The authors examine how social and structural factors influence access to rehabilitation services in Denmark’s healthcare system. Adults with hearing loss who choose to seek or not seek additional aural rehabilitation after receiving hearing aids, cochlear implants or bone-anchored devices participated. Semi-structured interviews with 27 adults with hearing loss and 6 hearing healthcare professionals were conducted. Although aural rehabilitation services such as communication training, counselling and psychosocial support are freely available in Denmark, participants reported unequal and varied levels of awareness of these services and varying abilities to access them. Two key themes are identified: limited knowledge about available rehabilitation opportunities and unequal access to the social, cultural and economic resources needed to navigate the system effectively and therefore understand availability of those services. Participants were grouped according to their perceived rehabilitation needs and access to resources (‘capital’). Those with significant needs but limited capital often felt unable to challenge professional decisions and struggled to obtain support beyond hearing devices. In contrast, individuals with greater social and cultural capital were more confident in advocating for themselves, understanding their rights and negotiating for preferred treatments or services. A third group relied primarily on technology, rather than broader rehabilitation support. Access to effective support depends on patients’ ability to recognise needs, understand available services and communicate confidently with professionals. The authors conclude that universal healthcare alone does not guarantee equitable access. Improved information, provision, navigation of support offered and greater attention to psychosocial aspects of hearing loss are needed to reduce inequalities and ensure that all individuals can benefit fully from the available rehabilitation services.
When availability does not mean accessibility: inequalities in aural rehabilitation
Reviewed by Charlotte Rogers
What drives help-seeking for aural rehabilitation? Perspectives of hearing aid users and professionals in Denmark.
CONTRIBUTOR
Charlotte Rogers
BSc Healthcare Science (Audiology), Allied Health Sciences, De Montfort University, Leicester.
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