Protective measures against COVID-19: communicative, social and emotional impacts on hearing aids users

Fornari, Bruna Luísa; Patatt, Fernanda Soares Aurélio

doi:10.1590/2317-6431-2022-2722en

Bruna Luísa Fornari

conception of the study

carried out data collection

analysis and interpretation of results

writing

Curso de Fonoaudiologia, Departamento de Fonoaudiologia, Universidade Federal de Santa Maria - UFSM - Santa Maria (RS), Brasil.

https://orcid.org/0000-0001-7577-2302

Fernanda Soares Aurélio Patatt

supervisor

conception of the study

analysis and interpretation of the results

review

Departamento de Fonoaudiologia, Universidade Federal de Santa Maria - UFSM - Santa Maria (RS), Brasil.

https://orcid.org/0000-0002-8175-9398

Conflict of interests: No.

Correspondence address: Bruna Luísa Fornari. E-mail: luisabrunaf@gmail.com

Tables (7)

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FORMULÁRIO DE COLETA DE DADOS (USUÁRIO DE PRÓTESE AUDITIVA) IDENTIFICAÇÃO DA COLETA Nº _________ Data da coleta: _______/_______/_______ Local: ____________________________________ IDENTIFICAÇÃO DO SUJEITO Nome: ________________________________________________________________________ Sexo: __________ Idade: _______ anos Data de nascimento: _______/_______/_______ CPF: ____________________________ Chegou acompanhado(a) de: ___________________________________________________________________________ Telefone: ____________ e ____________ E-mail: ____________________________________________________ Estado civil: __________ Reside com: ______________________________________________________________ 1. Faz acompanhamento médico/com outros profissionais da saúde: ( ) Sim ( ) Não 2. Em caso afirmativo, quais:____________________________________________________________________________ DADOS AUDIOLÓGICOS E DA PROTETIZAÇÃO Data da última audiometria: _______/_______/_______ Data da protetização: _______/_______/_______ 3. Em média, quantas horas por dia você fez uso dos aparelhos auditivos: ( ) no máximo 3 horas por dia ( ) de 3 a 6 horas por dia ( ) de 6 a 9 horas por dia ( ) de 9 a 12 horas por dia ( ) de 12 a 15 horas por dia ( ) mais de 15 horas por dia 4. Ficou sem usar o aparelho nos últimos meses: ( ) Sim ( ) Não Em caso afirmativo: 5. Quando_______/_______/_______ 6. Por quanto tempo: ______________________________ OCUPAÇÃO 7. Trabalha: ( ) Sim ( ) Não 8. Em que local trabalha: _________________________________________________ 9. Função exercida: ___________________________________________________________________________________ 10. Caso trabalhe, se manteve no mesmo emprego após o início da pandemia: ( ) Não ( ) Sim 11. Como ficou sua rotina de trabalho após o início da pandemia:________________________________________________ COVID-19 E MEDIDAS DE PROTEÇÃO 12. Adotou as medidas de isolamento social: ( ) Não ( ) Sim 13. Adotou as medidas de proteção ( ) Não ( ) Sim 14. Teve diagnóstico positivo para COVID-19: ( ) Sim ( ) Não 15. Quando: _______/_______/_______ 16. Percebeu alterações na audição após o diagnóstico: ( ) Sim ( ) Não 17. Caso sim, o que percebeu: ( ) Piora na audição - se teve, de qual lado: ( ) direito ( ) esquerdo ( ) ambos ( ) Passou a ter zumbido - Se sim, de qual lado: ( ) direito ( ) esquerdo ( ) ambos ( ) Piora do zumbido - se teve, de qual lado: ( ) direito ( ) esquerdo ( ) ambos ( ) Otalgia - se