Victor de Andrade

Background COVID-19 drastically impacted access to teaching worldwide. Furthermore, for children who are hard-of-hearing (HoH), these challenges were exacerbated, especially within contexts of infrastructural and resource constraints. Necessary COVID-19 protocols had implications for teaching HoH learners (HoHL) online and in-person, where, for example, connectivity and facemask-muffled speech impacted on teaching. Moreover, the reliance on technology during COVID-19 South African level 5 to level 1 restrictions revealed particular challenges for teachers of HoHL and the learners themselves. Methodology This qualitative, cross-sectional study explored the experiences of teachers of oral HoHL in South Africa during the COVID-19 pandemic. 11 teachers of grades 1–7 oral HoHL who were recruited through purposive and snowball sampling participated in individual, online, semi-structured interviews. Thereafter, interview transcriptions underwent thematic analysis. Findings Participants reported that infrastructural constraints, information and communication technology resource limitations, interruptions in the continuity of education and COVID-19 precautions amplified challenges when teaching oral HoHL. Teachers reported behavioural and emotional challenges in the children whom they taught. Moreover, there seemed to be limited access to medical services for HoHL. Participants reported attempting to bridge the gap between the human and technology interfaces, notwithstanding the inconsistent and limited support services. Conclusion This study revealed that, as a consequence of COVID-19, South African teachers had to amend their teaching and assessment methodologies which emphasised the inequality in access to education in South Africa, especially the particular challenges related to education for HoHL. Teachers had to navigate an unknown terrain using modified methodologies and were reliant on technology within the constrained South African context where structural limitations further complicated the teaching of HoHL. COVID-19 highlighted that the confluence of disability, constrained resources and poor support mechanisms in South Africa threatens educational provision for learners with special needs.

Equitable access to hearing aids and related services remains a global health challenge, particularly in resource-limited settings. A major barrier to access is the lack of diagnostic and rehabilitative services, which is substantially attributable to the persistent shortage of ear and hearing care specialists. This discussion article provides an overview of limitations in the ear and hearing care workforce, the relevance of task sharing to ear and hearing care, and a new, evidence-based World Health Organization (WHO) technical resource aimed at improving access to hearing aids worldwide. A synthesis of current research and expert opinion. First, this article describes the global shortage of qualified ear and hearing care specialists. Next, it describes how community-based care, supported by task sharing among trained non-specialist providers and qualified ear and hearing care providers, could overcome these workforce limitations, and describes the critical role of qualified ear and hearing care providers in task sharing. Finally, this article provides an overview of a WHO resource which provides practical information for hearing aid service provision in resource-limited settings. Innovative strategies to expand the ear and hearing care workforce are essential to advance efforts towards equitable access to hearing aids and related services.

Introduction: The needs of people living with disabilities regarding sex and sexual health remain largely neglected. Knowledge and resources about disabled sexuality have emerged mainly from the global north and have centered on heteronormative ideas about sex, gender, and sexuality. Methods: An affirmative, sex positive, queer, and intersectional exploration was undertaken of the experiences and needs a group of adults with disabilities living in Gauteng, South Africa in relation to accessing information about sex, sexuality, and sexual health. Interviews were conducted with people of diverse disabilities, language groups, and cultural backgrounds. Interviews were analyzed using thematic analysis. Results: The participants revealed that sexual encounters, relationships, and dating were infused with negative experiences related to lack of understanding about sex, internalized ableism, exploitation, and physical, sexual, and emotional abuse resulting from societal stigma and ignorance regarding disability. Participants offered suggestions for how their needs could be addressed. Conclusion: Our study concludes that the denial of sexual rights is a central element of the broader forms of social exclusion that people with disabilities. In South Africa, many of these forms of exclusion have been compounded by the legacy of apartheid, and the persistence of racial inequality, taboos about sex, and stigmas associated with disability.

Background: Limited research is available regarding the professional quality of life experiences of South African speech-language therapists and audiologists, despite the implications this has for wellbeing, quality of patient care, productivity and attrition from the professions. Objectives: This study explored levels of compassion satisfaction, burnout, and secondary traumatic stress, the relationships between these, differences on the basis of registration and years of experience and participants’ perceptions of their professional quality of life. Method: A sample of 92 South African speech-language therapists and audiologists completed an online survey that included the Professional Quality of Life (ProQOL) scale. The data were analysed using descriptive statistics, analysis of variation (ANOVA), correlations and thematic analysis. Results: The findings indicated that participants experienced slightly higher levels of secondary traumatic stress and burnout and slightly lower levels of compassion satisfaction than international samples. There were significant inter-relationships between the three elements of professional quality of life, and no significant differences for these on the basis of registration or years of experience. Participants identified a range of factors that contributed to their experiences of compassion satisfaction and fatigue, as well as suggestions for improvement. Conclusion: Professional quality of life plays an important role in South African speech-language therapists and audiologists’ professionalism, job performance and satisfaction and retention. Contribution: The data collected provide valuable insights into the professional quality of life experiences of South African speech-language therapists and audiologists, as well as those working in similar contexts. It also offers suggestions that may contribute to future research and interventions.

