Exploring the relationship between technology use,hearing help-seeking,and hearing aid outcomes in older adults

Abstract

Objective: The objective of this study was to explore technology use and its relationship to help-seeking for hearing impairment (HI) and success with hearing aids among older adults. Previous research had suggested a link between higher levels of technology use and hearing aid success. Design: General technology use was evaluated using a purposefully developed 25-item questionnaire. Twelve items related to everyday technology use (e.g. DVD player) and 13 related to advanced technology use (e.g. Bluetooth). Study sample: Four groups of older adults with HI participated in the study: (1) non-consulters (n = 49), (2) consulters (n = 62), (3) unsuccessful hearing aid owners (n = 61), and (4) successful hearing aid owners (n = 79). Results: Preliminary analyses revealed a main effect in the use of everyday and advanced technology across the four participant groups. However, it was found that age and living arrangements accounted for most of the variance in reported everyday technology use (p = .030; p = .029, respectively) and age and gender accounted for the variance in reported advanced technology use (p <.001; p = .040, respectively). For everyday technology, an increase in age and living alone were associated with decreased technology use and for advanced technology use, age and female gender were associated with decreased technology use. Conclusions: Although we hypothesized that technology use would be less amongst non-consulters and unsuccessful hearing aid owners, our findings did not support this prediction. Technology use did not vary by group membership once the covariates of age, gender, and living arrangements were accounted for.     

An investigation of factors that influence help-seeking for hearing impairment in older adults

Abstract

Objective: To examine the influence of audiological and non-audiological factors on help-seeking for hearing impairment (HI) in older adults. Design: A retrospective research design was employed. Participants completed 14 measures, after which two multivariate, multinomial logistic regression models were fitted to the data to determine which factors were associated with consultation for HI and hearing aid uptake. Study sample: Three-hundred-and-seven individuals who were 60 years or older and who presented with a unilateral or bilateral HI participated in the study. Non-hearing aid owners were assigned to a non-consulter group (n = 55) or a consulter group (n = 92); hearing aid owners were assigned to an unsuccessful hearing aid owner group (n = 75) or a successful hearing aid owner group (n = 85). Results: A similar combination of factors was associated with the decisions to consult a health professional about HI and/or to adopt hearing aids. The most important factors related to attitudinal beliefs (e.g. perceived benefits of hearing aids) and external cues to action (e.g. support from significant others). Greater HI also influenced consultation and adoption of hearing aids. Conclusions: Findings highlight the importance of non-audiological factors in hearing rehabilitation to improve consultation for HI and hearing aid adoption.     

Unilateral hearing loss: benefits and satisfaction from the use of hearing aids

Aunilateral hearing loss is characterized by reduced hearing in one ear. The problems caused by sensory deprivation can be minimized with the use of hearing aids (HA).AimTo analyze the correlation between the prescribed grain and the insertion gain difference and with the results obtained regarding the benefit and satisfaction with the use of hearing aids in unilateral hearing impaired patients.Materials and MethodsProspective study with 15 subjects, mean age of 41.6 years, of both genders, users of hearing aids effectively. We used the International Questionnaire Results for hearing aids (International Outcome Inventory for Hearing Aids - IOI-HA), measured with a probe microphone.ResultsThe mean values in the analyses of the IOI-HA per item were positive and higher than four points. In relation to the objective measures, the frequencies in which we obtained the gain values which were closer to the target were: 1K Hz, 2K Hz and 500 Hz, respectively.ConclusionThe satisfaction of individuals using hearing aid unilaterally is not completely correlated to the prescribed gain, because even if the target is not being reached in some frequencies, the individuals were pleased as to the use of their hearing aids.     

Prediction of the use of conventional hearing aids in Korean adults with unilateral hearing impairment

Objective: To determine the use of a hearing aid at six months post-fitting and to evaluate the predictors of its ongoing use in Korean adults with unilateral hearing impairment (HI). Design: Retrospective study at a secondary referral hospital over a 15-year period. Study sample: This study analysed 119 adults with unilateral HI who had been recommended for hearing amplification (55 men and 64 women, mean age, 58.0 ± 11.7 years). Six months after the fitting, all of the participants were surveyed regarding subsequent decisions and actions about obtaining hearing aids. Results: General uptake rate for a hearing aid was 68.1% (58.0% of participants surveyed were successful users, and 10.1% were intermittent users). The most significant parameter associated with hearing-aid use was social and/or work activities (R² = 0.457), and the significant predictors for successful hearing-aid use were social and/or work activities and method of signal processing (discriminatory power = 56.3%). Conclusions: Six months post-fitting, 68.1% of Korean adults with unilateral HI who had agreed to try a hearing aid continued to use it regularly. The predictors for hearing-aid use six months post-fitting included social and/or work activities and digital signal processing.     

