The Role of Training in Changing the Attitude of Audiologists in Iran Towards Using Cognitive-Behavioral Therapy for Tinnitus Management
,
Abstract
Background and Aim: Evidence-Based Practice (EBP) is recommended by specialists for curing the patients more than other conventional treatments. In tinnitus management, Cognitive-Behavioral Therapy (CBT) is the only EBP-based method. Different factors, such as training, can affect the therapists’ attitudes towards the use of these treatments. This study aimed to investigate the effect of a training program in CBT on Iranian audiologists’attitudes towards using CBT for tinnitus management.
Methods: This descriptive-analytical study was conducted on 88 audiologists (including 65 females) with a mean age of 33±9.54 years, who were randomly divided into two groups of intervention (receiving CBT training) and control (no training). The data were collected by a researcher-made demographic/clinical questionnaire and the Persian version of the Evidence-Based Practice Attitude Scale-35 (EBPAS-P35), which was completed before and after training.
Results: Comparison of the total score of EBPAS-P35 showed a significant difference in the intervention groups before and after training (p<0.001). In addition, all EBPAS-P35 subscales scores were significantly different before and after training in the intervention group (p<0.001). A positive significant correlation was observed between the total score of the EBPAS-P35 and two factors of age (r=0.38, p=0.009) and clinical experience (r=0.34, p=0.009).
Conclusion: Training in CBT can improve the attitude of audiologists in Iran towards using CBT for tinnitus management in patients. The age and clinical experience can affect the attitude of audiologists toward using CBT.
1. Aarons GA. Mental health provider attitudes toward adoption of evidence-based practice: The Evidence-Based Practice Attitude Scale (EBPAS). Ment Health Serv Res. 2004;6(2):61-74. [DOI:10.1023/b:mhsr.0000024351.12294.65]
2. Frambach RT, Schillewaert N. Organizational innovation adoption: a multi-level framework of determinants and opportunities for future research. J Bus Res. 2002;55(2):163-76. [DOI:10.1016/S0148-2963(00)00152-1]
3. Glisson C. The organizational context of children’s mental health services. Clin Child Fam Psychol Rev. 2002;5(4):233-53. [DOI:10.1023/a:1020972906177]
4. Rim SH, Zittleman L, Westfall JM, Overholser L, Froshaug D, Coughlin SS. Knowledge, attitudes, beliefs, and personal practices regarding colorectal cancer screening among health care professionals in rural Colorado: a pilot survey. J Rural Health. 2009;25(3):303-8. [DOI:10.1111/j.1748-0361.2009.00234.x]
5. Rogers EM, Singhal A, Quinlan MM. Diffusion of innovations. In: Don W. Stacks DW, Salwen MB, editors. An Integrated Approach to Communication Theory and Research. 2nd ed. New York: Routledge; 2014. p. 418-34.
6. Axelsson A, Ringdahl A. Tinnitus--a study of its prevalence and characteristics. Br J Audiol. 1989;23(1):53-62. [DOI:10.3109/03005368909077819]
7. Mohsen S, Sadeghijam M, Talebian S, Pourbakht A. Use of Some Relevant Parameters for Primary Prediction of Brain Activity in Idiopathic Tinnitus Based on a Machine Learning Application. Audiol Neurootol. 2023:1-12. [DOI:10.1159/000530811]
8. Hallam RS, Rachman S, Hinchcliffe R. Psychological aspects of tinnitus. In: Rachman S, editor. Contributions to Medical Psychology. Vol. 3. Oxford, UK: Pergamon Press; 1984. p. 31-53.
