Validation of the Chinese version “satisfaction with amplification in daily life (SADL)” survey for hearing-aid users

Abstract

Objective: Satisfaction with amplification in daily life (SADL) may quantify satisfaction with hearing aids. We translated and validated a Chinese version of SADL (CSADL). Design: The SADL was translated from English to Mandarin Chinese by two bilingual physicians. The CSADL was administered to hearing-aid users and tested for reliability and validity. Study sample: There were 155 hearing-aid users who completed the CSADL prospectively, and 39 subjects were retested after 4 to 6 weeks for test-retest reliability. Results: The CSADL had good internal consistency (Cronbach α = 0.63 to 0.92), within survey reliability (r = 0.54 to 0.69; P ≤ .05), and test-retest reliability (r = 0.93 to 0.98; P ≤ .05). The CSADL dimensions correlated well with worse-ear speech discrimination score (P ≤ .05). The CSADL global score significantly correlated with the general health (r = 0.236; P ≤ .05), vitality (r = 0.162; P ≤ .05), social functioning (r = 0.190; P ≤ .05), and mental health (r = 0.224; P ≤ .05) subscales of the Mandarin Chinese Taiwan version of the medical outcome 36-item short-form health survey. Conclusions: The CSADL is a valid and reliable questionnaire to evaluate satisfaction among Chinese hearing-aid users.     

Cross-cultural adaptation and validation of the Chinese Abbreviated Profile of Hearing Aid Benefit

Abstract

Objective: The objective of the study was to investigate the cross-cultural validity and reliability of the Chinese version of the Abbreviated Profile of the Hearing Aid Benefit questionnaire (APHAB-CH). Design: A convenience sampling method was used to identify and recruit subjects. The subjects completed a history form seeking demographic data, the APHAB-CH, and a questionnaire seeking a subjective rating of hearing aid performance and overall satisfaction with their hearing aid. Study Sample: The subjects were 134 experienced hearing aid users. Results: The APHAB-CH had a good internal consistency reliability estimate (α = 0.85) comparable to that of the original version. Significant correlation was observed between the APHAB-CH scores and other subjective ratings for hearing aid performance and the overall satisfaction measure. A high test-retest reliability (intraclass correlation coefficient = 0.84) was observed. Confirmatory factor analysis revealed that the APHAB-CH had a two-factor structure comprising “hearing disability” and “averviseness.” Normative data in terms of equal-percentile profiles were dervied for the APHAB-CH. Conclusion: The results suggest that the APHAB-CH is a reliable and valid measure of the outcomes of hearing aid fitting

Sumario

Objetivo: El objetivo de este estudio fue investigar la validez y confiabilidad transcultural de la versión china del Cuestionario de Perfil Abreviado de Beneficios del Auxiliar Auditivo (APHAB-CH). Diseño: Se usó un método conveniente de muestreo para identificar y reclutar sujetos. Los sujetos completaron un formulario de historia para obtener datos demográficos, el APHAB-CH, y un cuestionario para encontrar los rangos subjetivos de rendimiento del auxiliar auditivo y de satisfacción general con el mismo. Muestra de Estudio: Los sujetos fueron 134 usuarios experimentados en el uso de auxiliar auditivo. Resultados: El APHAB-CH tuvo un estimado de confiabilidad con buena consistencia interna (α = 0.85) comparable con la de la versión original. Se observó una correlación significativa entre las puntuaciones del APHAB-CH con otras puntuaciones subjetivas de rendimiento del auxiliar auditivo y de mediciones de satisfacción general. Se observó una alta confiabilidad test-retest (coeficiente de correlación interno = 0.84). El análisis de factor de confirmación reveló que el APHAB-CH tuvo una estructura de dos factores que comprendía la “discapacidad auditiva” y la “aversión” Los datos normativos en términos de perfiles de igual percentil, se derivaron del APHAB-CH. Conclusion: Los resultados sugieren que el APHAB-CH es una medida válida y confiable de los resultados de la adaptación de auxiliares auditivos.     

