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Scarinci N, Nickbakht M, Timmer BH, Ekberg K, Cheng B, Hickson L. A Qualitative Investigation of Clients, Significant Others, and Clinicians' Experiences of Using Wireless Microphone Systems to Manage Hearing Impairment. Audiol Res 2022; 12:596-619. [PMID: 36412654 PMCID: PMC9680209 DOI: 10.3390/audiolres12060059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/19/2022] [Accepted: 10/19/2022] [Indexed: 12/14/2022] Open
Abstract
This study aimed to explore the perceptions and experiences of adults with hearing impairment (HI), their significant others (SOs), and clinicians regarding the use and provision of wireless microphone systems (WMS). A qualitative descriptive methodology was used, with a total of 43 participants across three groups: (1) 23 adults with HI who used WMS; (2) 7 SOs of adults who used WMS; and (3) 13 clinicians who provided WMSs to adults with HI. Participants completed an individual semi-structured in-depth interview to explore their experiences, with the data analysed using thematic analysis. The analysis revealed five themes encompassing the perceptions and experiences of WMSs: (1) with experience and clear expectations, users believe that WMS can make a difference; (2) the trial and decision-making process is important; (3) clients' experiences using WMS; (4) issues with WMS and technology; and (5) users require ongoing training and support to use WMS. These findings highlight the complexities of providing and using WMS with adults with HI. However, clients, SOs, and clinicians all reported that, with appropriate experience, expectations, training, and support, WMS can make a real difference in listening and communicating in different situations. There is also an opportunity to involve SOs more throughout the rehabilitation process.
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Affiliation(s)
- Nerina Scarinci
- School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia 4072, Australia
- Correspondence: ; Tel.: +61-7-3365-3097
| | - Mansoureh Nickbakht
- School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia 4072, Australia
| | - Barbra H. Timmer
- School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia 4072, Australia
- Sonova, 8712 Stäfa, Switzerland
| | - Katie Ekberg
- School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia 4072, Australia
| | - Bonnie Cheng
- School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia 4072, Australia
| | - Louise Hickson
- School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia 4072, Australia
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Hughes SE, Boisvert I, McMahon CM, Steyn A, Neal K. Perceived listening ability and hearing loss: Systematic review and qualitative meta-synthesis. PLoS One 2022; 17:e0276265. [PMID: 36282860 PMCID: PMC9595527 DOI: 10.1371/journal.pone.0276265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 10/04/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Hearing loss (HL) can affect communication in complex ways. Understanding how adults with HL reflect on and conceptualise the way they listen (metacognition) is required if interventions, and the outcome measures used to evaluate them, are to address barriers to functional communication arising from HL. OBJECTIVES This study describes how adults with HL experience and report the processes, behaviours, and components of listening, as presented in published studies. DESIGN Systematic review and meta-synthesis of qualitative studies. METHODS Systematic searches identified English-language, peer-reviewed journal articles reporting the results of qualitative or mixed-methods studies of adults' with HL perceived listening abilities. Medline, PsychInfo, Web of Science, Embase, and Google Scholar were searched from inception to November 2021. Handsearching reference lists of included studies identified additional studies for inclusion. The Critical Appraisal Skills Programme (CASP) qualitative checklist was used to appraise studies' methodological quality. Data from included studies were analysed using thematic meta-synthesis. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) Confidence in the Evidence from Reviews of QUALitative (CERQual) approach assessed confidence in the review findings. Two reviewers independently completed all screening and quality appraisal. Thematic meta-synthesis and GRADE CERQual assessment was completed by one reviewer and confirmed by a second reviewer. Discrepancies were resolved through discussion. RESULTS Data from 46 studies were included in the review. Thematic meta-synthesis identified six descriptive themes: 1) perceived listening ability; 2) external modifiers; 3) psychosocial impacts of hearing loss; 4) communication partner perspectives; 5) self-efficacy for listening; and 6) cognitive load. GRADE CERQual ratings for descriptive themes ranged from low to moderate confidence. Descriptive themes were related by analytic themes of liminality and reciprocity. CONCLUSIONS Adults with HL provide in-depth accounts of components and processes of listening, with studies reporting both cognitive and affective experiences consistent with theoretical models of metacognition. The findings will inform content generation for a hearing-specific patient-reported outcome measure of perceived listening ability in everyday communication.