9. Sadeghijam M, Moossavi A, Akbari M, Haghani H, Yousefi A, Mohsen S. An increase in the auditory steady-state response amplitudes after a period of listening to binaural beat stimuli in tinnitus patients: a pilot study. Egypt J Otolaryngol. 2023;39:39. [DOI:10.1186/s43163-023-00402-6]
10. Langguth B. A review of tinnitus symptoms beyond ‘ringing in the ears’: a call to action. Curr Med Res Opin. 2011;27(8):1635-43. [DOI:10.1185/03007995.2011.595781]
11. Cima RF, Maes IH, Joore MA, Scheyen DJ, El Refaie A, Baguley DM, et al. Specialised treatment based on cognitive behaviour therapy versus usual care for tinnitus: a randomised controlled trial. Lancet. 2012;379(9830):1951-9. [DOI:10.1016/S0140-6736(12)60469-3]
12. Hesser H, Weise C, Westin VZ, Andersson G. A systematic review and meta-analysis of randomized controlled trials of cognitive-behavioral therapy for tinnitus distress. Clin Psychol Rev. 2011;31(4):545-53. [DOI:10.1016/j.cpr.2010.12.006]
13. Jastreboff PJ. Phantom auditory perception (tinnitus): mechanisms of generation and perception. Neurosci Res. 1990;8(4):221-54. [DOI:10.1016/0168-0102(90)90031-9]
14. Hallam RS, Jakes SC, Hinchcliffe R. Cognitive variables in tinnitus annoyance. Br J Clin Psychol. 1988;27(3):213-22. [DOI:10.1111/j.2044-8260.1988.tb00778.x]
15. Shayanmehr S, Sadeghijam M, Jalaie S, Pourbakht A, Jarollahi F, Asghari A, et al. Cultural Adaptation and Psychometric Properties of the Persian Version of the Evidence-Based Practice Attitudes Scale in Audiologists. Aud Vestib Res. 2023;32(4):322-33. [DOI:10.18502/avr.v32i4.13596]
16. Nelson TD, Steele RG. Predictors of practitioner self-reported use of evidence-based practices: practitioner training, clinical setting, and attitudes toward research. Adm Policy Ment Health. 2007;34(4):319-30. [DOI:10.1007/s10488-006-0111-x]
17. Bearman SK, Wadkins M, Bailin A, Doctoroff G. Pre-Practicum Training in Professional Psychology to Close the Research-Practice Gap: Changing Attitudes Towards Evidence-Based Practice. Train Educ Prof Psychol. 2015;9(1):13-20. [DOI:10.1037/tep0000052]
18. Leathers SJ, Melka-Kaffer C, Spielfogel JE, Atkins MS. Use of evidence-based interventions in child welfare: Do attitudes matter? Child Youth Serv Rev. 2016;70:375-82. [DOI:10.1016/j.childyouth.2016.10.022]
19. James S, Lampe L, Behnken S, Schulz D. Evidence-based practice and knowledge utilisation – a study of attitudes and practices among social workers in Germany. Eur J Soc Work. 2019;22(5):763-77. [DOI:10.1080/13691457.2018.1469475]
20. Tomotaki A, Fukahori H, Sakai I. Exploring sociodemographic factors related to practice, attitude, knowledge, and skills concerning evidence-based practice in clinical nursing. Jpn J Nurs Sci. 2020;17(1):e12260. [DOI:10.1111/jjns.12260]
21. Sadeghi-Bazargani H, Tabrizi JS, Azami-Aghdash S. Barriers to evidence-based medicine: a systematic review. J Eval Clin Pract. 2014;20(6):793-802. [DOI:10.1111/jep.12222]
22. Zwolsman S, te Pas E, Hooft L, Wieringa-de Waard M, van Dijk N. Barriers to GPs’ use of evidence-based medicine: a systematic review. Br J Gen Pract. 2012;62(600):e511-21. [DOI:10.3399/bjgp12X652382]