teve, de qual lado: ( ) direito ( ) esquerdo ( ) ambos ( ) Otorreia - se teve, de qual lado: ( ) direito ( ) esquerdo ( ) ambos ( ) Plenitude Auricular - se teve, de qual lado: ( ) direito ( ) esquerdo ( ) ambos 18. Apresentou tontura após o diagnóstico: ( ) Sim ( ) Não 19. Se teve tontura, esta foi de que tipo: ( ) Vertigem subjetiva ( ) Vertigem objetiva 20. Em caso afirmativo, quanto tempo durava a tontura: ( ) Segundos ( ) Minutos ( ) Horas ( ) Dias ( ) Meses ( ) Anos 21. Apresentou piora da tontura após o diagnóstico: ( ) Sim ( ) Não 22. Em caso afirmativo, antes a tontura era de que tipo: ( ) Vertigem subjetiva ( ) Vertigem objetiva 23. Em caso afirmativo, qual a duração da tontura antes: ( ) Segundos ( ) Minutos ( ) Horas ( ) Dias ( ) Meses ( ) Anos 24. Fez uso de medicamentos para tratamento dos sintomas da COVID-19: ( ) Sim ( ) Não 25. Em caso afirmativo, quais: ( ) Não se recorda ( ) Cloroquina ( ) Hidroxicloroquina ( ) Azitromicina ( ) Remdesivir ( ) Favipiravir ( ) Lopinavir ( ) Outros quais:______________________________________________________________ USO DE MÁSCARAS DE PROTEÇÃO FACIAL 26. Se comunicou com outras pessoas enquanto estas faziam uso de máscaras? ( ) Não ( ) Sim 27. Sentiu dificuldades para compreender o que as pessoas lhe diziam enquanto usavam máscaras? ( ) Não ( ) Às vezes ( ) Sim 28. Acredita que o fato das pessoas usarem máscaras quando conversam com você dificulta a comunicação com elas? ( ) Não ( ) Às vezes ( ) Sim DISTANCIAMENTO FÍSICO 29. Se comunicou com alguém mantendo distanciamento em relação a essa pessoa? ( ) Sim ( ) Não 30. Sentiu dificuldades para compreender o que lhe era dito ao manter distanciamento em relação ao falante? ( ) Não ( ) Às vezes ( ) Sim 31. Sentiu-se frustrado/triste ao não compreender o que estes lhe diziam por estarem mantendo distância? ( ) Não ( ) Às vezes ( ) Sim USO DE TECNOLOGIAS DIGITAIS 32. Fez uso de tecnologias digitais para se comunicar com outras pessoas a distância? ( ) Não ( ) Sim 33. Antes da pandemia você já fazia uso de tecnologias digitais para se comunicar com outras pessoas ou para trabalhar? ( ) Não ( ) Sim 34. Sentiu dificuldades para se comunicar por meio das tecnologias digitais? ( ) Não ( ) Às vezes ( ) Sim 35. Participou de videochamadas após o início da pandemia? ( ) Não ( ) Sim 36. Caso tenha participado de videochamadas, você sentiu que sua comunicação foi prejudicada, em virtude de dificuldades auditivas? ( ) Não ( ) Às vezes ( ) Sim MEDIDAS DE PROTEÇÃO E DIFICULDADES COMUNICATIVAS 37. No geral, sente que as medidas de proteção dificultaram sua comunicação com outras pessoas? ( ) Não ( ) Às vezes ( ) Sim 38. No geral, sentiu-se frustrado/triste por não compreender o que queriam lhe dizer por causa das medidas de proteção? ( ) Não ( ) Às vezes ( ) Sim 39. No geral, sente que as medidas de proteção dificultaram sua vida social? ( ) Não ( ) Às vezes ( ) Sim 40. No geral, caso trabalhe, sente que as medidas de proteção dificultaram sua vida profissional? ( ) Não ( ) Às vezes ( ) Sim 41. No geral, as dificuldades de compreensão advindas das medidas de proteção fazem com que você interaja menos com outras pessoas? ( ) Não ( ) Às vezes ( ) Sim 42. Deixou de se comunicar com as pessoas em alguns momentos em virtude de possíveis dificuldades comunicativas causadas pelas modificações impostas pela pandemia? ( ) Não ( ) Às vezes ( ) Sim

