The relationship between pre-fitting expectations and willingness to use hearing aids

Hearing-aid use in the elderly population is problematic since not all people who would benefit from hearing aids actually obtain one. In this study, the relationship between pre-fitting expectations and willingness to use hearing aids is addressed. One hundred adult hearing aid candidates (mean age 68.6 years) were randomly recruited from eight different private ENT practices. The subjects completed a questionnaire comprising a number of different aspects of expectation and some additional variables potentially influencing willingness to use hearing aids. Based on the outcome of the questionnaire a linear regression model predicting motivation to use hearing aids was calculated and evaluated. Among the 11 parameters evaluated three contributed significantly to the model of willingness. The three predictor variables were expectations towards improvement of quality of life, stigmatization, and self-rated hearing ability. They accounted for about 55% of the variability in the data for willingness. Examination of a sub-sample three months after the survey had taken place revealed a distinct relationship between willingness and the decision to obtain or decline hearing aids. In conclusion, the results strongly encourage supporting positive expectations in order to motivate individuals with hearing impairment to use hearing systems.     

Self-reported disability and handicap after hearing-aid fitting and benefit of hearing aids: comparison of fitting procedures, degree of hearing loss, experience with hearing aids and uni- and bilateral fittings

Self-reported outcome on hearing disability and handicap as well as overall health-related quality of life were measured after hearing-aid fitting in a large-scale clinical population. Fitting was performed according to two different procedures in a double-blind study design. We used a comparative procedure based on optimizing speech intelligibility scores and a strictly implemented fitting formula. Hearing disability and handicap were assessed with the hearing handicap and disability inventory and benefit of hearing aids with the abbreviated profile of hearing aid benefit. Effects on health-related quality of life and depression were assessed with the EuroQol-5D questionnaire and the geriatric depression scale. We found that hearing-aid fitting according to either procedure had a significantly positive effect on disability and handicap associated with hearing loss. This effect lasted for several months. Only the effect on disability persisted after 1-year of follow-up. Self-reported benefit from hearing aids was comparable for both fitting procedures. Unaided hearing disability was more pronounced in groups of participants with greater hearing loss, while the benefit of hearing aids was independent from the degree of hearing impairment. First-time hearing aid users reported greater benefit from their hearing aids. The added value from a bilateral hearing-aid fitting was not significant. Overall health-related quality of life and incidence of depression did not alter after hearing-aid fitting.     

The role of bone anchored hearing aids in children with Down syndrome

OBJECTIVES: To evaluate complication rates and outcomes of children with Down syndrome fitted with a Bone Anchored Hearing Aid (Baha). To evaluate whether the Bone Anchored Hearing Aid is a successful form of aural rehabilitation in children with Down syndrome from a patients' perspective. STUDY DESIGN: Retrospective case analysis and postal questionnaire study. SETTING: The Birmingham Children's Hospital, UK. METHODS: A total of 15 children were fitted with a Baha between February 1992 and February 2007. The age range was 2-15 years. A postal questionnaire was sent to each family. The Glasgow Children's Benefit Inventory (GCBI) was used in this study. OUTCOME MEASURES: Implantation results, skin reactions and other complications were recorded. Quality of life after receiving a Baha was assessed with the GCBI. RESULTS: All 15 patients are using their Baha 7 days a week for more than 8h a day after a follow-up of 14 months with continuing audiological benefit. No fixtures were lost, and skin problems were encountered in 3 (20%). Regarding quality of life, all 15 patients had improved social and physical functioning as a result of better hearing. CONCLUSIONS: Baha has an important role in the overall management of individuals with Down syndrome after conventional hearing aids and/or ventilation tubes have been considered or already failed. This study has shown a 20% rate of soft tissue reaction and there were no fixture losses in this group. No significant increase in complication rates was identified in children with Down syndrome. Finally, there was a significantly improved quality of life in children with Down syndrome after receiving their Baha. There was a high patient/carer satisfaction with Baha. Two of our series had bilateral two stage fixture procedures without any complications. More consideration should be given to bilateral bone anchored hearing aids in this group.     