Directional hearing aid benefit in listeners with severe hearing loss

The purpose of this investigation was to examine the potential for directional hearing aid benefit in listeners with severe hearing loss at multiple SNRs for both auditory only and audio-visual presentation modes. Speech recognition performance was measured using the connected speech test at six SNRs individually determined for each subject in order to avoid floor and ceiling effects. The results revealed significant directional benefit was present at all tested SNRs in the presence of visual information. For auditory only presentations, significant directional benefit was only present at the least positive SNR. The largest directional benefit was measured at the poorest tested SNR for both auditory only and audio-visual presentation modes. The results of this study generally support small but significant directional for listeners with severe hearing loss benefit in a difficult listening environment both with and without the presence of visual information.

Sumario

El objetivo de esta investigación fue examinar el beneficio potencial de los auxiliares auditivos direccionales en personas con hipoacusia severa en múltiples condiciones de señal/ruido (SNR) tanto en modo auditivo como en audio-visual. Se midió el desempeño en el reconocimiento del lenguaje mediante la prueba de lenguaje conectado a seis diferentes SNR, determinados en cada individuo para evitar el efecto de piso/techo. Los resultados revelan un beneficio direccional significativo en las seis condiciones de prueba en presencia de información visual. En la presentación exclusivamente auditiva, el beneficio sólo se presentó con la SNR menos positiva. El mayor beneficio direccional se midió con la SNR mas pobre tanto en el modo auditivo como en el audio-visual. Los resultados generales de este estudio apoyan que existe un beneficio direccional pequeño pero significativo para personas con hipoacusia severa en ambientes sonoros difíciles, con o sin información visual.     

Quality of life in elderly adults before and after hearing aid fitting

Presbycusis is a common disorder in the elderly, which causes hearing loss and may contribute to the development of some psychiatric disorders, leading to isolation due to communication difficulties in the social environment.ObjectiveTo identify through the WHOQOL (World Health Organization Quality of Life Questionnaire), the quality of life of hearing impaired individuals before and after hearing aid fittings.MethodWe had 30 individuals with hearing loss, all over 60 years of age - patients from a Speech Therapy Clinic. The patients answered the WHOQOL questions without the use of hearing aids; and after the effective use of a sound amplification device for a period of three months they answered it again. The WHOQOL - Bref consists of 26 questions, two general quality-of-life questions and 24 associated with four aspects: physical, psychological, environmental and social relations.ResultsThere was a significant improvement in quality of life in general, as far as leisure activities were concerned, there were no major changes regarding the frequency of negative feelings; even after the hearing aid fitting, the patients continue to have such feelings.ConclusionThe use of hearing aids favored the overall quality of life of the individuals evaluated.     

Sex-specific predictors of hearing-aid use in older persons: The age,gene/environment susceptibility - Reykjavik study

Objective: We estimate the prevalence of hearing-aid use in Iceland and identify sex-specific factors associated with use. Design: Population-based cohort study. Study sample: A total of 5172 age, gene/environment susceptibility - Reykjavik study (AGES-RS) participants, aged 67 to 96 years (mean age 76.5 years), who completed air-conduction and pure-tone audiometry. Results: Hearing-aid use was reported by 23.0% of men and 15.9% of women in the cohort, although among participants with at least moderate hearing loss in the better ear (pure-tone average [PTA] of thresholds at 0.5, 1, 2, and 4 kHz ≥ 35 dB hearing level [HL]) it was 49.9% and did not differ by sex. Self-reported hearing loss was the strongest predictor of hearing-aid use in men [OR: 2.68 (95% CI: 1.77, 4.08)] and women [OR: 3.07 (95% CI: 1.94, 4.86)], followed by hearing loss severity based on audiometry. Having diabetes or osteoarthritis were significant positive predictors of use in men, whereas greater physical activity and unimpaired cognitive status were important in women. Conclusions: Hearing-aid use was comparable in Icelandic men and women with moderate or greater hearing loss. Self-recognition of hearing loss was the factor most predictive of hearing-aid use; other influential factors differed for men and women.     

