Reasons for the non-use of hearing aids: perspectives of non-users, past users, and family members

Exploring factors influencing hearing Aid uptake: insights from a Korean population with unilateral and bilateral hearing loss

OBJECTIVE

To evaluate audiological and nonaudiological predictors of hearing aid (HA) uptake in patients with unilateral hearing loss (UHL) and bilateral hearing loss (BHL).

DESIGN

Retrospective study.

STUDY SAMPLES

A total of 655 patients with UHL and 3,699 patients with BHL were retrospectively included over a 10-year period. The primary audiological measurements were 4-frequency average pure-tone audiometry, speech discrimination score, hearing loss type, and presence of tinnitus.

RESULTS

The HA uptake rates in patients with UHL and BHL were 28.4% and 45.0%, respectively. In the UHL group, no substantial differences were identified between the HA uptake and refusal groups, except for sex. In contrast, the BHL group showed significant differences based on age, sex, and hearing threshold.The significant associations between potential explanatory variables and HA uptake were observed for age, SDS, and tinnitus, with odd ratios of 1.015, 1.004, and 1.251, respectively. The predictive accuracy (discriminating power) was 52.0% for UHL and 55.9% for BHL.

CONCLUSIONS

The statistical analysis of this study indicates that audiological predictors accounted for approximately 50% of the impact on HA uptake. Our findings underscore the importance of considering nonaudiological factors during counselling to enhance HA uptake.

Impact of Hearing Loss Severity on Hearing Aid Benefit Among Adult Users

BACKGROUND

Hearing loss (HL) among older adults is a major global health concern. Hearing aids (HAs) offer an effective solution to manage HL and enhance the quality of life. However, the adoption and the consistent use of HAs remain low, making non-use a significant barrier to successful audiological rehabilitation. The aim of the study was to assess the benefit of HAs among patients with different degrees of HL and to determine the profiles of patients who have the least benefit from HAs.

METHODS

the HA benefits were assessed by using the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire. Participants were assigned to the study groups based on the pure-tone audiometry. This paper presents the results obtained by using HAs in various listening environments among 167 patients.

RESULTS

The majority of individuals benefited from HAs in a noisy environment while a reverberant environment provided the lowest benefit. It was observed that the degree of HL had a statistically significant impact on the benefits of HAs in terms of the communication ease, the reverberation, the background noise, and the global score. A moderately positive correlation was observed between the unaided APHAB and the HL degree. The subjects' APHAB scores ranged from the 50th to the 65th percentile. Additionally, women had a significantly better improvement than men.

CONCLUSIONS

HAs improved communication in everyday life situations among 91.6% of HA users. The degree of HL influences APHAB scores. Patients with a severe degree of HL achieved the greatest APHAB scores while male patients with mild HL received the lowest benefits of HAs. Both HL and the age, gender, and HA type are factors that also play important roles. The APHAB questionnaire is a reliable screening test for patients with hearing difficulties.

Perceptions of older and younger adults who wear hearing aids

OBJECTIVE

To investigate older and younger adults' perceptions of older and younger adults who wear hearing aids.

DESIGN

Participants completed two Implicit Association Tests: One with images of older adults (OA-IAT) and one with images of younger adults (YA-IAT), either wearing or not wearing hearing aids. Participants also rated age, attractiveness, and intelligence of younger and older adults pictured with or without a hearing aid.

STUDY SAMPLE

Thirty older adults (M age = 70 years, SD = 4.38) and 30 younger adults (M age = 23 years, SD = 3.01) who reported not having hearing aids or a diagnosed hearing impairment.

RESULTS

For both IATs, older and younger participants responded faster and more accurately when images of individuals wearing hearing aids were paired with negative words in comparison to positive words. Photo ratings did not vary in relation to the presence or absence of hearing aids for either age group.

CONCLUSION

Although the photo rating tasks indicate neutral explicit attitudes towards individuals who wear hearing aids, our interpretation of the IAT results indicates that younger and older adults may hold negative implicit attitudes towards both older and younger hearing aid users.

