Perceptions Toward Internet-Based Delivery of Hearing Aids among Older Hearing-Impaired Adults

2016 ◽  
Vol 27 (06) ◽  
pp. 441-457
Author(s):  
Navshika Chandra ◽  
Grant D. Searchfield
Keyword(s):  
Older Adults ◽  
Hearing Aids ◽  
Rural Areas ◽  
Psychological Functioning ◽  
Hearing Aid ◽  
Hearing Impaired ◽  
Fine Tuning ◽  
Face To Face ◽  
General Lack ◽  
Internet Sales

Background: Despite evidence that hearing aids can improve the social and psychological functioning of older hearing-impaired adults, hearing aid uptake is low. High cost of hearing aids and poor access to audiology services in rural areas are potential barriers to hearing aid acquisition. Methods of hearing aid delivery deviating from the traditional clinician-based model have been available to consumers for many years. One such method is Internet hearing aid sales. However, research exploring Internet-based hearing aid delivery, as a method to improve hearing aid uptake in this population, is limited. Purpose: The purpose of this study was to explore the perceptions of older hearing aid users (aged ≥65 yr) toward Internet-based hearing aid delivery. Research Design: A qualitative approach was adopted to investigate older adults’ perceptions of buying hearing aids online. Study Sample: The sample consisted of 18 participants aged between 64 and 81 yr. Fourteen men and four women participated in this study. Participants were all experienced hearing aid users. Data Collection and Analysis: Face-to-face semistructured interviews were conducted. An interview schedule guided the interview. Interviews were recorded with a voice recorder and transcribed verbatim. Thematic analysis of the data was carried out. Results: Seven main themes emerged from the data. A general lack of awareness, but willingness to learn more about Internet hearing aid sales, was found. Two perceived benefits of Internet-based hearing aid delivery were identified: lower cost of hearing aids and greater convenience or physical accessibility. Numerous concerns and limitations were communicated. Concerns regarding the availability of clinical procedures, such as hearing tests, obtaining the correct-sized earmolds, and fine-tuning of hearing aids, were expressed. Participants conveyed distrust in online retailers. However, trust in and a preference for audiologists’ expertise, which was not perceived to be available online, was found. Participants further conveyed a preference for face-to-face contact. Finally, in this sample, a general lack of familiarity and confidence in using the Internet was communicated. Conclusions: Internet sales of hearing aids is a controversial topic in audiology. Although Internet-based delivery of hearing aids was perceived by older adults to be potentially beneficial, several shortcomings and concerns were conveyed. Irrespective of opinion of the role of Internet sales, audiologists should consider the opinions of the elderly as to how different service models may improve hearing aid uptake.

Expectations, Prefitting Counseling, and Hearing Aid Outcome

2009 ◽  
Vol 20 (05) ◽  
pp. 320-334 ◽  
Author(s):  
Gabrielle H. Saunders ◽  
M Samantha Lewis ◽  
Anna Forsline
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Well Being ◽  
Fine Tuning ◽  
Initial Contact ◽  
High Expectations ◽  
Digital Hearing Aids ◽  
The Impact ◽  
Unrealistic Expectations

