Från förnekande till integration. En kvalitativ studie av kvinnors förhållningssätt inför audiologisk rehabilitering.

Abstract

Adjustment to acquired hearing loss can be understood as a process of learning and change where the point of departure is the subjective apppraisal of a person’s hearing loss in a social and cultural context. The aim of the study was to describe women’s thoughts, emotions and actions prior to audiological rehabilitation, since these are considered important for the ongoing process of adjustment and for the planning of rehabilitation. A phenomenographical approach was used in order to describe the variation in the women’s attitudes before attending rehabilitation. The subjects in the study were 14 women with acquired hearing loss, waiting for their first visit to the hearing clinic. The result shows 17 separate categories of description representing qualitatively different attitudes. The categories are presented from three different angles. The ability to hear, The hearing loss and The encounter with the health care system/hearing care system. The descriptive categories regarding “The ability to hear” are: Normative, Perceptual, Interactive and Existential. From the aspect of “The hearing loss” the categories are: Denial, Stigmatisation, Being left out, Deception, One-sidedness, Integration and Mutuality. With regard to “The encounter with the health care system/Hearing care system” the categories are divided up into the following: Uncertainty, Reluctance, Autonomy, confirmation, Dependence and Self-reliance. The results show an extensive variation in the women’s attitudes, influenced by whether the hearing loss is a part of the self-image or if it is perceived as a threat. This individualized process of adjustment cannot easily be defined as stages in a help-seeking process as suggested by Jones et al. (1978). If the process instead is understood as a learning-process, generated by the construction of meaning in a social and cultural context, the different starting-points for adjustment and rehabilitation become obvious. Mezirows theory on transformative learning (Mezirow, 1991) describes how learning and change in adult years are structured. In this study, Mezirows theory is discussed as the basis for understanding the adjustment process and how rehabilitation can support change and development in the individual. The results also show the significance of confirmation, knowledge and self-direction in the process of adjustment, which are all fundamental components in theories of adult learning.