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Affiliation(s)
- Sarah E. Hughes
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC), West Midlands, United Kingdom
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, United Kingdom
- National Institute of Health and Care Research (NIHR) Blood and Transplant Research Unit (BTRU) in Precision Therapeutics, University of Birmingham, Birmingham, United Kingdom
- Narra Consulting Limited, Wales, United Kingdom
- Faculty of Medicine, Health, and Life Science, Swansea University, Swansea, United Kingdom
- * E-mail:
| | - Isabelle Boisvert
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- HEAR Centre, Macquarie University, Sydney, Australia
| | - Catherine M. McMahon
- HEAR Centre, Macquarie University, Sydney, Australia
- Department of Linguistics, Macquarie University, Sydney, NSW, Australia
| | | | - Katie Neal
- HEAR Centre, Macquarie University, Sydney, Australia
- Department of Linguistics, Macquarie University, Sydney, NSW, Australia
- The Shepherd Centre, Sydney, NSW, Australia
- The Listening Lab, Sydney, NSW, Australia
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Husstedt H, Kahl J, Fitschen C, Griepentrog S, Frenz M, Jürgens T, Tchorz J. Design and verification of a measurement setup for wireless remote microphone systems (WRMSs). Int J Audiol 2021; 61:34-45. [PMID: 34028326 DOI: 10.1080/14992027.2021.1915505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This work presents the design and verification of a simplified measurement setup for wireless remote microphone systems (WRMSs), which has been incorporated into guidelines of the European Union of Hearing Aid Acousticians (EUHA). DESIGN Three studies were conducted. First, speech intelligibility scores within the simplified setup were compared to that in an actual classroom. Second, different WRMSs were compared in the simplified setup, and third, normative data for normal-hearing people with and without WRMS were collected. STUDY SAMPLE The first two studies include 40 older hearing impaired and the third study 20 young normal-hearing adults. RESULTS Speech intelligibility with WRMS was not different across actual classroom and simplified setup. An analog omnidirectional WRMS showed poorer speech intelligibility and poorer quality ratings than digital WMRSs. The usage of a WRMS in the simplified setup resulted in significantly higher speech intelligibility across all tested background noise levels. CONCLUSIONS Despite being a simplified measurement setup, it realistically emulates a situation where people are listening to speech in noise from a distance, such as in a classroom or meeting room. Hence, with standard audiological equipment, the individual benefit of WRMSs can be measured and experienced by the user in clinical practice.
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Affiliation(s)
| | - Julia Kahl
- Academy of Hearing Acoustics, Lübeck, Germany
| | | | | | | | - Tim Jürgens
- Technische Hochschule Lübeck, Lübeck, Germany
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Dixon PR, Feeny D, Tomlinson G, Cushing S, Chen JM, Krahn MD. Health-Related Quality of Life Changes Associated With Hearing Loss. JAMA Otolaryngol Head Neck Surg 2021; 146:630-638. [PMID: 32407468 DOI: 10.1001/jamaoto.2020.0674] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Importance Utility is a single-value, preference-based measure of health-related quality of life that represents the desirability of a health state relative to being dead or in perfect health. Clinical, funding, and policy decisions rely on measured changes in utility. The benefit of hearing loss treatments may be underestimated because existing utility measures fail to capture important changes in quality of life associated with hearing loss. Objective To develop a comprehensive profile of items that describe how quality of life is associated with hearing loss and its treatments that can be used to generate hearing-related quality of life measures, including a novel utility measure. Design, Setting, and Participants This qualitative study, performed from August 1, 2018, to August 1, 2019, in tertiary referral centers, comprised a systematic literature review, focus groups, and semistructured interviews. The systematic review evaluated studies published from 1982 to August 1, 2018. Focus groups included 8 clinical experts experienced in the measurement, diagnosis, treatment, and rehabilitation of hearing loss. Semistructured interviews included 26 adults with hearing loss recruited from an institutional data set and outpatient hearing aid and otology clinics using stratified convenience sampling to include individuals of diverse ages, urban and rural residency, causes of hearing loss, severity of hearing loss, and treatment experience. Main Outcomes and Measures A set of items and subdomains that collectively describe the association of hearing loss with health-related quality of life. Results The literature search yielded 2779 articles from the MEDLINE, Embase, Cochrane, PsycINFO, and CINAHL databases. Forty-five studies including 1036 