Background: Data suggest that having high expectations about hearing aids results in better overall outcome. However, some have postulated that excessively high expectations will result in disappointment and thus poor outcome. It has been suggested that counseling patients with unrealistic expectations about hearing aids prior to fitting may be beneficial. Data, however, are mixed as to the effectiveness of such counseling, in terms of both changes in expectations and final outcome. Purpose: The primary purpose of this study was to determine whether supplementing prefitting counseling with demonstration of real-world listening can (1) alter expectations of new hearing aid users and (2) increase satisfaction over verbal-only counseling. Secondary goals of the study were to examine (1) the relationship between prefitting expectations and postfitting outcome, and (2) the effect of hearing aid fine-tuning on hearing aid outcome. Research Design: Sixty new hearing aid users were fitted binaurally with Beltone Oria behind-the-ear digital hearing aids. Forty participants received prefitting counseling and demonstration of listening situations with the Beltone AVE™ (Audio Verification Environment) system; 20 received prefitting counseling without a demonstration of listening situations. Hearing aid expectations were measured at initial contact and following prefitting counseling. Reported hearing aid outcome was measured after eight to ten weeks of hearing aid use. Study Sample: Sixty new hearing aid users aged between 55 and 81 years with symmetrical sensorineural hearing loss. Intervention: Participants were randomly assigned to one of three experimental groups, between which the prefitting counseling and follow-up differed: Group 1 received prefitting counseling in combination with demonstration of listening situations. Additionally, if the participant had complaints about sound quality at the follow-up visit, the hearing aids were fine-tuned using the Beltone AVE system. Group 2 received prefitting counseling in combination with demonstration of listening situations with the Beltone AVE system, but no fine-tuning was provided at follow-up. Group 3 received prefitting hearing aid counseling that did not include demonstration of listening, and the hearing aids were not fine-tuned at the follow-up appointment. Results: The results showed that prefitting hearing aid counseling had small but significant effects on expectations. The two forms of counseling did not differ in their effectiveness at changing expectations; however, anecdotally, we learned from many participants that that they enjoyed listening to the auditory demonstrations and that they found them to be an interesting listening exercise. The data also show that positive expectations result in more positive outcome and that hearing aid fine-tuning is beneficial to the user. Conclusions: We conclude that prefitting counseling can be advantageous to hearing aid outcome and recommend the addition of prefitting counseling to address expectations associated with quality of life and self-image. The data emphasize the need to address unrealistic expectations prior to fitting hearing aids cautiously, so as not to decrease expectations to the extent of discouraging and demotivating the patient. Data also show that positive expectations regarding the impact hearing aids will have on psychosocial well-being are important for successful hearing aid outcome.

Hearing Loss, Control, and Demographic Factors Influencing Hearing Aid Use Among Older Adults

1998 ◽  
Vol 41 (3) ◽  
pp. 527-537 ◽  
Author(s):  
Dean C. Garstecki ◽  
Susan F. Erler
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Hearing Aids ◽  
Psychological Control ◽  
Hearing Aid ◽  
Demographic Factors ◽  
Ego Strength ◽  
Hearing Sensitivity ◽  
Hearing Aid Use ◽  
Hearing Handicap

Preference for non-use of hearing aids among older adults who are candidates for amplification remains to be explained. Clinical studies have examined the contribution of consumer attitudes, behaviors, and life circumstances to this phenomenon. The present study extends the interests of earlier investigators in that it examines psychological control tendencies in combination with hearing loss and demographic variables among older adults who elected to accept (adherents) or ignore (nonadherents) advice from hearing professionals to acquire and use hearing aids. One hundred thirty-one individuals participated by completing measures of hearing, hearing handicap, psychological control, depression, and ego strength. Participants were asked to provide demographic information and personal opinions regarding hearing aid use. Adherence group and gender differences were noted on measures of hearing sensitivity, psychological control, and demographic factors. Female adherents demonstrated greater hearing loss and poorer word recognition ability but less hearing handicap, higher internal locus of control, higher ego strength, and fewer depressive tendencies than female nonadherents. They reported demographic advantages. Female adherents assumed responsibility for effective communication. Although male adherents and nonadherents did not differ significantly demographically, male adherents were more accepting of their hearing loss, took responsibility for communication problems, and found hearing aids less stigmatizing. Implications for clinical practice and future clinical investigations are identified and discussed. Results are expected to be of interest to clinicians, clinical investigators, and health care policymakers.