Evaluation of the NAL Dynamic Conversations Test in older listeners with hearing loss

Objective: The National Acoustic Laboratories Dynamic Conversations Test (NAL-DCT) is a new test of speech comprehension that incorporates a realistic environment and dynamic speech materials that capture certain features of everyday conversations. The goal of this study was to assess the suitability of the test for studying the consequences of hearing loss and amplification in older listeners. Design: Unaided and aided comprehension scores were measured for single-, two- and three-talker passages, along with unaided and aided sentence recall. To characterise the relevant cognitive abilities of the group, measures of short-term working memory, verbal information-processing speed and reading comprehension speed were collected. Study sample: Participants were 41 older listeners with varying degrees of hearing loss. Results: Performance on both the NAL-DCT and the sentence test was strongly driven by hearing loss, but performance on the NAL-DCT was additionally related to a composite cognitive deficit score. Benefits of amplification were measurable but influenced by individual test SNRs. Conclusions: The NAL-DCT is sensitive to the same factors as a traditional sentence recall test, but in addition is sensitive to the cognitive factors required for speech processing. The test shows promise as a tool for research concerned with real-world listening.     

Determinants of hearing-aid adoption and use among the elderly: A systematic review

Objective: While the benefits of hearing aids among older adults with presbycusis have been well documented, there is limited research on hearing-aid usage. The aim of this review is to synthesize current evidence to identify the determinants of hearing-aid adoption and use among the elderly. Design: Systematic review. Study sample: Articles were identified through systematic searches in the Web of Science, Medline, CINAHL, and a manual search. Studies that explore the potential determinants of hearing-aid usage were to be included. Results: A total of twenty-two articles were reviewed. Four audiological determinants (the severity of hearing loss, the type of hearing aids, background noise acceptance, and insertion gain) and seven non-audiological determinants (self-perceived hearing problems, expectation, demographics, group consultation, support from significant others, self-perceived benefit, and satisfaction) were identified as affecting the adoption and use of hearing aids. Conclusions: There is a need to explore the influence of significant others, health professionals, and user demographics on hearing rehabilitation for future research. The determinants identified in this review depicted the stage progression of the trans-theoretical model (TTM) in explaining an individual's readiness to hearing-aid usage.     

Exploring the sensitivity of speech-in-noise tests for noise-induced hearing loss

Abstract

Objective: Recently, the digit triplet test was shown to be a sensitive speech-in-noise test for early high-frequency hearing loss in noise-exposed workers. This study investigates if a further improvement is achieved when using a closed set of consonant-vowel-consonant (CVC) speech items with the same vowel, and/or a low-pass (LP) filtered version of the standard speech-shaped noise. Design: Speech reception thresholds in noise were gathered for the digit triplet, CVC, and CVC_LP test and compared to the high-frequency pure-tone average (PTA). Study sample: 118 noise-exposed workers showing a wide range of high-frequency hearing losses. Results: For the 84 Dutch-speaking participants, the CVC test showed an increased measurement error and a decreased between-subject variation, leading to a weaker correlation with the PTA_2,3,4,6 (R = 0.64) and thus a lower sensitivity compared to the digit triplet test (R = 0.86). However, the use of LP-filtered noise resulted in a sensitivity improvement (R = 0.79 versus R = 0.64) due to the large increase in between-subject spread. Similar trends were found for the 34 French-speaking workers. Conclusions: Using CVC words with the same vowel could not increase the sensitivity to detect isolated high-frequency hearing loss. With LP-filtered noise, test sensitivity improved, but it did not surpass the original digit triplet test.     

Degree of satisfaction of patients fitted with hearing aids at a high complexity service

Some individuals with hearing loss choose to be fitted with hearing aids. Compliance is significantly affected by how satisfied patients are with their hearing aids. Patient satisfaction can be assessed through questionnaires and scales.ObjectiveTo assess the degree of satisfaction of patients fitted with hearing aids.MethodScale “Satisfaction With Amplification in Daily Life” (SADL) was applied to 180 patients fitted with hearing aids; results were categorized based on the mean values observed for global satisfaction scores and scores attained on each subscale. Patients were interviewed for additional information.ResultsMean global score was 5.6; 48.9% of the subjects were very satisfied, 47.2% were satisfied, and 3.9% were dissatisfied. The mean score on subscale Positive Effects was 5.6; the mean score for Service and Cost was 6.2; for Negative Factors the mean score was 4.9; and the mean score on subscale Personal Image was 5.8. Of the patients fitted with in-the-ear hearing aids, 83.3% were very satisfied. Fifteen percent of the individuals were dissatisfied with their Personal Image. Sensorineural and profound hearing loss patients were less satisfied, with 5.4% and 50.0% of the subjects revealing dissatisfaction with their hearing aids.ConclusionPatients were generally very satisfied with their hearing aids. Satisfaction rates were higher among patients fitted with in-the-ear hearing aids. Dissatisfaction was higher in subscale Personal Image. Lesser degrees of satisfaction were seen in patients with sensorineural and profound hearing loss.     