23. Nussbaumer-Streit B, Jesser A, Humer E, Barke A, Doering BK, Haid B, et al. A web-survey assessed attitudes toward evidence-based practice among psychotherapists in Austria. Sci Rep. 2022;12(1):9374. [DOI:10.1038/s41598-022-13266-2]
24. Ogborne AC, Wild TC, Braun K, Newton-Taylor B. Measuring treatment process beliefs among staff of specialized addiction treatment services. J Subst Abuse Treat. 1998;15(4):301-12. [DOI:10.1016/s0740-5472(97)00196-7]
25. Aarons GA, Sawitzky AC. Organizational Culture and Climate and Mental Health Provider Attitudes Toward Evidence-Based Practice. Psychol Serv. 2006;3(1):61-72. [DOI:10.1037/1541-1559.3.1.61]
26. Walrath CM, Sheehan AK, Holden EW, Hernandez M, Blau G. Evidence-based treatments in the field: a brief report on provider knowledge, implementation, and practice. J Behav Health Serv Res. 2006;33(2):244-53. [DOI:10.1007/s11414-005-9008-9]
27. Scurlock-Evans L, Upton P, Upton D. Evidence-based practice in physiotherapy: a systematic review of barriers, enablers and interventions. Physiotherapy. 2014;100(3):208-19. [DOI:10.1016/j.physio.2014.03.001]
28. Khammarnia M, Haj Mohammadi M, Amani Z, Rezaeian S, Setoodehzadeh F. Barriers to implementation of evidence based practice in zahedan teaching hospitals, Iran, 2014. Nurs Res Pract. 2015;2015:357140. [DOI:10.1155/2015/357140]
29. Jordan PJ, Bowers CA, Morton D. Barriers to implementing evidence-based practice in a private intensive care unit in the Eastern Cape. South Afr J Crit Care. 2016;32(2):50-4. [DOI:10.7196/SAJCC.2016.v32i2.253]
30. Johnston B, Coole C, Narayanasamy M, Feakes R, Whitworth G, Tyrell T, et al. Exploring the barriers to and facilitators of implementing research into practice. Br J Community Nurs. 2016;21(8):392-8. [DOI:10.12968/bjcn.2016.21.8.392]
31. Azmoude E, Aradmehr M, Dehghani F. Midwives’ Attitude and Barriers of Evidence Based Practice in Maternity Care. Malays J Med Sci. 2018;25(3):120-8. [DOI:10.21315/mjms2018.25.3.12]
32. Alatawi M, Aljuhani E, Alsufiany F, Aleid K, Rawah R, Aljanabi S, et al. Barriers of Implementing Evidence-Based Practice in Nursing Profession: A Literature Review. Am J Nurs. 2020;9(1):35-42. [DOI:10.11648/j.ajns.20200901.16]
2. Frambach RT, Schillewaert N. Organizational innovation adoption: a multi-level framework of determinants and opportunities for future research. J Bus Res. 2002;55(2):163-76. [DOI:10.1016/S0148-2963(00)00152-1]
3. Glisson C. The organizational context of children’s mental health services. Clin Child Fam Psychol Rev. 2002;5(4):233-53. [DOI:10.1023/a:1020972906177]
4. Rim SH, Zittleman L, Westfall JM, Overholser L, Froshaug D, Coughlin SS. Knowledge, attitudes, beliefs, and personal practices regarding colorectal cancer screening among health care professionals in rural Colorado: a pilot survey. J Rural Health. 2009;25(3):303-8. [DOI:10.1111/j.1748-0361.2009.00234.x]
5. Rogers EM, Singhal A, Quinlan MM. Diffusion of innovations. In: Don W. Stacks DW, Salwen MB, editors. An Integrated Approach to Communication Theory and Research. 2nd ed. New York: Routledge; 2014. p. 418-34.