Fitting Frequency-Lowering Signal Processing Applying the American Academy of Audiology Pediatric Amplification Guideline: Updates and Protocols

2016 ◽  
Vol 27 (03) ◽  
pp. 219-236 ◽  
Author(s):  
Susan Scollie ◽  
Danielle Glista ◽  
Julie Seto ◽  
Andrea Dunn ◽  
Brittany Schuett ◽  
...  
Keyword(s):  
Signal Processing ◽  
Frequency Response ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Fine Tuning ◽  
Sensation Level ◽  
Response Level ◽  
Strong Basis ◽  
Wide Range ◽  
Signal Processors

Background: Although guidelines for fitting hearing aids for children are well developed and have strong basis in evidence, specific protocols for fitting and verifying technologies can supplement such guidelines. One such technology is frequency-lowering signal processing. Children require access to a broad bandwidth of speech to detect and use all phonemes including female /s/. When access through conventional amplification is not possible, the use of frequency-lowering signal processing may be considered as a means to overcome limitations. Fitting and verification protocols are needed to better define candidacy determination and options for assessing and fine tuning frequency-lowering signal processing for individuals. Purpose: This work aims to (1) describe a set of calibrated phonemes that can be used to characterize the variation in different brands of frequency-lowering processors in hearing aids and the verification with these signals and (2) determine whether verification with these signal are predictive of perceptual changes associated with changes in the strength of frequency-lowering signal processing. Finally, we aimed to develop a fitting protocol for use in pediatric clinical practice. Study Sample: Study 1 used a sample of six hearing aids spanning four types of frequency lowering algorithms for an electroacoustic evaluation. Study 2 included 21 adults who had hearing loss (mean age 66 yr). Data Collection and Analysis: Simulated fricatives were designed to mimic the level and frequency shape of female fricatives extracted from two sources of speech. These signals were used to verify the frequency-lowering effects of four distinct types of frequency-lowering signal processors available in commercial hearing aids, and verification measures were compared to extracted fricatives made in a reference system. In a second study, the simulated fricatives were used within a probe microphone measurement system to verify a wide range of frequency compression settings in a commercial hearing aid, and 27 adult listeners were tested at each setting. The relation between the hearing aid verification measures and the listener’s ability to detect and discriminate between fricatives was examined. Results: Verification measures made with the simulated fricatives agreed to within 4 dB, on average, and tended to mimic the frequency response shape of fricatives presented in a running speech context. Some processors showed a greater aided response level for fricatives in running speech than fricatives presented in isolation. Results with listeners indicated that verified settings that provided a positive sensation level of /s/ and that maximized the frequency difference between /s/ and /∫/ tended to have the best performance. Conclusions: Frequency-lowering signal processors have measureable effects on the high-frequency fricative content of speech, particularly female /s/. It is possible to measure these effects either with a simple strategy that presents an isolated simulated fricative and measures the aided frequency response or with a more complex system that extracts fricatives from running speech. For some processors, a more accurate result may be achieved with a running speech system. In listeners, the aided frequency location and sensation level of fricatives may be helpful in predicting whether a specific hearing aid fitting, with or without frequency-lowering, will support access to the fricatives of speech.

scholarly journals Survey of Hearing Aid Conditions for Hearing Impaired Persons While Driving

2020 ◽  
pp. 132-136
Author(s):  
Hiroshi Ikeda ◽  
Shigeyuki Minami
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Visual Information ◽  
Hearing Aid ◽  
Hearing Impaired ◽  
Safe Driving ◽  
Actual Usage ◽  
Hearing Ability ◽  
Acquired Hearing Loss ◽  
The Impact

Hearing impaired persons are required to drive with hearing aids to supplement their hearing ability, however, there has not been sufficient discussion regarding the impact of the use of a hearing aid on driving a vehicle. In order to investigate the actual usage and driving conditions of using hearing aids while driving a vehicle, this paper uses a questionnaire to survey (1) how easy it is to drive when wearing hearing aids, and (2) how often hearing aids are not worn while driving. Concerning the ease of driving when wearing a hearing aid, it was suggested that people with congenital hearing loss were more likely to rely on visual information, and those with acquired hearing loss continue to use their experience of hearing. When the level of disability is high, it is difficult to drive when using the hearing aid, and when the disability level is low, it is easier to drive. Regarding the frequency of driving without wearing hearing aids, about 60 % of respondents had such an experience. Those who often drive without hearing aids had experienced headaches due to noise from wearing hearing aids compared to those who wear hearing aids at all times. Hearing aids are necessary assistive devices for hearing impaired persons to obtain hearing information, and to provide a safe driving environment. Therefore, this paper addresses issues to maintain a comfortable driving environment while wearing a hearing aid.