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.     

On the relationship between functional hearing and depression

Objective: To establish the effect of self-rated and measured functional hearing on depression, taking age and gender into account. Additionally, the study investigates if hearing-aid usage mitigates the effect, and if other physical health problems and social engagement confound it. Design: Cross-sectional data from the UK Biobank resource, including subjective and behavioural measures of functional hearing and multifactorial measures of depressive episodes and symptoms, were accessed and analysed using multi-regression analyses. Study sample: Over 100 000 community-dwelling, 39–70 year-old volunteers. Results: Irrespective of measurement method, poor functional hearing was significantly (p < 0.001) associated with higher levels of depressive episodes (≤ 0.16 factor scores) and depressive symptoms (≤ 0.30 factor scores) when controlling for age and gender. Associations were stronger for subjective reports, for depressive symptoms, and the younger participants. Females generally reported higher levels of depression. Hearing-aid usage did not show a mitigating effect on the associations. Other physical health problems particularly partially confounded the effects. Conclusion: Data support an association between functional hearing and depression that is stronger in the younger participants (40–49 years old) and for milder depression. The association was not alleviated by hearing-aid usage, but was partially confounded by other physical health problems.     

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.     

Cochrane corner: hearing aids for mild to moderate hearing loss in adults

This Cochrane corner features the review entitled “Hearing aids for mild to moderate hearing loss in adults” published in 2017. In their review, Ferguson et al. identified five randomised controlled trials (RCTs) involving 825 participants, with moderate quality of evidence shown for all domains except adverse effects. Results showed a large beneficial effect of hearing aids on hearing-specific health-related quality of life and listening ability, and a small yet significant beneficial effect on overall health-related quality of life. Ferguson et al. concluded that according to the available evidence, hearing aids are effective at improving hearing-specific health-related quality of life, general health-related quality of life and listening ability in adults with mild to moderate hearing loss. The evidence supports the widespread provision of hearing aids as the first-line clinical management for those seeking help for hearing difficulties.     

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.     

Satisfaction with hearing aids: A consumer research perspective

This research aimed at describing satisfaction with hearing aids from the perspective of the client as a consumer. A disconfirmation-expectancy model, derived from consumer research, was evaluated. This model posits that pre-fitting expectations, post-fitting performance, and the experience of how performance compares to expectations (disconfirmation), contribute to satisfaction. Positive disconfirmation occurs when performance is better than original expectations and is associated with higher satisfaction. Negative disconfirmation is when performance is poorer than expectations and is associated with dissatisfaction. New hearing aid users in Hong Kong (N=42) were tested with a newly developed self-report measure (PHACS: profile of hearing aid consumer satisfaction) that included items focused on hearing ability, problems, cost, and service. Pre-fitting expectations and post-fitting performance, disconfirmation, and satisfaction were measured. Results showed that expectations were generally not related to satisfaction, that disconfirmation was correlated with many aspects of satisfaction, and that performance was most strongly related to satisfaction. The implications of the findings are that hearing aid performance is the most important element for determining satisfaction; however disconfirmation should not be overlooked.     