Effectiveness of the HEAR-Aware App for Adults Not Ready for Hearing Aids, but Open to Self-Management Support: Results of a Randomized Controlled Trial

INTRODUCTION

Recently, the HEAR-aware app was developed to support adults who are eligible for hearing aids (HAs) but not yet ready to use them. The app serves as a self-management tool, offering assistance for a range of target behaviors (TBs), such as communication strategies and emotional coping. Using ecological momentary assessment and intervention, the app prompts users to complete brief surveys regarding challenging listening situations they encounter in their daily lives (ecological momentary assessment). In response, users receive educational content in the form of "snippets" (videos, texts, web links) on the TBs, some of which are customized based on the reported acoustic environmental characteristics (ecological momentary intervention). The primary objective of this study was to assess the effectiveness of the HEAR-aware app in enhancing readiness to take action on various TBs and evaluate its impact on secondary outcomes. The secondary objective was to examine the app's usability, usefulness, and user satisfaction.

METHODS

A randomized controlled trial design with two arms was used. Participants with hearing loss aged 50 years and over were recruited via an HA retailer and randomly assigned to the intervention group (n = 42, mean age = 65 years [SD = 9.1]) or the control group (n = 45, mean age = 68 years [SD 8.7]). The intervention group used the app during 4 weeks. The control group received no intervention. All participants completed online questionnaires at baseline (T0), after 4 weeks (T1), and again 4 weeks later (T2). Participants' readiness to take action on five TBs was measured with The Line Composite. A list of secondary outcomes was used. Intention-to-treat analyses were performed using Linear Mixed effect Models including group (intervention/control), time (T0/T1/T2), and Group × Time Interactions. In addition, a per protocol analysis was carried out to explore whether effects depended on app usage. For the secondary aim the System Usability Scale (SUS), the Intrinsic Motivation Inventory, item 4 of the International Outcome Inventory-Alternative Intervention (IOI-AI), and a recommendation item were used (intervention group only at T1).

RESULTS

For objective 1, there was no significant group difference for The Line Composite over the course of T0, T1, and T2. However, a significant ( p = 0.033) Group × Time Interaction was found for The Line Emotional coping, with higher increase in readiness to take action on emotional coping in the intervention group than in the control group. The intention-to-treat analyses revealed no other significant group differences, but the per protocol analyses showed that participants in the intervention group were significantly more ready to take up Assistive Listening Devices (The Line Assistive Listening Devices) and less ready to take up HAs (Staging Algorithm HAs) than the control group ( p = 0.049). Results for objective 2 showed that on average, participants rated the app as moderately useful (mean Intrinsic Motivation Inventory score 5 out of 7) and its usability as "marginal" (mean SUS score 68 out of 100) with about half of the participants rating the app as "good" (SUS score >70) and a minority rating is as "unacceptable" (SUS score ≤50).

CONCLUSIONS

This study underscores the potential of self-management support tools like the HEAR-aware app in the rehabilitation of adults with hearing loss who are not yet ready for HAs. The range in usability scores suggest that it may not be a suitable intervention for everyone.

Changing Knowledge, Principles, and Technology in Contemporary Clinical Audiological Practice: A Narrative Review

The field of audiology as a collection of auditory science knowledge, research, and clinical methods, technologies, and practices has seen great changes. A deeper understanding of psychological, cognitive, and behavioural interactions has led to a growing range of variables of interest to measure and track in diagnostic and rehabilitative processes. Technology-led changes to clinical practices, including teleaudiology, have heralded a call to action in order to recognise the role and impact of autonomy and agency on clinical practice, engagement, and outcomes. Advances in and new information on loudness models, tinnitus, psychoacoustics, deep neural networks, machine learning, predictive and adaptive algorithms, and PREMs/PROMs have enabled innovations in technology to revolutionise clinical principles and practices for the following: (i) assessment, (ii) fitting and programming of hearing devices, and (iii) rehabilitation. This narrative review will consider how the rise of teleaudiology as a growing and increasingly fundamental element of contemporary adult audiological practice has affected the principles and practices of audiology based on a new era of knowledge and capability. What areas of knowledge have grown? How has new knowledge shifted the priorities in clinical audiology? What technological innovations have been combined with these to change clinical practices? Above all, where is hearing loss now consequently positioned in its journey as a field of health and medicine?

