Speech Intelligibility and Cognition: Are Inpatients Impaired by Noise?
Condition: Auditory Perception; Memory; Hearing Impairment
MeSH terms: Hearing Loss; Deafness
Study type: Interventional

Summary: 
      Study Objectives:

        -  1. To examine the extent to which noise typical of nursing units reduces speech
           intelligibility in acutely ill hospitalized patients

        -  2. To examine the extent to which noise typical of nursing units impairs recall in
           acutely ill hospitalized patients

        -  3. To quantify severity of reduced performance associated with age, familiarity with the
           healthcare setting, hearing and health status.

      Plan:

      One hundred and twenty inpatients from the four medical/surgical nursing units at the
      Portland VA Medical Center, 60 with normal hearing and 60 with hearing impairment will be
      recruited to participate in the study. Following assessment to ascertain eligibility and
      obtaining informed consent, patients will be tested in a sound booth housed at the National
      Center for Rehabilitative Auditory Research (NCRAR). Designed so that each patient serves as
      his or her own control, we can accommodate considerable baseline variability between patients
      without adversely affecting required sample size. Patients' performance in speech
      intelligibility and recall tests will be measured using a constant level of speech, in
      controlled environments of no noise (baseline), white noise, hospital noise and hospital
      noise with speech, all delivered via headphones in pseudo-random order. Performance will be
      measured in each type of noise at decibel levels equivalent to those currently experienced on
      nursing units and at lower levels that prior studies have shown are more conducive to
      effective communication

      By selecting measures that are particularly relevant to the safe care of hospitalized
      patients, and that have been studied extensively in healthy populations in highly controlled
      conditions, we expect to find compelling and unambiguous evidence that hospitalized patients
      correctly hear and recall very little of what is said to them during their hospitalizations.
      The majority of hospitalized patients stay on acute care nursing units during most or all of
      their hospitalizations, making this an appropriate population to study in the context of
      their responses to the noises typical in these environments. Perhaps most importantly, this
      study will heighten awareness of health-care personnel to the levels of impairment suffered
      by their patients - both in their ability to correctly interpret speech and to recall it - in
      the typical noisy environments of nursing units.
    


Intervention name(s): quiet; non-speech noise; speech noise
Intervention type(s): Other; Other; Other
Intervention description(s): no noise; noise without speech; noise with speech present
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: noise; speech intelligibility; cognition