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Table 1
Audiological profile of the sample subjects, according to the groups

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Table 2
Characterization and comparison of the sample of both groups regarding the variable time of use of the devices

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Table 3
Distribution of users’ responses to questions regarding protective measures and comparison between groups

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Table 4
Association between the communicative difficulties generated by the protective measures and the variables time of use of the devices and degree of hearing loss, in both groups

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Table 5
Association between difficulties in socialization generated by protective measures and the variables time of use of devices and degree of hearing loss, in both groups

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DATA COLLECTION FORM (HEARING AID USER) COLLECTION IDENTIFICATION No. _________ Collection date: _______/_______/_______ Location: ____________________________________ SUBJECT IDENTIFICATION Name: ______________________________________________________________________ Gender: __________ Age: _______ years Date of birth: _______/_______/_______ CPF: ____________________________ Arrived accompanied by: ___________________________________________________________________________ Phone: ____________ and ____________ Email: ____________________________________________________ Marital status: __________ Resides with: ____________________________________________________________ 1. Performs medical follow-up/with other health professionals: ( ) Yes ( ) No 2. If yes, which:____________________________________________________________________________ AUDIOLOGICAL AND PROSTHETIZATION DATA Date of last audiometry: _______/_______/_______ Date of prosthetization: _______/_______/_______ 3. On average, how many hours per day did you use the hearing aids: ( ) maximum 3 hours per day ( ) from 3 to 6 hours per day ( ) from 6 to 9 hours per day ( ) from 9 to 12 hours per day ( ) from 12 to 15 hours per day ( ) more than 15 hours per day 4. Did not use the device in the last months: ( ) Yes ( ) No If yes: 5. When_______/_______/_______ 6. How long: ______________________________ OCCUPATION 7. Do you work: ( ) Yes ( ) No 8. Where you work: _________________________________________________9. Job function: ___________________________________________________________________________________10. If you work, did you remain in the same job after the beginning of the pandemic: ( ) No ( ) Yes11. How was your work routine after the beginning of the pandemic:________________________________________________ COVID-19 AND PROTECTIVE MEASURES 12. Did you adopt social isolation measures: ( ) No ( ) Yes 13. Did you adopt protective measures ( ) No ( ) Yes 14. Did you have a positive diagnosis for COVID-19: ( ) Yes ( ) No 15. When: _______/_______/_______ 16. Did you perceive changes in hearing after diagnosis: ( ) Yes ( ) No 17. If so, what did you notice: ( ) Worsening in hearing - if you had it, on which side: ( ) right ( ) left ( ) both ( ) Started to have tinnitus - If so, on which side: ( ) right ( ) left ( ) both ( ) Worsening of tinnitus - if you had it, on which side: ( ) right ( ) left ( ) both ( ) Otalgia - if you had it, on which side: ( ) right ( ) left ( ) both ( ) Otorrhea - if you had it, on which side: ( ) right ( ) left ( ) both ( ) Auricular Fullness - if you had it, on which side: ( ) right ( ) left ( ) both 18. Did you experience dizziness after diagnosis: ( ) Yes ( ) No 19. If you had dizziness, this was of what type: ( ) Subjective vertigo ( ) Objective vertigo 20. If so, how long did the dizziness last: ( ) Seconds ( ) Minutes ( ) Hours ( ) Days ( ) Months ( ) Years 21. Did you present worsening of dizziness after diagnosis: ( ) Yes ( ) No 22. If yes, before the dizziness was of what type: ( ) Subjective vertigo ( ) Objective vertigo 23. If yes, what was the duration of dizziness before: ( ) Seconds ( ) Minutes ( ) Hours ( ) Days ( ) Months ( ) Years 24. Did you use medications to treat the symptoms of COVID-19: ( ) Yes ( ) No 25. If yes, which: ( ) Do not remember ( ) Chloroquine ( ) Hydroxychloroquine ( ) Azithromycin ( ) Remdesivir ( ) Favipiravir ( ) Lopinavir ( ) Other, which:______________________________________________________________ USE OF FACE PROTECTION MASKS 26. Did you communicate with others while wearing masks? ( ) No ( ) Yes 27. Did you have difficulty understanding what people were saying to you while wearing masks? ( ) No ( ) Sometimes ( ) Yes 28. Do you believe that the fact that people wear masks when talking to you makes it difficult to communicate with them? ( ) No ( ) Sometimes ( ) Yes PHYSICAL DISTANCING 29. Have you communicated with anyone while distancing from them? ( ) Yes ( ) No 30. Did you have difficulty understanding what was said to you when distancing from the speaker? ( ) No ( ) Sometimes ( ) Yes 31. Did you feel frustrated/sad when you did not understand what they told you because they kept their distance? ( ) No ( ) Sometimes ( ) Yes USE OF DIGITAL TECHNOLOGIES 32. Did you use digital technologies to communicate with others at a distance? ( ) No ( ) Yes 33. Before the pandemic, did you already use digital technologies to communicate with others or to work? ( ) No ( ) Yes 34. Did you have difficulties communicating through digital technologies? ( ) No ( ) Sometimes ( ) Yes 35. Did you participate in video calls after the beginning of the pandemic? ( ) No ( ) Yes 36. If you participated in video calls, did you feel your communication was impaired due to hearing difficulties? ( ) No ( ) Sometimes ( ) Yes PROTECTION MEASURES AND COMMUNICATION DIFFICULTIES 37. Overall, do you feel that protective measures made it difficult for you to communicate with others? ( ) No ( ) Sometimes ( ) Yes 38. Overall, did you feel frustrated/sad about not understanding what they wanted to tell you because of the protective measures? ( ) No ( ) Sometimes ( ) Yes 39. Overall, do you feel protective measures made your social life difficult? ( ) No ( ) Sometimes ( ) Yes 40. Overall, if you work, do you feel the protective measures have made your professional life difficult? ( ) No ( ) Sometimes ( ) Yes 41. Overall, do the difficulties of understanding arising from protective measures cause you to interact less with other people? ( ) No ( ) Sometimes ( ) Yes 42. Did you stop communicating with people at times due to possible communication difficulties caused by the changes imposed by the pandemic? ( ) No ( ) Sometimes ( ) Yes