individuals (age range, 18-84 years) were included. The focus group included 4 audiologists and 4 otologists. Hour-long semistructured interviews were conducted with 26 individuals (13 women; median age, 54 years; range, 25-83 years) with a broad range of hearing loss causes, configurations, and severities. From all 3 sources, a total of 125 items were generated and organized into 29 subdomains derived from the World Health Organization's International Classification of Functioning, Disability and Health. Conclusions and Relevance The association of hearing loss with quality of life is multidimensional and includes subdomains that are not considered in the estimation of health utility by existing utility measures. The presented comprehensive profile of items can be used to generate or evaluate measures of hearing-related quality of life, including utility measures.
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Affiliation(s)
- Peter R Dixon
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Toronto Health Economics and Technology Assessment Collaborative, Toronto, Ontario, Canada
| | - David Feeny
- Department of Economics, McMaster University, Hamilton, Ontario, Canada.,Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada.,Health Utilities Incorporated, Hamilton, Ontario, Canada
| | - George Tomlinson
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Toronto Health Economics and Technology Assessment Collaborative, Toronto, Ontario, Canada
| | - Sharon Cushing
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada.,Department of Otolaryngology-Head & Neck Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Joseph M Chen
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada.,Department of Otolaryngology-Head & Neck Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Murray D Krahn
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Toronto Health Economics and Technology Assessment Collaborative, Toronto, Ontario, Canada.,University Health Network, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Turton L, Souza P, Thibodeau L, Hickson L, Gifford R, Bird J, Stropahl M, Gailey L, Fulton B, Scarinci N, Ekberg K, Timmer B. Guidelines for Best Practice in the Audiological Management of Adults with Severe and Profound Hearing Loss. Semin Hear 2020; 41:141-246. [PMID: 33364673 PMCID: PMC7744249 DOI: 10.1055/s-0040-1714744] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Individuals with severe to profound hearing loss are likely to present with complex listening needs that require evidence-based solutions. This document is intended to inform the practice of hearing care professionals who are involved in the audiological management of adults with a severe to profound degree of hearing loss and will highlight the special considerations and practices required to optimize outcomes for these individuals.
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Affiliation(s)
- Laura Turton
- Department of Audiology, South Warwickshire NHS Foundation Trust, Warwick, United Kingdom
| | - Pamela Souza
- Communication Sciences and Disorders and Knowles Hearing Center, Northwestern University, Evanston, Illinois
| | - Linda Thibodeau
- University of Texas at Dallas, Callier Center for Communication Disorders, Dallas, Texas
| | - Louise Hickson
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia
| | - René Gifford
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Judith Bird
- Cambridge University Hospital NHS Foundation Trust, United Kingdom
| | - Maren Stropahl
- Department of Science and Technology, Sonova AG, Stäfa, Switzerland
| | | | | | - Nerina Scarinci
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia
| | - Katie Ekberg
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia
| | - Barbra Timmer
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia
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Entwisle LK, Warren SE, Messersmith JJ. Cochlear Implantation for Children and Adults with Severe-to-Profound Hearing Loss. Semin Hear 2018; 39:390-404. [PMID: 30374210 DOI: 10.1055/s-0038-1670705] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Cochlear implants (CIs) have proven to be a useful treatment option for individuals with severe-to-profound hearing loss by providing improved access to one's surrounding auditory environment. CIs differ from traditional acoustic amplification by providing information to the auditory system via electrical stimulation. Both postlingually deafened adults and prelingually deafened children can benefit from a CI; however, outcomes with a CI can vary. Numerous factors can impact performance outcomes with a CI. It is important for the audiologist to understand what factors might play a role and impact performance outcomes with a CI so that they can effectively counsel the recipient and their family, as well as establish appropriate and realistic expectations with a CI. This review article will discuss the CI candidacy process, CI programming and postoperative follow-up care, as well as considerations across the lifespan that may affect performance outcomes with a CI.