显微镜下骨锚式助听器植入术和适宜植入部位的初步研究

目的 探讨局麻下通过显微镜进行骨锚式助听器(BAHA)植入手术的优点,总结植入的适宜部位。方法 选择2例男性患者,①62岁患者为左耳混合性聋, 右耳极重度感音神经性聋(近全聋),气导左耳为92.5dB,右耳＞100dB (取0.5、1、2、4kHz均数,当听阈＞100dB时仍作100dB,下同),声场检查双耳均大于100dB,声场软带BAHA试验45～100dB下降斜坡型,4kHz以上消失。BAHA植入部位选择在耳后沟后3cm,外耳道口上缘水平上方2.5～3.0cm处,距外耳道口约5.0～5.5cm植入基座;②16岁患者为双耳传导性耳聋,曾先后行鼓室成形听骨链重建术,均因3听骨畸形固定,术后听力提高不明显。声场检查50～70dB水平型(左耳为67.5dB,右耳为52.5dB),声场软带BAHA试验40～50dB,水平型。BAHA植入部位选择外耳道口上缘平面、耳后沟后2cm距外耳道口约4.5～5.0cm处。结果 带机后声场检查结果,病例1术耳平均57.5dB,对侧耳平均72.5dB;曲线呈水平型,且双侧4kHz亦测出,术侧较术前平均提高35dB,对侧耳平均提高27.5dB,较术前试戴结果术侧也平均提高26.25dB;病例2术耳32.5dB,曲线呈水平型,较术前声场检查术侧平均提高35dB,比术前软带试验结果也平均提高13.75dB。2例术后3个月复查CT均显示骨融合良好。三维重建显示,病例1钛钉虽未穿入颅骨中,但局部向颅内突起。病例2见钛钉远端离颅内面至少有2cm的距离。结论 BAHA对改善传导性耳聋及独耳患者听力效果确切,局麻下显微镜手术一般可以适用。耳道正后方乳突骨质较厚,比传统耳道后上方植入基座产生颅内损伤机率更少。     

A comparison of the quality of life of parents of children using hearing aids and those using cochlear implants

ObjectiveThe goal of this study was to evaluate the quality of life of parents of children who use hearing aids (HA) with those who use cochlear implants (CI) in the Indian context and document any differences found.MethodsThe Kannada version of the AQoL-4D was administered in a modified fashion to 131 parents (87 HA and 44 CI). Sociodemographic details were collected for supplemental information on the intervention strategy used.ResultsA total of 49 parents (29 HA and 20 CI) responded to the questionnaire sent. The mean total scores for both the groups were similar (HA group = 17.9 (SD = 5.5), CI group = 17.2 (SD = 3.4)), as was the score for the first subscale (HA group = 8.6 (SD = 2.9); CI group = 8.5 (SD = 2.6)) of the AQoL-4D. No significant differences were found between the two groups on either scores [Total Score: U (N_HA = 29, N_CI = 20) = 280.5, z = ?0.194, p > 0.05; Subscale 1 Score: U (N_HA = 29, N_CI = 20) = 281.5, z = ?0.176, p > 0.05]. The degree of hearing loss in the hearing aid group was equivalent to that of the cochlear implant group but this did not appear to influence parental quality of life.ConclusionParents of children with hearing aids and cochlear implants appear to be similar on several psychosocial factors in the realms of functional, social, and psychological well-being. In terms of parental quality of life, hearing aids and cochlear implants appear to be equally effective intervention techniques.     

Bone anchored hearing aids: a second fixture reduces auditory deprivation in Cambridge

Bone anchored hearing aids are well established for canal atresia, otosclerosis and chronic suppurative otitis media. Refinements in technique to maximise gain while keeping the complications to a minimum are desirable. This study was taken up in order to explore the potential advantage of a second or spare fixture placed at the time of primary surgery. A group of patients who underwent BAHA insertion at The Emmeline Centre for Cochlear Implants and Bone Anchored Hearing Aids, Addenbrookes hospital, Cambridge, UK with the placement of a spare fixture between 1999 and 2002 were compared to those patients with one fixture BAHA undertaken from 1991. Main outcome measures were complications encountered and duration of disability, (i.e. loss of hearing while waiting for new fixture placement). Both groups had similar incidence of complications, but the group with two fixtures suffered a shorter period of disability when a fixture failed. In our experience the use of second or spare fixture reduces the duration of disability. It engenders no additional complications with minimal extra cost. This paper was presented at 24th Politzer society meeting, Amsterdam, September 2003.     

