Hearing aids (HAs) are often left unused. Several investigations have shown that the use of HAs and the skills to use them can be significantly improved through counselling. Follow-up counselling is often restricted by increased cost. The objective of the study was to assess the cost and the effect of follow-up counselling on HA use. In a prospective pre-post design study, 98 first-time HA users were counselled 6 months after the fitting of a HA, and the use of and benefit from HAs were measured by means of an interview and the short form of the hearing handicap inventory for the elderly (HHIE-S) and the EuroQoL (EQ-5D) questionnaires. The results obtained before and 6 months after counselling were compared and the cost of counselling was calculated. After follow-up counselling, over half of the occasional users of a HA and as many as one third of the non-users became regular users. The number of regular users increased by 16 subjects, and non-users decreased from 29 subjects to 17. The HHIE-S results showed a significant positive change, but the EQ-5D results showed practically no change. The additional expense of follow-up counselling at home was approximately 8.8% (83 euro per visit) of the calculated 942 euro cost of fitting a HA. Bringing one unused HA into regular use required 508 euro. The results show that HA use and the consequent benefit can be significantly increased through counselling. The expense caused by follow-up counselling at home is highly acceptable in addition to the cost of fitting a HA.
The aim of this study was to assess the effects of fitting a hearing aid by measuring the benefits derived from hearing aid use. Besides audiologic tests, a short version of the Hearing Handicap Inventory for the Elderly, and the EuroQol questionnaire were used in a prospective study. Ninety-eight first-time hearing aid users were interviewed prior to, and six months after, the fitting of their first hearing aids. The total HHIE-S score changed from 28.7 before, to 12.7 six months after, hearing aid fitting. Altogether 40%-60% of the users reported fewer social or emotional problems. There was a statistically significant positive change in the EQ-VAS score. According to the HHIE-S, hearing aids clearly alleviated hearing disability. The EQ-5D questionnaire was not sensitive enough for measuring the health-related quality of life of subjects with hearing impairment.
Innovations in information and communication technologies are changing society, but only 1 in 15 Canadian seniors used a computer at the turn of the millennium (Statistics Canada, 2000). Furthermore, about 1 in 5 Canadian seniors has difficulty hearing, seeing, or communicating. The primary goal of the study was to investigate the relationship between hearing impairment and the use of information and communication technologies by older adults. A questionnaire about use of technologies was administered to 135 older adults and hearing was measured using audiometry. Hearing was found to be related to the extent of use of communication technologies, especially newer and more specialized technologies. Those with hearing loss who did not use a hearing aid did not use other technologies as much as peers with good hearing or hearing-aid users. Overall, the extent of and ability to use information and communication technologies was greater for the study sample than in previous findings for a national sample; however, the patterns of usage of various technologies and the factors influencing use were similar in the two samples. Recommendations are made for future research, health education programs, and universal design.
Hearing rehabilitation in Sweden is based on the Swedish medical system, with its regional and university hospital services. The medical service is supervised by audiology physicians, usually working in ENT clinics. Other important professionals include the hearing educationalist and audiologists who are responsible for audiometric testing and hearing aid fitting. The organization of the service is described.
The purpose of this study was to analyze a database of completed International Outcome Inventory for Hearing Aids (IOI-HA) questionnaires obtained from over 100,000 clients fitted with new hearing aids in Sweden during the period of 2012-2016. Mean IOI-HA total scores were correlated with degree of hearing loss, unilateral versus bilateral fitting, first-time versus return clients, gender, and variation among dispensing clinics. The correlations with expectations, service quality, and technical functioning of the hearing aids were also analyzed.
Questionnaires containing the 7 IOI-HA items as well as questions concerning some additional issues were mailed to clients 3-6 months after fitting of new hearing aids. The questionnaires were returned to and analyzed by an independent research institute.
More than 100 dispensing clinics nationwide take part in this project. A response rate of 52.6% resulted in 106,631 data sets after excluding incomplete questionnaires. Forty-six percent of the responders were women, and 54% were men. The largest difference in mean score (0.66) was found for the IOI-HA item "use" between return clients and first-time users. Women reported significantly higher (better) scores for the item "impact on others" compared with men. The bilaterally fitted subgroup reported significantly higher scores for all 7 items compared with the unilaterally fitted subgroup. Experienced users produced higher scores on benefit and satisfaction items, whereas first-time users gave higher scores for residual problems. No correlation was found between mean IOI-HA total score and average hearing threshold level (pure-tone average [PTA]). Mean IOI-HA total scores were found to correlate significantly with perceived service quality of the dispensing center and with the technical functionality of the hearing aids.