Application of the health belief model: Development of the hearing beliefs questionnaire (HBQ) and its associations with hearing health behaviors

Abstract

Objective: To develop a hearing beliefs questionnaire (HBQ) that assesses hearing beliefs within the constructs of the health belief model, and to investigate whether HBQ scores are associated with hearing health behaviors. Design: A 60-item version of the questionnaire was developed and completed by 223 participants who also provided information about their hearing health behaviors (help seeking, hearing-aid acquisition, and hearing-aid use). Study sample: Individuals aged between 22 and 90 years recruited from a primary care waiting area at a Veterans hospital. Seventy-six percent were male, 80% were Veterans. Results: A 26-item version of the HBQ with six scales was derived using factor analysis and reliability analyses. The scales measured: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived self-efficacy, and cues to action. HBQ scores differed significantly between individuals with different hearing health behaviors. Logistic regression analyses resulted in robust models of hearing health behaviors that correctly classified between 59% and 100% of participant hearing health behaviors. Conclusions: The HBM appears to be an appropriate framework for examining hearing health behaviors, and the HBQ is a valuable tool for assessing hearing health beliefs and predicting hearing health behaviors.     

Placebo effects in hearing-aid trials are reliable

Abstract

Objective: A recent study suggested that placebo effects are a source of bias in non-blinded hearing-aid trials. Given the potential impact of this finding on the interpretation of non-blinded trials and design of future research trials, the objective of the present study was to investigate the reliability of this effect. Design: Using the same procedure as an earlier study, participants were told that they were taking part in a trial of new hearing-aid technology. Participants compared two devices that were acoustically identical, except one was described as “new” and the other as “conventional”. Participants completed a speech-in-noise test, sound quality ratings, and rated overall personal preference for both hearing aids. Study sample: Sixteen adult hearing-aid users. Results: Participants had significantly better mean speech-in-noise performance (70.9% versus 66.8%, Z = 2.30, p = 0.02, effect size Pearson's r = 0.15) and sound quality ratings for the “new” hearing aid (8.1 versus 7.4, Z = ? 2.99, p = 0.003, r = 0.28). A significant proportion of participants (75%) expressed an overall preference for the “new” hearing aid (p = 0.001, effect size φ_c = 0.66). Conclusion: Placebo effects reliably impact on hearing-aid trials. In order to control for placebo effects, double-blind methodology is optimal. However, when double-blinding is not possible other strategies may be appropriate.     

Acceptable noise level (ANL) with Danish and non-semantic speech materials in adult hearing-aid users

Abstract

Objective: The acceptable noise level (ANL) test is used for quantification of the amount of background noise subjects accept when listening to speech. This study investigates Danish hearing-aid users’ ANL performance using Danish and non-semantic speech signals, the repeatability of ANL, and the association between ANL and outcome of the international outcome inventory for hearing aids (IOI-HA). Design: ANL was measured in three conditions in both ears at two test sessions. Subjects completed the IOI-HA and the ANL questionnaire. Study sample: Sixty-three Danish hearing-aid users; fifty-seven subjects were full time users and 6 were part time/non users of hearing aids according to the ANL questionnaire. Results: ANLs were similar to results with American English speech material. The coefficient of repeatability (CR) was 6.5–8.8 dB. IOI-HA scores were not associated to ANL. Conclusions: Danish and non-semantic ANL versions yield results similar to the American English version. The magnitude of the CR indicates that ANL with Danish and non-semantic speech materials is not suitable for prediction of individual patterns of future hearing-aid use or evaluation of individual benefit from hearing-aid features. The ANL with Danish and non-semantic speech materials is not related to IOI-HA outcome.     