6. Axelsson A, Ringdahl A. Tinnitus--a study of its prevalence and characteristics. Br J Audiol. 1989;23(1):53-62. [DOI:10.3109/03005368909077819]
7. Mohsen S, Sadeghijam M, Talebian S, Pourbakht A. Use of Some Relevant Parameters for Primary Prediction of Brain Activity in Idiopathic Tinnitus Based on a Machine Learning Application. Audiol Neurootol. 2023:1-12. [DOI:10.1159/000530811]
8. Hallam RS, Rachman S, Hinchcliffe R. Psychological aspects of tinnitus. In: Rachman S, editor. Contributions to Medical Psychology. Vol. 3. Oxford, UK: Pergamon Press; 1984. p. 31-53.
9. Sadeghijam M, Moossavi A, Akbari M, Haghani H, Yousefi A, Mohsen S. An increase in the auditory steady-state response amplitudes after a period of listening to binaural beat stimuli in tinnitus patients: a pilot study. Egypt J Otolaryngol. 2023;39:39. [DOI:10.1186/s43163-023-00402-6]
10. Langguth B. A review of tinnitus symptoms beyond ‘ringing in the ears’: a call to action. Curr Med Res Opin. 2011;27(8):1635-43. [DOI:10.1185/03007995.2011.595781]
11. Cima RF, Maes IH, Joore MA, Scheyen DJ, El Refaie A, Baguley DM, et al. Specialised treatment based on cognitive behaviour therapy versus usual care for tinnitus: a randomised controlled trial. Lancet. 2012;379(9830):1951-9. [DOI:10.1016/S0140-6736(12)60469-3]
12. Hesser H, Weise C, Westin VZ, Andersson G. A systematic review and meta-analysis of randomized controlled trials of cognitive-behavioral therapy for tinnitus distress. Clin Psychol Rev. 2011;31(4):545-53. [DOI:10.1016/j.cpr.2010.12.006]
13. Jastreboff PJ. Phantom auditory perception (tinnitus): mechanisms of generation and perception. Neurosci Res. 1990;8(4):221-54. [DOI:10.1016/0168-0102(90)90031-9]
14. Hallam RS, Jakes SC, Hinchcliffe R. Cognitive variables in tinnitus annoyance. Br J Clin Psychol. 1988;27(3):213-22. [DOI:10.1111/j.2044-8260.1988.tb00778.x]
15. Shayanmehr S, Sadeghijam M, Jalaie S, Pourbakht A, Jarollahi F, Asghari A, et al. Cultural Adaptation and Psychometric Properties of the Persian Version of the Evidence-Based Practice Attitudes Scale in Audiologists. Aud Vestib Res. 2023;32(4):322-33. [DOI:10.18502/avr.v32i4.13596]
16. Nelson TD, Steele RG. Predictors of practitioner self-reported use of evidence-based practices: practitioner training, clinical setting, and attitudes toward research. Adm Policy Ment Health. 2007;34(4):319-30. [DOI:10.1007/s10488-006-0111-x]
17. Bearman SK, Wadkins M, Bailin A, Doctoroff G. Pre-Practicum Training in Professional Psychology to Close the Research-Practice Gap: Changing Attitudes Towards Evidence-Based Practice. Train Educ Prof Psychol. 2015;9(1):13-20. [DOI:10.1037/tep0000052]
18. Leathers SJ, Melka-Kaffer C, Spielfogel JE, Atkins MS. Use of evidence-based interventions in child welfare: Do attitudes matter? Child Youth Serv Rev. 2016;70:375-82. [DOI:10.1016/j.childyouth.2016.10.022]
19. James S, Lampe L, Behnken S, Schulz D. Evidence-based practice and knowledge utilisation – a study of attitudes and practices among social workers in Germany. Eur J Soc Work. 2019;22(5):763-77. [DOI:10.1080/13691457.2018.1469475]
20. Tomotaki A, Fukahori H, Sakai I. Exploring sociodemographic factors related to practice, attitude, knowledge, and skills concerning evidence-based practice in clinical nursing. Jpn J Nurs Sci. 2020;17(1):e12260. [DOI:10.1111/jjns.12260]