scholarly journals Investigating the Impact of Hearing Aid Use and Auditory Training on Cognition, Depressive Symptoms, and Social Interaction in Adults With Hearing Loss: Protocol for a Crossover Trial (Preprint)

2017 ◽  
Author(s):  
Joanna Nkyekyer ◽  
Denny Meyer ◽  
Peter J Blamey ◽  
Andrew Pipingas ◽  
Sunil Bhar
Keyword(s):  
Hearing Loss ◽  
Depressive Symptoms ◽  
Social Interaction ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Sensorineural Hearing ◽  
Auditory Training ◽  
Face To Face ◽  
Hearing Aid Use

BACKGROUND Sensorineural hearing loss is the most common sensory deficit among older adults. Some of the psychosocial consequences of this condition include difficulty in understanding speech, depression, and social isolation. Studies have shown that older adults with hearing loss show some age-related cognitive decline. Hearing aids have been proven as successful interventions to alleviate sensorineural hearing loss. In addition to hearing aid use, the positive effects of auditory training—formal listening activities designed to optimize speech perception—are now being documented among adults with hearing loss who use hearing aids, especially new hearing aid users. Auditory training has also been shown to produce prolonged cognitive performance improvements. However, there is still little evidence to support the benefits of simultaneous hearing aid use and individualized face-to-face auditory training on cognitive performance in adults with hearing loss. OBJECTIVE This study will investigate whether using hearing aids for the first time will improve the impact of individualized face-to-face auditory training on cognition, depression, and social interaction for adults with sensorineural hearing loss. The rationale for this study is based on the hypothesis that, in adults with sensorineural hearing loss, using hearing aids for the first time in combination with individualized face-to-face auditory training will be more effective for improving cognition, depressive symptoms, and social interaction rather than auditory training on its own. METHODS This is a crossover trial targeting 40 men and women between 50 and 90 years of age with either mild or moderate symmetric sensorineural hearing loss. Consented, willing participants will be recruited from either an independent living accommodation or via a community database to undergo a 6-month intensive face-to-face auditory training program (active control). Participants will be assigned in random order to receive hearing aid (intervention) for either the first 3 or last 3 months of the 6-month auditory training program. Each participant will be tested at baseline, 3, and 6 months using a neuropsychological battery of computer-based cognitive assessments, together with a depression symptom instrument and a social interaction measure. The primary outcome will be cognitive performance with regard to spatial working memory. Secondary outcome measures include other cognition performance measures, depressive symptoms, social interaction, and hearing satisfaction. RESULTS Data analysis is currently under way and the first results are expected to be submitted for publication in June 2018. CONCLUSIONS Results from the study will inform strategies for aural rehabilitation, hearing aid delivery, and future hearing loss intervention trials. CLINICALTRIAL ClinicalTrials.gov NCT03112850; https://clinicaltrials.gov/ct2/show/NCT03112850 (Archived by WebCite at http://www.webcitation.org/6xz12fD0B).

Evaluation of an Articulation-Index Based Model for Predicting the Effects of Adaptive Frequency Response Hearing Aids

1990 ◽  
Vol 33 (4) ◽  
pp. 676-689 ◽  
Author(s):  
David A. Fabry ◽  
Dianne J. Van Tasell
Keyword(s):  
Transfer Function ◽  
Frequency Response ◽  
Hearing Aids ◽  
Background Noise ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Hearing Impaired ◽  
Articulation Index ◽  
Intelligibility Ratings ◽  
High Pass