Proposed norms for the Glasgow hearing-aid benefit profile (Ghabp) questionnaire

Abstract

Objective: To form a normative set of responses to the GHABP questionnaire from a large regional dataset. Design: Participants were asked to rate their hearing disability, handicap, hearing-aid (HA) use, HA benefit, HA satisfaction, and residual (aided) disability on a five-point scale for four situations: quiet conversation, television (TV) listening, noisy conversation, and group conversation. A subset of participants also estimated the time spent in these situations. Study sample: A group of 1574 adults with normal to profound hearing thresholds participated. Results: There was a significant relationship between increasing perceived disability and increasing hearing loss as given by the better-ear audiometric average (BEA). Responses for HA measures did not vary greatly with hearing loss: HA use was reported as high, whereas residual disability, HA benefit, and satisfaction were all reported on average as moderate. Conclusions: The results can be used as a normative dataset with which to evaluate individual responses in the clinic, where the GHABP provides a useful short-form questionnaire to engage the patient. The lack of systematic changes in hearing-aid related responses shows room for improvement in the benefit afforded by amplification.     

Health-related quality of life in adults with hearing impairment before and after hearing-aid rehabilitation in Finland

Objective: The aim of this study was to evaluate health-related quality of life (HRQoL) in adults with hearing impairment in Finland before and after hearing rehabilitation. Design: The study was prospective with hearing-aid rehabilitation as the intervention. The data was collected, using the 15D instrument, before and six months after hearing-aid rehabilitation. The data was analysed using t-tests and multiple linear regression methods. Study sample: The study sample included 949 adults with hearing impairment, and the control group included a sample of age- and gender-standardized general population. Results: The study population had significantly poorer HRQoL on most dimensions of the 15D when compared to the control group both before and after hearing-aid rehabilitation. Hearing-aid rehabilitation resulted in improved mean scores on the dimensions of hearing and in the overall 15D score that were statistically significant, although the mean improvement in the overall score was marginal. Self-reported hearing ability can better predict the change in HRQoL, as a result of a hearing aid, when compared with measured hearing sensitivity. Conclusions: The study supports the hypothesis that on average, use of a unilateral hearing aid results in improved subjective hearing and marginal improvement in HRQoL in adults with hearing impairment.     

Acceptable noise level (ANL) and real-world hearing-aid success in Taiwanese listeners

Abstract

Objective: The objective of this prospective study was to investigate the relationship between acceptable noise level (ANL), which was measured using Taiwanese and the international speech test signal (ISTS), and real-world hearing-aid success for listeners who were representative of the population commonly seen in clinics. Design: Unaided ANLs were measured pre-hearing-aid fitting. Hearing-aid success was assessed three months post-fitting using the international outcome inventory for hearing aids (IOI-HA) and a hearing-aid use questionnaire. Study sample: Eighty adults with hearing impairment completed the study. Results: Both Taiwanese and ISTS ANLs were significantly associated with hearing-aid success, with higher ANLs suggesting poorer outcomes. However, the ANL's prediction accuracy for the probability of hearing-aid success was either much lower than that suggested by some literature, or was not much different from that of simply predicting all listeners as successful users. Conclusions: The current study suggested the possibility of using ANL to predict hearing-aid success. However, the usefulness of ANL as a clinical tool is unlikely to be as great as indicated by the literature.     

Exploring the influence of culture on hearing help-seeking and hearing-aid uptake

Objective: The purpose of this paper was to highlight the importance of cultural influence in understanding hearing-help seeking and hearing-aid uptake. Design: Information on audiological services in different countries and ‘theories related to cross-culture’ is presented, followed by a general discussion. Study sample: Twenty-seven relevant literature reviews on hearing impairment, cross-cultural studies, and the health psychology model and others as secondary resources. Results: Despite the adverse consequences of hearing impairment and the significant potential benefits of audiological rehabilitation, only a small number of those with hearing impairment seek professional help and take up appropriate rehabilitation. Therefore, hearing help-seeking and hearing-aid uptake has recently become the hot topic for clinicians and researchers. Previous research has identified many contributing factors for hearing help-seeking with self-reported hearing disability being one of the main factors. Although significant differences in help-seeking and hearing-aid adoption rates have been reported across countries in population studies, limited literature on the influence of cross-cultural factors in this area calls for an immediate need for research. Conclusions: This paper highlights the importance of psychological models and cross-cultural research in the area of hearing help-seeking and hearing-aid uptake, and consequently some directions for future research are proposed.     