Variables		Adults			Older people			p-value
Variables		N	%	p-value	N	%	p-value	p-value
Degree of hearing loss RE** (n=72)	Mild	0	0.0%	<0.001*	4	8.2%	<0.001*	0.369
	Moderate	7	30.4%	0.008*	14	28.6%	<0.001*
	Mod. Severe	16	69.6%	Ref.	31	63.3%	Ref.
Degree of hearing loss LE^ Classification of the degree of hearing loss according to WHO15 (n=72)	Mild	0	0.0%	<0.001*	3	6.1%	<0.001*	0.046
	Moderate	12	52.2%	Ref.	12	24.5%	<0.001*
	Mod. Severe	11	47.8%	0.768	34	69.4%	Ref.
Type of hearing loss RE (n=72)	Sensorineural	18	78.3%	Ref.	44	89.8%	Ref.	0.419
	Mixed	4	17.4%	<0.001^* * Statistically significant values (p≤0.05) - Test of Equality of Two Proportions and Chi-Square; < less than;	4	8.2%	<0.001*
	Conductive	1	4.3%	<0.001*	1	2.0%	<0.001*
Type of hearing loss LE (n=72)	Sensorineural	17	73.9%	Ref.	45	91.8%	Ref.	0.081
	Mixed	5	21.7%	<0.001*	4	8.2%	<0.001*
	Conductive	1	4.3%	<0.001*	0	0.0%	<0.001*

Time of daily use	Adult			Older people			p-value
Time of daily use	n	%	p-value	n	%	p-value	p-value
Up to 6 hours	0	0.0%	<0.001^* * Statistically significant values (p≤0.05) - Test of Equality of Two Proportions and Chi-Square; < less than	7	14.3%	<0.001*
From 6 to 12 hours	6	26.1%	0.001*	15	30.6%	0.014*	0.116
12 hours or more	17	73.9%	Ref.	27	55.1%	Ref.

Questions		Adults			Older people			p-value
Questions		n	%	p-value	N	%	p-value	p-value
Masks: Did you have difficulty understanding what people were saying to you while wearing masks?	No	2	8.7%	0.001*	9	18.4%	<0.001*	0.264
	Sometimes	9	39.1%	0.375	11	22.4%	<0.001*
	Yes	12	52.2%	Ref.	29	59.2%	Ref.
Masks: Do you believe that the fact that people wear masks when talking to you makes it difficult to communicate with them?	No	2	8.7%	<0.001*	7	14.3%	<0.001*	0.781
	Sometimes	5	21.7%	0.001*	9	18.4%	<0.001*
	Yes	16	69.6%	Ref.	33	67.3%	Ref.
Distancing: Did you have difficulty understanding what was said to you when distancing from the speaker?	No	3	14.3%	0.001*	12	26.1%	<0.001*	0.102
	Sometimes	5	23.8%	0.013*	3	6.5%	<0.001*
	Yes	13	61.9%	Ref.	31	67.4%	Ref.
Distancing: Did you feel frustrated/sad when you did not understand what they told you because they were keeping their distance?	No	11	52.4%	Ref.	22	47.8%	Ref.	0.160
	Sometimes	0	0.0%	<0.001*	7	15.2%	<0.001*
	Yes	10	47.6%	0.758	17	37.0%	0.291
Technologies: Before the pandemic, did you already use digital technologies to communicate with others or to work?	Yes	22	95.7%	Ref.	43	87.8%	Ref.	0.292
	No	1	4.3%	<0.001*	6	12.2%	<0.001*	0.292
Technologies: Did you have difficulties communicating through digital technologies?	No	10	43.5%	Ref.	30	68.2%	Ref.	0.090
	Sometimes	7	30.4%	0.359	5	11.4%	<0.001*
	Yes	6	26.1%	0.216	9	20.5%	<0.001*
Technologies: Did you participate in video calls after the beginning of the pandemic?	Yes	15	65.2%	Ref.	26	53.1%	Ref.	0.331
	No	8	34.8%	0.039*	23	46.9%	0.544	0.331
Technologies: If you participated in video calls, did you feel your communication was impaired due to hearing difficulties?	No	8	53.3%	Ref.	14	53.8%	Ref.	0.038*
	Sometimes	6	40.0%	0.464	3	11.5%	0.001*
	Yes	1	6.7%	0.005*	9	34.6%	0.163
Overall, did you feel that protective measures made it difficult for you to communicate with others?	No	7	30.4%	0.134	11	22.4%	0.031*	0.316
	Sometimes	4	17.4%	0.013*	17	34.7%	0.407
	Yes	12	52.2%	Ref.	21	42.9%	Ref.
Overall, did you feel frustrated/sad about not understanding what they wanted to tell you because of the protective measures?	No	6	26.1%	0.008*	30	61.2%	Ref.	0.020*
	Sometimes	2	8.7%	<0.001^* * Statistically significant values (p≤0.05) - Test of Equality of Two Proportions; < less than	3	6.1%	<0.001*
	Yes	15	65.2%	Ref.	16	32.7%	0.005*
Overall, did you feel that protective measures made your social life difficult?	No	11	47.8%	Ref.	24	49.0%	Ref.	0.938
	Sometimes	3	13.0%	0.010*	5	10.2%	<0.001*
	Yes	9	39.1%	0.552	20	40.8%	0.417
Overall, did you stop communicating due to possible communication difficulties caused by the changes imposed by the pandemic?	No	11	47.8%	Ref.	25	51.0%	Ref.	0.847
	Sometimes	3	13.0%	0.010*	8	16.3%	<0.001*
	Yes	9	39.1%	0.552	16	32.7%	0.065