Multiple studies have noted the impacts on student mental health of the COVID-19 pandemic, associated national lockdowns and emergency remote teaching. In light of COVID-19 shifting from pandemic to endemic status, this study investigates the developmental and mental health consequences of the pandemic for a group of South African undergraduate students. A qualitative design allowed for the thematic analysis of the narratives of 140 humanities students, gathered through an online survey. This paper presents the ‘voices’ of this group to convey the intensity of their COVID-19 experience. The results suggest a loss of a sense of freedom and opportunities to explore and experiment, high levels of depression with a notable sense of hopelessness regarding the future and decreased motivation, and significant reports of social anxiety related to delays in the development of social skills due to social isolation, particular to the first-year cohort.

Quantitative studies have explored the work abilities of persons with specific vestibular-related symptoms, but there seems to be a dearth of research that has explored the work experience of perso...

South Africa has experienced considerable international outward migration in the last half century, which has had a severe psychological impact on members of families affected by this phenomenon. Older parents who remain behind may experience feelings of loss and isolation. Information Communication Technologies (ICTs) are useful in maintaining relationships between family members separated by migration and increasingly allow migrant families to experience a virtual co-presence despite geographical separation. However, the process may be challenging, especially for older people with hearing difficulties. This article reports on a qualitative study exploring the perceptions of a group of older adults who have difficulty hearing and who live in a residential care home about using ICTs to communicate with family abroad. Interview data were analysed using thematic analysis. Most of the participants used either a fixed line telephone or a mobile phone. They reported challenges in communicating with family members abroad arising from their deafness, as well as difficulties using technological devices together with their hearing aids. These challenges resulted in feelings of helplessness and frustration. Although the data collection took place prior to the COVID-19 pandemic, these findings may be of particular relevance to situations such as those during the pandemic when many older adults became more reliant on technology to communicate with family members because of restrictions on direct contact. Accordingly, suggestions are made to address challenges in communication between older adults and loved ones who are geographically separated.

Background: Residential care homes for older persons were especially affected during the coronavirus disease 2019 (COVID-19) pandemic lockdowns which resulted in limited social interactions and service provision. Communication became challenging due to the prophylactic use of masks and social distancing.Objectives: This qualitative research study set out to explore audiological service considerations in residential care homes for older persons during the COVID-19 restrictions.Method: Through purposive sampling, nine managers from residential care homes for older persons in Johannesburg participated in semi-structured, online interviews. The transcriptions of these recorded interviews underwent thematic analysis.Results: Managers employed various strategies to attend to residents’ audiological needs, audiological health, hearing aid use, and hearing aid provision. Furthermore, it transpired that other health related services were prioritised over audiological services in general, but especially during the pandemic lockdowns. Managers reported that staff had to use various communication strategies due to COVID-19 precautions and that masks and social distancing made communication more challenging for residents with hearing loss. Moreover, isolation and modified service provision were extremely taxing on residents.Conclusion: This study highlights the need for continued audiological services at residential care homes, but also the need to balance audiological needs with other health needs because these seem to be prioritised over hearing loss, especially in this population who may have limited agency and choice in the health care options available to them. Furthermore, adapted strategies need to be considered to support communication considering COVID-19 precautions so that communicative difficulties do not exacerbate lockdown isolation.

Background: Speech–language therapists and audiologists (SLT&As) may encounter difficulties when confronted with patient death and dying, which may conflict with their moral beliefs and result in moral injury. Furthermore, South African SLT&As practice in a country with a high mortality rate, which may add to the complexity of their experience. Moreover, they may be influenced by African philosophies promoting care, which might conflict with their experiences of patient death and dying.Aims: To explore the moral injury experienced by South African SLT&As in patient death and dying, and how they overcame the injury.Methods & Procedures: This article forms part of a larger qualitative study that explored SLT&As’ experiences of patient death and dying in South Africa. Thematic analysis was conducted on the transcripts of 25 episodic narrative interviews conducted with South African SLT&As on their experiences of patient death and dying.Outcomes & Results: Findings suggest that South African SLT&As experienced helplessness, guilt and anger in patient death and dying. However, with support from the allied team, engaging in self‐reflection and religious practices, they reported alleviation of moral injury.Conclusions & Implications: In order to mitigate moral injury in South African SLT&As, they require professional education, self‐care strategies, guidelines and support from the teams in which they work and their supervisors. Research is needed that explores how SLT&As’ biographical characteristics and interactions with significant others of dying and deceased patients, may result in moral injury.What this paper adds?: What is already known on this subject?: Moral injury and measures used to overcome the injury have been explored in military personnel, doctors and nurses, but not in SLT&As. However, studies that explored the perceptions of SLTs and/or audiologists regarding providing palliative care and of death and dying, particularly that by Rivers et al. in 2009, suggested that these professionals may be at risk of experiencing emotional trauma due to patient death, particularly when not receiving undergraduate education on this subject. However, the extent of this trauma and the support needed to overcome it is unknown because the participants in these studies may have not experienced patient death, and were only students or just SLTs. What this article adds?: This article highlights the complexity of speech–language therapy and audiology practice when confronted with patient death and dying. South African SLT&As may have to make decisions that conflict with their morals and professional practice standards, especially as the helping nature of their profession is characterized by African philosophies that promote care, which may result in moral injury. Clinical implications of this article: This article indicates that in addition to undergraduate education on patient death and dying, SLTs and audiologists require continuous professional education on this topic, self‐care strategies, support from the teams in which they work, and their supervisors and guidelines for when they encounter patient death and dying.