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.     

Sounds perceived as annoying by hearing-aid users in their daily soundscape

Abstract

Background: The noises in modern soundscapes continue to increase and are a major origin for annoyance. For a hearing-impaired person, a hearing aid is often beneficial, but noise and annoying sounds can result in non-use of the hearing aid, temporary or permanently. Objective: The purpose of this study was to identify annoying sounds in a daily soundscape for hearing-aid users. Design: A diary was used to collect data where the participants answered four questions per day about annoying sounds in the daily soundscape over a two-week period. Study sample: Sixty adult hearing-aid users. Results: Of the 60 participants 91% experienced annoying sounds daily when using hearing aids. The annoying sound mentioned by most users, was verbal human sounds, followed by other daily sound sources categorized into 17 groups such as TV/radio, vehicles, and machine tools. When the hearing-aid users were grouped in relation to age, hearing loss, gender, hearing-aid experience, and type of signal processing used in their hearing aids, small and only few significant differences were found when comparing their experience of annoying sounds. Conclusions: The results indicate that hearing-aid users often experience annoying sounds and improved clinical fitting routines may reduce the problem.     

Parent Satisfaction Questionnaire with Neonatal Hearing Screening Programs: Psychometric properties of the Persian version

Objectives

Measuring parent satisfaction with neonatal hearing screening programs is one of the most important indicators for assessing the quality and effectiveness and a useful instrument to identify service shortfalls. The aims of this study were to translate and adapt Parent Satisfaction Questionnaire with Neonatal Hearing Screening Programs (PSQ-NHSPs) to Persian language, determine the validity and reliability of this translation, and determine the level of parent satisfaction with neonatal hearing screening programs in Iran.

Methods

Translated Persian version of the original English PSQ-HNSPs was presented to 138 parents whose children had received hearing screening before discharge from hospital.

Results

The majority of parents responded strongly agree or agree to all dimensions of the questionnaire: overall satisfaction (90.6%), personnel in charge of hearing test (60.1%), and appointment activities (58%). Good internal consistency reliability (a = 0.89) and moderate test–retest reliability (r = 0.61) of the Persian version of PSQ-NHSPs were indicated. Construct validity was demonstrated by a significant positive relationship between overall satisfaction and specific dimensions in the questionnaire.

Conclusion

The Persian version of PSQ-NHSPs is a valid and reliable tool to assess the level of parent satisfaction with neonatal hearing screening programs.     

Predicting three-month and 12-month post-fitting real-world hearing-aid outcome using pre-fitting acceptable noise level (ANL)

Objective: Determine the extent to which pre-fitting acceptable noise level (ANL), with or without other predictors such as hearing-aid experience, can predict real-world hearing-aid outcomes at three and 12 months post-fitting. Design: ANLs were measured before hearing-aid fitting. Post-fitting outcome was assessed using the international outcome inventory for hearing aids (IOI-HA) and a hearing-aid use questionnaire. Models that predicted outcomes (successful vs. unsuccessful) were built using logistic regression and several machine learning algorithms, and were evaluated using the cross-validation technique. Study sample: A total of 132 adults with hearing impairment. Results: The prediction accuracy of the models ranged from 61% to 68% (IOI-HA) and from 55% to 61% (hearing-aid use questionnaire). The models performed more poorly in predicting 12-month than three-month outcomes. The ANL cutoff between successful and unsuccessful users was higher for experienced (～18 dB) than first-time hearing-aid users (～10 dB), indicating that most experienced users will be predicted as successful users regardless of their ANLs. Conclusions: Pre-fitting ANL is more useful in predicting short-term (three months) hearing-aid outcomes for first-time users, as measured by the IOI-HA. The prediction accuracy was lower than the accuracy reported by some previous research that used a cross-sectional design.     