Overall, did you feel that protective measures made it difficult for you to communicate with others?			No		Sometimes		Yes		Total		p-value
			n	%	n	%	n	%	n	%	p-value
Adults	Time of daily use of hearing aids	6-12 hours	2	28.6%	2	50.0%	2	16.7%	6	26.1%	0.415
	Time of daily use of hearing aids	12 hours or more	5	71.4%	2	50.0%	10	83.3%	17	73.9%	0.415
	Degree of hearing loss BE^* * Classification of the degree of hearing loss according to WHO(15)	Moderate	3	42.9%	2	50.0%	9	75.0%	14	60.9%	0.340
		Moderately Severe	4	57.1%	2	50.0%	3	25.0%	9	39.1%	0.340
Older people	Time of daily use of hearing aids	Up to 6 hours	1	9.1%	2	11.8%	4	19.0%	7	14.3%	0.892
		6-12 hours	3	27.3%	5	29.4%	7	33.3%	15	30.6%
		12 hours or more	7	63.6%	10	58.8%	10	47.6%	27	55.1%
	Degree of hearing loss BE*	Mild	2	18.2%	3	17.6%	0	0.0%	5	10.2%	0.234
		Moderate	4	36.4%	5	29.4%	5	23.8%	14	28.6%
		Moderately Severe	5	45.5%	9	52.9%	16	76.2%	30	61.2%

Overall, did you feel that protective measures made your social life difficult?			No		Sometimes		Yes		Total		p-value
			N	%	N	%	N	%	N	%	p-value
Adults	Time of daily use of hearing aids	From 6 to 12 hours	4	36.4%	0	0%	2	22.2%	6	26.1%	0.421
	Time of daily use of hearing aids	More than 12 hours	7	63.6%	3	100%	7	77.8%	17	73.9%	0.421
	Degree of hearing loss BE*	Moderate	5	45.5%	1	33.3%	8	88.9%	14	60.9%	0.081
	Degree of hearing loss BE*	Mod. Severe	6	54.5%	2	66.7%	1	11.1%	9	39.1%	0.081
Older people	Time of daily use of hearing aids	Up to 6 hours	3	12.5%	1	20.0%	3	15.0%	7	14.3%	0.591
		From 6 to 12 hours	5	20.8%	2	40.0%	8	40.0%	15	30.6%
		More than 12 hours	16	66.7%	2	40.0%	9	45.0%	27	55.1%
	Degree of hearing loss BE^* * Classification of the degree of hearing loss according to WHO(15)	Mild	4	16.7%	0	0.0%	1	5.0%	5	10.2%	0.593
		Moderate	7	29.2%	2	40.0%	5	25.0%	14	28.6%
		Mod. Severe	13	54.2%	3	60.0%	14	70.0%	30	61.2%

[1] Conflict of interests: No.

Brasil

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Protective measures against COVID-19: communicative, social and emotional impacts on hearing aids users

ABSTRACT

Purpose

Methods

Results

Conclusion