Comparative outcomes of active and passive hearing devices by transcutaneous bone conduction

Conclusion Bonebridge (BB) and Sophono (SP) devices improved hearing; with the BB implant showing a better performance at medium and high frequencies. Furthermore, the BB, as an active implant, showed higher functional gain and increased time of use, when compared to the SP, a passive system. Objectives This study aims to compare surgical and audiological outcomes of SP and BB devices in order to assess and further differentiate the indication criteria. Methods Fourteen patients with conductive and mixed hearing loss were evaluated pre- and post-operatively (BB or SP) (period 2013–2014). Age, gender, surgical history, cause and type of hearing loss, implant use per day, levels of bone and air conduction, and functional gain were recorded. Data was analysed by Wilcoxon singed-rank and Wilcoxon rank-sum tests. Results Fourteen patients (BB; n?=?10 and SP; n?=?4) with an average age?=?25.42 years (CI95?=?12.41–38.43) were evaluated. The gender relation was equal (1:1), with pre-implantation osseous thresholds of 20.42?dB (CI95?=?11.15–29.69), and pre-implantation aerial thresholds of 70.83?dB (CI95?=?62.52–79.14). The SP wearing time was significantly lower than that of the BB (SP?=?7–10?h/day, BB?=?8–12?h/day; p?=?0.0323). The functional gain did not differ significantly between the two devices (BB?=?40.00?±?13.19?dB, SP?=?34.06?±?15.63?dB; p?=?0.3434), but a significant improvement from pre- to post-implantation was observed (p?p?=?0.0140) and 4?kHz (p?相似文献   

Evaluation of wideband frequency responses and non-linear frequency compression for children with mild to moderate high-frequency hearing loss

Objective: To evaluate wideband amplification and non-linear frequency compression (NLFC) as a means to improve speech recognition for children with mild/moderate hearing loss. Design: Randomized within-subject design with repeated measures across test conditions. Study sample: Eleven children with mild to moderate hearing loss were evaluated with: (1) Phonak BTE without NLFC, (2) Phonak BTE with NLFC, and (3) Oticon BTE with wideband response extending to 8000 Hz. Results: Use of NLFC provided better detection and recognition of high-frequency stimuli (e.g. /sh/ and /s/). No difference in performance between conditions was observed for speech recognition when measured with the University of Western Ontario (UWO) plurals test and the UWO distinctive features difference test. Finally, there were no differences between conditions on the BKB-SIN test. Conclusions: Children with mild to moderate hearing loss have good access to high-frequency phonemes presented at fixed levels (e.g. 50 to 60 dBA) with both wideband and NLFC technology. Similarly, sentence recognition in noise was similar with wideband and NLFC. Adaptive test procedures that probe performance at lower input levels showed small but significant improvements in the detection and recognition of the phonemes /s/ and /sh/ with NLFC condition when compared to the NLFC Off and wideband conditions.     

Amplification of transcutaneous and percutaneous bone-conduction devices with a test-band in an induced model of conductive hearing loss

Objective: Transcutaneous devices have a disadvantage, the dampening effect by soft tissue between the bone and devices. We investigated hearing outcomes with percutaneous and transcutaneous devices using test-bands in an induced unilateral conductive hearing loss. Design: Comparison of hearing outcomes of two devices in the same individuals. Study sample: The right ear was plugged in 30 subjects and a test-band with devices (Cochlear? Baha® BP110 Power and Sophono® Alpha-2 MPO?) was applied on the right mastoid tip with the left ear masked. Sound-field thresholds, speech recognition thresholds (SRTs), and word recognition scores (WRSs) were compared. Results: Aided thresholds of Sophono were significantly better than those of Baha at most frequencies. Sophono WRSs (86?±?12%) at 40?dB SPL and SRTs (14?±?5?dB HL) were significantly better than those (73?±?24% and 23?±?8?dB HL) of Baha. However, Sophono WRSs (98?±?3%) at 60?dB SPL did not differ from Baha WRSs (95?±?12%). Conclusion: Amplifications of the current transcutaneous device were not inferior to those of percutaneous devices with a test-band in subjects with normal bone-conduction thresholds. Since the percutaneous devices can increase the gain when fixed to the skull by eliminating the dampening effect, both devices are expected to provide sufficient hearing amplification.