022 nov 2]. Programa de Apoio à Informatização e Qualificação dos Dados da Atenção Primária à Saúde - Informatiza APS. Available at: https://www.in.gov.br/en/web/dou/-/portaria-n-2.983-de-11-de-novembro-de-2019-227652196.

25. Nicholson N, Rhoades EA, Glade RE. Analysis of health disparities in the screening and diagnosis of hearing loss: early hearing detection and intervention hearing screening follow-up survey. Am J Audiol. 2022;31(3):764-88.

26. Juarez JM, Shaffer AD, Chi DH. Follow-up after failed newborn hearing screening: parental and primary care provider awareness. Am J Otolaryngol. 2020;41(6):102614. https://doi.org/10.1016/j.amjoto.2020.102614. PMID: 32622290.

27. Joint Committee on Infant Hearing. Year 2019 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs. J Early Hear Detect Interv. 2019;4(2):1-44. https://doi.org/10.15142/fptk-b748.

28. Oliveira TDS, Dutra MRP, Cavalcanti HG. Newborn Hearing Screening: association between coverage, and the availability of speech therapists and equipment in Brazil. Codas. 2021;33(2):e20190259. https://doi.org/10.1590/2317-1782/20202019259. PMID: 33978104.

29. Vernier LS, Cazella SC, Levandowski DC. Neonatal Hearing Screening: protocols, obstacles and perspectives of speech therapists in Brazil - 10 years of Brazilian Federal Law 12,303/2010. Codas. 2022;34(2):e20200331. https://doi.org/10.1590/2317-1782/20212020331. PMID: 35043864.

30. Lopes DMQ, Lunardi Filho WD, Beck CLC, Coelho APF. The workload of the community health agent: research and assistance in the perspective of convergent-care. Texto Contexto Enferm. 2018;27(4):e3850017. https://doi.org/10.1590/0104-07072018003850017.

31. Costa IS da S, Torres ACS, Bezerra MIC, Pires RR. Processo de trabalho de agentes comunitários e saúde mental: percepções de trabalhadores da saúde de um município do interior do Ceará. RSD. 2022;11(2):e4711225520. https://doi.org/10.33448/rsd-v11i2.25520.

32. Alsudays AM, Alharbi AA, Althunayyan FS, Alsudays AA, Alanazy SM, Al-Wutay O et al. Parental knowledge and attitudes to childhood hearing loss and hearing services in Qassim, Saudi Arabia. BMC Pediatr. 2020;20(1). https://doi.org/10.1186/s12887-020-02080-2. PMID: 32312244.

33. Ayas M, Yaseen H. Knowledge and attitudes of parents towards childhood hearing loss and pediatric hearing services in Sharjah, United Arab Emirates. Int J Environ Res Public Health. 2021;18(12):6188. https://doi.org/10.3390/ijerph18126188. PMID: 34201064.

34. Wong YA, Mukari SZS, Harithasan D, Mazlan R. Knowledge and attitude on childhood hearing loss among mothers and mothers-to-be in urban and rural areas in Malaysia. Int J Pediatr Otorhinolaryngol. 2019;124:79-84. https://doi.org/10.1016/j.ijporl.2019.05.040. PMID: 31174022.

35. Hussein D, D'Alessandro HD, Batuk MÖ, Ekhwan A, Sennaroglu G. Views of Syrian mothers in Ankara on infant hearing loss: cross-sectional survey. Matern Child Health J. 2022;26(11):2247-2253. https://doi.org/10.1007/s10995-022-03488-1. PMID: 36065040.

36. Ehlert K, Coetzer C. Maternal knowledge and views regarding early hearing detection and intervention in children aged 0-5 years at a semi-urban primary care clinic in South Africa. S Afr J Commun Disord. 2020;67(1):e1-e8. https://doi.org/10.4102/sajcd.v67i1.681. PMID: 32787415.
 


Submitted date:
11/03/2022

Accepted date:
02/23/2023

65c51abba953950c9623c7d4 cefac Articles
Links & Downloads

Revista CEFAC

Share this page
Page Sections