Date of Completion

2025

Document Type

Thesis

Degree Name

Master of Arts in Nursing

Keywords

hearing loss, hearing health, assessment competencies, primary care, geriatric nursing, health outcomes

Abstract

Introduction: The aging population is a global phenomenon, and with it comes an increase in the number of older persons facing various health challenges, including hearing impairments. Hearing loss among older persons can significantly impact their quality of life, communication abilities, and overall health outcomes. Registered nurses play a critical role in the assessment and care of these individuals; however, their competencies in assessing hearing-challenged older persons are often underdeveloped and inconsistent. This primary objective of the study was to evaluate the level of registered nurses’ assessment competencies in assessing hearing-challenged persons and to use the results of this study to create standardized assessment guidelines for registered nurses to use in clinical practice.

Methods: Using a non-experimental, quantitative, descriptive-analytical design, this research gathered data from 125 registered nurses working at a Level III private hospital in the province of Cavite, Philippines. Employing a self-made research questionnaire, the study evaluated the assessment competencies of the respondents in three domains, which were anchored on Benner’s and Yu-Ching Chuang’s frameworks. Data analysis included frequency distribution, percentage, mean, standard deviation, Mann-Whitney U test, and Kruskal-Wallis test.

Results: The study revealed that nurses at the selected institution generally demonstrated a "proficient" level of assessment competencies for hearing-challenged older persons (overall mean Score=3.17, SD=0.90), underpinned by "expert" communication and psychosocial skills (mean Score=3.41, SD=0.38). While age, gender, and years of experience did not yield statistically significant differences in overall competency, the area of practice significantly impacted assessment skills. Specifically, a statistically significant difference was found in overall assessment competency between medical-surgical and emergency room departments (U=949, p=0.02), with medical-surgical nurses demonstrating higher proficiency. Notably, nurses assigned to the oncology department were categorized as "novice" in all assessment domains. These findings suggest varying levels of preparedness and highlight areas requiring targeted training and intervention, partially supporting the hypothesis for some variables while refuting it for the area of practice.

Conclusion: The study concluded that while nurses demonstrated an overall "proficient" level of assessment competency for hearing-challenged older persons, with "expert" proficiency in Communication and Psychosocial aspects, there were areas for improvement, particularly in History and Physical Assessment and Functional and Risk Assessment, where they were rated "proficient". Key findings revealed that younger nurses excelled in communication due to modern curricula, and that nursing experience did not linearly guarantee higher competency across all domains, with veteran nurses showing surprisingly lower ratings in some areas. Furthermore, the area of practice significantly influenced competencies, as evidenced by “novice” ratings in Oncology and distinct challenges in the emergency room. Despite observed differences in perceived strengths by age, gender, and experience, statistical analysis showed no significant difference in overall assessment competency across these demographic profiles. However, a statistically significant difference was found between medical-surgical and emergency room nurses, with the former demonstrating a higher overall assessment competency. These findings emphasize the critical need for standardized assessment guidelines, intensive sensory impairment training, targeted professional development and lifelong learning to ensure uniformly high-quality care for hearing-impaired older adults across all nursing settings.

First Advisor

Nancy D. De Los Santos, RN, MAN

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