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Affiliation(s)
- Lavin K Entwisle
- Department of Communication Sciences and Disorders, University of South Dakota, Vermillion, South Dakota.,Department of Otolaryngology, New York University School of Medicine, New York, New York
| | - Sarah E Warren
- School of Communication Sciences and Disorders, University of Memphis, Memphis, Tennessee
| | - Jessica J Messersmith
- Department of Communication Sciences and Disorders, University of South Dakota, Vermillion, South Dakota
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Meyer S, Larrivee L, Veneziano-Korzec A, Stacy K. Improving Art Museum Accessibility for Adults With Acquired Hearing Loss. Am J Audiol 2017; 26:10-17. [PMID: 28114629 DOI: 10.1044/2016_aja-15-0084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 10/07/2016] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Adults with hearing loss rated the accessibility of guided or docent-led art museum tours with and without hearing assistive technology (HAT). METHOD Nineteen individuals (average age 64 years, range 35-87 years) with acquired hearing loss participated. All participants had a bilateral hearing loss (mild to profound) using hearing aids (n = 12), cochlear implants (n = 5), or no technology (n = 2). Two docents who were previously trained to modify their presentations and use clear speech led the tours. Participants experienced a tour with and without the museum's HAT and rated its effectiveness using a rating scale. The study used a pre-post test design. RESULTS The docent-led tours with HAT were rated significantly higher (p = .003) than the tours without HAT. Participants made several suggestions on improving museum accessibility for individuals with hearing loss. CONCLUSIONS The use of HAT during a museum tour was beneficial for individuals with hearing loss. Training docents to modify their presentations, use clear speech, and HAT improved the accessibility of docent-led tours for individuals with hearing loss.
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Affiliation(s)
- Susanna Meyer
- Communication Sciences & Disorders Department, Worcester State University, MA
| | - Linda Larrivee
- Communication Sciences & Disorders Department, Worcester State University, MA
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Reynolds S, Miller Kuhaneck H, Pfeiffer B. Systematic Review of the Effectiveness of Frequency Modulation Devices in Improving Academic Outcomes in Children With Auditory Processing Difficulties. Am J Occup Ther 2016; 70:7001220030p1-7001220030p11. [PMID: 26709423 DOI: 10.5014/ajot.2016.016832] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This systematic review describes the published evidence related to the effectiveness of frequency modulation (FM) devices in improving academic outcomes in children with auditory processing difficulties. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards were used to identify articles published between January 2003 and March 2014. The Cochrane Population, Intervention, Control, Outcome, Study Design approach and the American Occupational Therapy Association process forms were used to guide the article selection and evaluation process. Of the 83 articles screened, 7 matched the systematic review inclusion criteria. Findings were consistently positive, although limitations were identified. Results of this review indicate moderate support for the use of FM devices to improve children's ability to listen and attend in the classroom and mixed evidence to improve specific academic performance areas. FM technology should be considered for school-age children with auditory processing impairments who are receiving occupational therapy services to improve functioning in the school setting.