When comparing mean IOI-HA total scores from different studies or between groups, differences with regard to hearing aid experience, gender, and unilateral versus bilateral fitting have to be considered. No correlation was found between mean IOI-HA total score and degree of hearing loss in terms of PTA. Thus, PTA is not a reliable predictor of benefit and satisfaction of hearing aid provision as represented by the IOI-HA items. Identification of a specific lower fence in PTA for hearing aid candidacy is therefore to be avoided. Large differences were found in mean IOI-HA total scores related to different dispensing centers.
Previous studies found that, on average, users overreport their daily amount of hearing aid use compared to objective measures such as data logging. However, the reasons for this are unclear.
This study assessed data-logged and self-reported amount of hearing aid use in a clinical sample of hearing aid users. It identified predictors of data-logged hearing aid use, self-reported hearing aid use, and hearing aid use overreport.
This observational study recruited adult hearing aid users from 22 private dispensers in the Netherlands and in Denmark.
The sample consisted of 228 hearing aid users. Typical participants were over the age of 65 and retired, were fitted binaurally, and had financially contributed to the cost of their hearing aids. Participants had on average a mild-to-severe sloping bilateral hearing impairment.
Participants completed a purposefully designed questionnaire regarding hearing aid usage and the International Outcome Inventory-Hearing Aids. Dispensers collected audiometric results and data logging. Multiple linear regression identified predictors of data-logged hearing aid use, self-reported hearing aid use, and hearing aid use overreport when controlling for covariates.
Data logging showed on average 10.5 hr of hearing aid use (n = 184), while participants reported on average 11.8 hr of daily hearing aid use (n = 206). In participants for which both data-logged and self-reported hearing aid use data were available (n = 166), the average absolute overreport of daily hearing aid use was 1.2 (1 hr and 11 min). Relative overreport was expressed as a rate of absolute overreport divided by data-logged hearing aid use. A positive rate denotes hearing aid use overreport: the average overreport rate was .38. Cluster analysis identified two data-logged patterns: "Regular," where hearing aids are typically switched on for between 12 and 20 hr before their user powers them off (57% of the sample), and "On-off," where hearing aids are typically switched on for shorter periods of time before being powered off (43% of the sample). In terms of self-report, 77% of the sample described their hearing aid use to be the same every day, while 23% of the sample described their hearing aid use to be different from day to day. Participants for whom data logging showed an On-off pattern or who reported their hearing aid use to be different from day to day had significantly fewer data-logged and self-reported hours of hearing aid use. Having an On-off data-logging pattern or describing hearing aid use as the same every day was associated with a significantly greater hearing aid use overreport.
Data-logged and self-reported usage patterns significantly predicted data-logged hearing aid use, self-reported hearing aid use, and overreport when controlling for covariates. The results point to patterns of hearing aid usage as being at least as important a concept as amount of hearing aid use. Dispensers should discuss not only the "how much", but also the "how" of hearing aid usage with their clients.
Previous research suggests that audiological rehabilitation for older adults could include group communication programs in addition to hearing aid fitting or as an alternative to hearing aid fitting for those people who do not wish to proceed with hearing aids. This pilot study was a first attempt to evaluate a Swedish version of such a program, Active Communication Education (ACE), which had been developed and previously evaluated in Australia (Hickson et al, 2007a).
The aim of the study was to explore the use of the ACE program in an older-old population of people aged 87 yr in Sweden.
A within-subject intervention study.
The participants were recruited from the Elderly in Linköping Screening Assessment (ELSA), a population-based study of the functional abilities of all inhabitants of the city of Linkoping aged 85 yr in 2007. Participants who responded to the hearing related items in the ELSA study were approached for this study; 29 people agreed to undertake ACE, and 23 (79%) completed three or more sessions.
The ACE program consists of five weekly 2 hr group sessions with six to ten participants per group.
Self-report measures of communication strategy use, activity and participation, health-related quality of life, and depression were obtained preprogram, 3 wk postprogram, and 6 mo postprogram. Within-group changes and effect sizes were calculated. In addition, outcomes were measured postprogram using the International Outcome Inventory-Alternative Interventions (IOI-AI; Noble, 2002) and a modified version of the Client Oriented Scale of Improvement (COSI; Dillon et al, 1997; Hickson et al, 2007b), and qualitative feedback was obtained.
The effect size of ACE was small (0.03-0.27), and, in the sample of 23 included in this pilot study, differences in pre- and postprogram assessments were not statistically significant. Results from the IOI-AI and the modified COSI indicated that these elderly participants found the program to be beneficial, and 90% stated that the course had increased their ability to deal with hearing loss and the problems it creates.
This preliminary investigation indicates the potential benefits of ACE for older adults, and further research is needed with larger numbers of participants in different age groups to draw conclusions about the effectiveness of the ACE program for a general Swedish population.
An outline is given of the rehabilitation of the hearing impaired adult in Denmark. Emphasis is put on the comprehensiveness and the professionalism of the services provided.