助听器助听效果的客观评价

目的 评价助听器的助听效果。方法 所采用的客观测试包括,声场情况下助听与未助听的由短声引起民的听性脑干反应（ＡＢＲ）测试及由短纯音引起的颅顶慢反应（ＳＶＲ）测试。结果与结论 ＳＶＲ阈值与声场纯音测试阈值间有高度的相关性,两种测试方法所测得的听力补偿间无显著性差异。     

A comparison of CIC and BTE hearing aids for three-dimensional localization of speech

Abstract

Three-dimensional sound localization of speech in anechoic space was examined for eleven listeners with sensorineural hearing loss. The listeners were fitted bilaterally with CIC and BTE hearing aids having similar bandwidth capabilities. The goal was to determine whether differences in microphone placement for these two styles (CICs at the ear canal entrance; BTEs above the pinna) would influence the availability of pinna-related spectral cues and hence localization performance. While lateral and polar angle localization was unaffected by the hearing aid style, the rate of front-back reversals was lower with CICs. This pattern persisted after listeners accommodated to each set of aids for a six week period, although the overall rate of reversals declined. Performance on all measures in all conditions was considerably poorer than in a control group of listeners with normal hearing.

Sumario

Se evaluó la localización tridimensional de sonidos del habla en un espacio anecoide en once personas con pérdida auditiva sensorineural. A los once se les adaptaron CIC y BTE bilateralmente con capacidad de ancho de banda similar. El objetivo fue determinar si las diferencias en la colocación del micrófono con ambos tipos (CIC en el ingreso del conducto auditivo; BTE sobre el pabellón auricular) podría influenciar la disponibilidad de claves espectrales relacionadas con el pabellón y por ello, el rendimiento para la localización. Mientras que la localización del ángulo lateral y polar no fue afectada por el tipo de auxiliar, la tasa de inversiones frente-atrás fue menor con los CIC. Este patrón persistió después de que estas personas se acostumbraron a cada set de auxiliares por un período de seis semanas, a pesar de que declinó la tasa global de reversiones. El rendimiento en todas las mediciones y condiciones fue considerablemente más pobre que en el grupo control de personas con audición normal.     

Results of hearing aids use dispensed by a publicly-funded health service

Hearing aid use and satisfaction can be used to analyze the effectiveness of hearing rehabilitation, an issue few explored in Brazilian users.ObjectiveEvaluate hearing aid use dispensed in a publicly-funded health service after one year, the interventions needed and users' satisfaction.MethodProspective observational cross-sectional study. Hearing aid users were invited by telephone to participate in an evaluation of hearing aid use.Results200 hearing aid users attended the evaluation (47% of sample loss); 76.5% of the subjects were using hearing aids bilaterally, 10.5% unilaterally and 13.0% none of them; 99.5% of users needed some kind of intervention. Users who kept wearing their hearing aids were considered “satisfied”.ConclusionActive search by telephone showed that hearing aid users who attend this publicly-funded health service have difficulties to attend follow-up appointments. Most of the users that came for evaluation kept using their hearing aids; non-use rate was 13%. Practically all hearing aid users needed some kind of intervention. Despite the high level of satisfaction, those findings did not include users who did not participate in evaluation, which could represent subjects less adhered to the treatment. Results highlighted the need of periodical follow-ups to ensure the effectiveness of auditory rehabilitation.     

婴幼聋儿助听器的验配及随诊

成立助听观察室专为双耳感音神经性聋婴幼儿选配助听器,并进行定期调试及康复指导,用声场验配法评估助听效果。结果发现佩戴助听器1～3年后的助听效果较初戴时好,两者之间有显著性差异（P＜0．01）,高频差异更大。表明聋儿听敏度特别是高频部分的听敏度有提高。     

Wireless binaural hearing aid technology for telephone use and listening in wind noise

Objective: To assess the speech perception benefits of binaural streaming technology for bilateral hearing aid users in two difficult listening conditions.

Design: Two studies were conducted to compare hearing aid processing features relating to telephone use and wind noise. Speech perception testing was conducted in four different experimental conditions in each study.

Study sample: Ten bilaterally-aided children in each study.

Results: Significant improvements in speech perception were obtained with a wireless feature for telephone use. Significant speech perception benefits were also obtained with wireless hearing aid features when listening to speech in simulated wind noise.

Conclusions: Binaural signal processing algorithms can significantly improve speech perception for bilateral hearing aid users in challenging listening situations.