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Affiliation(s)
- Stacey Reynolds
- Stacey Reynolds, PhD, OTR/L, is Associate Professor, Department of Occupational Therapy, Virginia Commonwealth University, Richmond;
| | - Heather Miller Kuhaneck
- Heather Miller Kuhaneck, PhD, OTR/L, FAOTA, is Associate Professor, Department of Occupational Therapy, Sacred Heart University, Fairfield, CT
| | - Beth Pfeiffer
- Beth Pfeiffer, PhD, OTR/L, BCP, is Associate Professor, Department of Rehabilitation Sciences, Temple University, Philadelphia, PA
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De Ceulaer G, Bestel J, Mülder HE, Goldbeck F, de Varebeke SPJ, Govaerts PJ. Speech understanding in noise with the Roger Pen, Naida CI Q70 processor, and integrated Roger 17 receiver in a multi-talker network. Eur Arch Otorhinolaryngol 2015; 273:1107-14. [PMID: 25983309 PMCID: PMC4824813 DOI: 10.1007/s00405-015-3643-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 04/28/2015] [Indexed: 11/30/2022]
Abstract
Roger is a digital adaptive multi-channel remote microphone technology that wirelessly transmits a speaker’s voice directly to a hearing instrument or cochlear implant sound processor. Frequency hopping between channels, in combination with repeated broadcast, avoids interference issues that have limited earlier generation FM systems. This study evaluated the benefit of the Roger Pen transmitter microphone in a multiple talker network (MTN) for cochlear implant users in a simulated noisy conversation setting. Twelve post-lingually deafened adult Advanced Bionics CII/HiRes 90K recipients were recruited. Subjects used a Naida CI Q70 processor with integrated Roger 17 receiver. The test environment simulated four people having a meal in a noisy restaurant, one the CI user (listener), and three companions (talkers) talking non-simultaneously in a diffuse field of multi-talker babble. Speech reception thresholds (SRTs) were determined without the Roger Pen, with one Roger Pen, and with three Roger Pens in an MTN. Using three Roger Pens in an MTN improved the SRT by 14.8 dB over using no Roger Pen, and by 13.1 dB over using a single Roger Pen (p < 0.0001). The Roger Pen in an MTN provided statistically and clinically significant improvement in speech perception in noise for Advanced Bionics cochlear implant recipients. The integrated Roger 17 receiver made it easy for users of the Naida CI Q70 processor to take advantage of the Roger system. The listening advantage and ease of use should encourage more clinicians to recommend and fit Roger in adult cochlear implant patients.
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Affiliation(s)
| | - Julie Bestel
- Advanced Bionics AG, Clinical Research International, Staffa, Switzerland.
| | | | | | | | - Paul J Govaerts
- The Eargroup, Antwerp-Deurne, Belgium
- University of Antwerp, Antwerp, Belgium
- University of Ghent, Ghent, Belgium
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Fitzpatrick EM, Leblanc S. Exploring the factors influencing discontinued hearing aid use in patients with unilateral cochlear implants. Trends Amplif 2011; 14:199-210. [PMID: 21406420 DOI: 10.1177/1084713810396511] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Studies have shown that unilateral cochlear implant users who have residual hearing in the contralateral ear can benefit from combining a hearing aid in the nonimplanted ear with their cochlear implant. The purpose of this study was to better understand the factors influencing decision making by adults. Adults who had discontinued hearing aid use shortly after cochlear implantation were selected from one Canadian cochlear implant program. An examination of hearing aid use revealed that of 96 patients, who used hearing aids preimplant, 49 had discontinued hearing aid use. Patient perspectives on the decision and experience of combining a hearing aid and a cochlear implant were collected through 12 individual semistructured interviews. The interviews were analyzed qualitatively to identify key themes. Questionnaires, based on the interview findings, were developed and sent to the 49 adults to further explore the factors affecting hearing aid decisions. Interview and questionnaire findings from 28 adults indicated that three factors primarily influenced patients' decision to discontinue hearing aid use: their perceptions of the experience with hearing aids prior to implantation, their views of superiority of a unilateral cochlear implant in comparison with hearing aids, and their perceptions of interference with sound quality when a cochlear implant and hearing aid were combined. This study provides information about patient perceptions, experiences, and understanding of the potential difficulties of a bimodal fitting that may assist clinicians in pre- and postimplant counseling.
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Affiliation(s)
- Elizabeth M Fitzpatrick
- Audiology and Speech-Language Pathology Program, Faculty of Health Sciences, University of Ottawa, Ottawa.
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