21. Sadeghi-Bazargani H, Tabrizi JS, Azami-Aghdash S. Barriers to evidence-based medicine: a systematic review. J Eval Clin Pract. 2014;20(6):793-802. [DOI:10.1111/jep.12222]
22. Zwolsman S, te Pas E, Hooft L, Wieringa-de Waard M, van Dijk N. Barriers to GPs’ use of evidence-based medicine: a systematic review. Br J Gen Pract. 2012;62(600):e511-21. [DOI:10.3399/bjgp12X652382]
23. Nussbaumer-Streit B, Jesser A, Humer E, Barke A, Doering BK, Haid B, et al. A web-survey assessed attitudes toward evidence-based practice among psychotherapists in Austria. Sci Rep. 2022;12(1):9374. [DOI:10.1038/s41598-022-13266-2]
24. Ogborne AC, Wild TC, Braun K, Newton-Taylor B. Measuring treatment process beliefs among staff of specialized addiction treatment services. J Subst Abuse Treat. 1998;15(4):301-12. [DOI:10.1016/s0740-5472(97)00196-7]
25. Aarons GA, Sawitzky AC. Organizational Culture and Climate and Mental Health Provider Attitudes Toward Evidence-Based Practice. Psychol Serv. 2006;3(1):61-72. [DOI:10.1037/1541-1559.3.1.61]
26. Walrath CM, Sheehan AK, Holden EW, Hernandez M, Blau G. Evidence-based treatments in the field: a brief report on provider knowledge, implementation, and practice. J Behav Health Serv Res. 2006;33(2):244-53. [DOI:10.1007/s11414-005-9008-9]
27. Scurlock-Evans L, Upton P, Upton D. Evidence-based practice in physiotherapy: a systematic review of barriers, enablers and interventions. Physiotherapy. 2014;100(3):208-19. [DOI:10.1016/j.physio.2014.03.001]
28. Khammarnia M, Haj Mohammadi M, Amani Z, Rezaeian S, Setoodehzadeh F. Barriers to implementation of evidence based practice in zahedan teaching hospitals, Iran, 2014. Nurs Res Pract. 2015;2015:357140. [DOI:10.1155/2015/357140]
29. Jordan PJ, Bowers CA, Morton D. Barriers to implementing evidence-based practice in a private intensive care unit in the Eastern Cape. South Afr J Crit Care. 2016;32(2):50-4. [DOI:10.7196/SAJCC.2016.v32i2.253]
30. Johnston B, Coole C, Narayanasamy M, Feakes R, Whitworth G, Tyrell T, et al. Exploring the barriers to and facilitators of implementing research into practice. Br J Community Nurs. 2016;21(8):392-8. [DOI:10.12968/bjcn.2016.21.8.392]
31. Azmoude E, Aradmehr M, Dehghani F. Midwives’ Attitude and Barriers of Evidence Based Practice in Maternity Care. Malays J Med Sci. 2018;25(3):120-8. [DOI:10.21315/mjms2018.25.3.12]
32. Alatawi M, Aljuhani E, Alsufiany F, Aleid K, Rawah R, Aljanabi S, et al. Barriers of Implementing Evidence-Based Practice in Nursing Profession: A Literature Review. Am J Nurs. 2020;9(1):35-42. [DOI:10.11648/j.ajns.20200901.16]
| Files | ||
| Issue | Vol 33 No 2 (2024) | |
| Section | Research Article(s) | |
| DOI | https://doi.org/10.18502/avr.v33i2.14815 | |
| Keywords | ||
| Evidence-based practice tinnitus coping techniques cognitive-behavioral therapy | ||
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How to Cite
1.
Pahlavan Yali K, Sadeghijam M, Jarollahi F, Saneii SH. The Role of Training in Changing the Attitude of Audiologists in Iran Towards Using Cognitive-Behavioral Therapy for Tinnitus Management. Aud Vestib Res. 2023;33(2):126-132.