Focusing on positive listening experiences improves hearing aid outcomes in first-time hearing aid users: a randomized controlled trial

OBJECTIVE

The objective of this study was to investigate whether positive focus (PF), an intervention that asks hearing aid users to focus on positive listening experiences, improves hearing aid outcomes for first-time hearing aid users.

DESIGN

The participants were randomised into a control or PF group. They were fitted with hearing aids and followed for six months after fitting. The PF group was asked to report positive listening experiences in their daily life via an app. Participants in both groups were periodically prompted by the app to answer questionnaires about hearing aid satisfaction and benefit. Two follow-up visits at approximately one and six months were performed.

STUDY SAMPLE

20 adult first-time hearing aid users in the control and 18 in the PF group.

RESULTS

Hearing aid satisfaction and benefit scores were significantly better in the PF group, already at two weeks and throughout the six months. In the PF group, the hearing aid outcomes were positively correlated with the number of submitted positive reports.

CONCLUSIONS

These results point to the importance of asking first-time hearing aid users to focus on positive listening experiences and to reflect upon them. This can lead to improved short- and long-term hearing aid outcomes.

Unveiling a novel GJB2 dominant K22T mutation in a Chinese family with hearing loss

Hearing loss constitutes one of the most prevalent conditions within the field of otolaryngology. Recent investigations have revealed that mutations in deafness-associated genes, including point mutations and variations in DNA sequences, can cause hearing impairments. With the ethology of deafness remaining unclear for a substantial portion of the affected population, further screenings for pathogenic mutations are imperative to unveil the underlying mechanisms. On this study, by using next-generation sequencing, we examine 129 commonly implicated deafness-related genes in a Chinese family with hearing loss, revealing a novel heterozygous dominant mutation in the GJB2 gene (GJB2: c.65T>G: p. Lys22Thr). This mutation consistently occurs in affected family members but is not detected in unaffected individuals, strongly suggesting its causative role in hearing loss. Structural analysis indicates potential disruption to the Cx26 gap junction channel's hydrogen bond and electrostatic interactions, aligning with predictions from the PolyPhen and SIFT algorithms. In conclusion, our study provides conclusive evidence that the identified heterozygous GJB2 mutation (GJB2: c.65T>G: p. Lys22Thr), specifically the K22T alteration, is the primary determinant of the family's deafness. This contribution enhances our understanding of the interplay between common deafness-associated genes and hearing loss, offering valuable insights for diagnostic guidance and the formulation of therapeutic strategies for this condition.

Digits-in-Noise Test as an Assessment Tool for Hearing Loss and Hearing Aids

The aim of this study was to examine the relationship between an American English Digits in Noise (DIN) test and commonly used audiological measures to evaluate the DIN test's ability to detect hearing loss and validate hearing aid fitting. QuickSIN and DIN tests were completed by participants with untreated hearing loss (n = 46), prescription hearing aids (n = 15), and over-the-counter (OTC) hearing aids (n = 12). Performance on the QuickSIN showed moderate positive correlations with DIN for untreated hearing loss participants and prescription hearing aid users, but not for OTC hearing aid users. For untreated hearing loss participants, both QuickSIN and DIN tests showed positive moderate to strong correlations with high frequency puretone averages. In OTC users, DIN scores did not significantly change over a 6-month time period and were better when conducted remotely compared to in-person testing. Our results suggest that the DIN test may be a feasible monitoring option for individuals with hearing loss and those fitted with hearing aids. However, due to small sample size in this pilot study, future research is needed to examine DIN test's utility for fitting and validating OTC hearing aids.