A randomized controlled trial evaluating the effects of online rehabilitative intervention for adult hearing-aid users

Abstract

Objective: Previous research shows that the internet can be used in the rehabilitation of hearing-aid users. By further developing the online program, it might be possible to foster behavioral changes that will positively affect hearing-aid users. Design: A randomized controlled study with two groups of participants. The intervention group underwent a five-week online intervention while the control group was referred to a waiting list. Questionnaires were used as outcome measures. Study sample: Seventy-six experienced hearing-aid users participated in the study, ranging in age from 26 to 81 years (mean 69.3 years). Results: The findings showed significant improvements in the intervention group after the intervention, measured by the hearing handicap inventory for the elderly. The effects were maintained and improved at the follow-up. Furthermore, the results indicated that the participants in the intervention group improved at two items of the international outcome inventory for hearing aids, and the effects were partly maintained at the follow-up. Finally, significant improvements in the domain of psychosocial wellbeing were found at the follow-up. Conclusions: This study provides further evidence that the internet can be used to deliver intervention of rehabilitation to hearing-aid users.     

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.     

Outcome assessment alternatives for young children during the first 12 months after pediatric hearing-aid fittings

Abstract

Objective: Perform longitudinal evaluations of young children during the first 12 months after initial hearing-aid fitting. Document evidence of early prelingual auditory development (EPLAD), identify factors that affect EPLAD, and define performance milestones that can guide best practices. Design: Unblinded, prospective, within-subject, repeated-measures design. Audiological measures and measures of EPLAD were taken at baseline, 3, 6, and 12 months after hearing-aid fitting. Study sample: Subjects were 45 pediatric patients initially fitted with hearing aids between 1 and 5.5 years of age. Four groups were formed for analysis purposes based on severity of hearing loss (moderate-to-severe and profound) and initial fitting age (≤?30 months and >?30 months). Results: All groups exhibited statistically significant increases in EPLAD within six months of hearing-aid fitting, and those with profound losses exhibited further statistically significant improvement between six and 12 months. Similar EPLAD levels were reached at 12 months regardless of severity of hearing loss. The EPLAD trajectory is similar to that following early cochlear implantation. Conclusions: Measures of EPLAD provide a means of evaluating outcomes following early pediatric hearing-aid intervention, supplementing behavioral audiological measures.     

Ear diseases and other risk factors for hearing impairment among adults: An epidemiological study

Abstract

Objective: To investigate the prevalence of ear diseases, other otological risk factors potentially affecting hearing, and noise exposure among adults. Furthermore, subject-related factors possibly associated with hearing impairment (HI), i.e. handedness, eye color, and susceptibility to sunburn, were studied. Design: A cross-sectional, unscreened, population-based, epidemiological study among adults. Study sample: The subjects (n =?850), aged 54–66 years, were randomly sampled from the population register. A questionnaire survey, an otological examination, and pure-tone audiometry were performed. Results: Chronic middle-ear disease (both active and inactive) was the most common ear disease with a prevalence of 5.3%, while the prevalence of otosclerosis was 1.3%, and that of Ménière's disease, 0.7%. Noise exposure was reported by 46% of the subjects, and it had no effect on hearing among those with no ear disease or other otological risk factors for HI. Dark eye color and non-susceptibility to sunburn were associated with HI among noise-exposed subjects. Conclusions: Common ear diseases and other otological risk factors constitute a major part of the etiologies of HI among adults. Contrary to previous studies, noise exposure turned out to have only marginal effect on hearing among those with no otological risk factors.