The Articulation Index (AI) was used to evaluate an “adaptive frequency response” (AFR) hearing aid with amplification characteristics that automatically change to become more high-pass with increasing levels of background noise. Speech intelligibility ratings of connected discourse by normal-hearing subjects were predicted well by an empirically derived AI transfer function. That transfer function was used to predict aided speech intelligibility ratings by 12 hearing-impaired subjects wearing a master hearing aid with the Argosy Manhattan Circuit enabled (AFR-on) or disabled (AFR-off). For all subjects, the AI predicted no improvements in speech intelligibility for the AFR-on versus AFR-off condition, and no significant improvements in rated intelligibility were observed. The ability of the AI to predict aided speech intelligibility varied across subjects. However, ratings from every hearing-impaired subject were related monotonically to AI. Therefore, AI calculations may be used to predict relative—but not absolute—levels of speech intelligibility produced under different amplification conditions.

Decreased Use of Hearing Aids following Training in Hearing Tactics

1998 ◽  
Vol 87 (2) ◽  
pp. 703-706 ◽  
Author(s):  
Gerhard Andersson
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Hearing Impaired ◽  
Daily Average ◽  
Randomized Controlled ◽  
Hearing Aid Use ◽  
Randomized Controlled Studies ◽  
Report Data

In this report data on hearing aid use were combined from three randomized controlled studies on behavioural hearing tactics. Daily average hearing aid use at pretreatment and posttreatment were analysed for 63 older hearing-impaired persons who had either received treatment or acted as controls. Analysis showed a significant, albeit weak, decrease in daily hearing aid use for those subjects who had received the treatment. The utility of amount of hearing aid use as an indicator of rehabilitation success is discussed.

Evaluation of the Self-Fitting Process with a Commercially Available Hearing Aid

2017 ◽  
Vol 28 (02) ◽  
pp. 109-118 ◽  
Author(s):  
Elizabeth Convery ◽  
Gitte Keidser ◽  
Mark Seeto ◽  
Margot McLelland
Keyword(s):  
Hearing Loss ◽  
Success Rate ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Low Cost ◽  
The Self ◽  
Fine Tuning ◽  
Successful Outcome ◽  
Fitting Procedure ◽  
Fitting Hearing Aids

Background: Hearing aids and personal sound amplification products that are designed to be self-fitted by the user at home are becoming increasingly available in the online marketplace. While these devices are often marketed as a low-cost alternative to traditional hearing health-care, little is known about people’s ability to successfully use and manage them. Previous research into the individual components of a simulated self-fitting procedure has been undertaken, but no study has evaluated performance of the procedure as a whole using a commercial product. Purpose: To evaluate the ability of a group of adults with a hearing loss to set up a pair of commercially available self-fitting hearing aids for their own use and to investigate factors associated with a successful outcome. Research Design: An interventional study that used regression analysis to identify potential contributors to the outcome. Study Sample: Forty adults with mild to moderately severe hearing loss participated in the study: 20 current hearing aid users (the “experienced” group) and 20 with no previous amplification experience (the “new” group). Twenty-four participants attended with partners, who were present to offer assistance with the study task as needed. Data Collection and Analysis: Participants followed a set of written, illustrated instructions to perform a multistep self-fitting procedure with a commercially available self-fitting hearing aid, with optional assistance from a lay partner. Standardized measures of cognitive function, health literacy, locus of control, hearing aid self-efficacy, and manual dexterity were collected. Statistical analysis was performed to examine the proportion of participants in each group who successfully performed the self-fitting procedure, factors that predicted successful completion of the task, and the contributions of partners to the outcome. Results: Fifty-five percent of participants were able to successfully perform the self-fitting procedure. Although the same success rate was observed for both experienced and new participants, the majority of the errors relating to the hearing test and the fine-tuning tasks were made by the experienced participants, while all of the errors associated with physically customizing the hearing aids and most of the insertion errors were made by the new participants. Although the majority of partners assisted in the self-fitting task, their contributions did not significantly influence the outcome. Further, no characteristic or combination of characteristics reliably predicted which participants would be successful at the self-fitting task. Conclusions: Although the majority of participants were able to complete the self-fitting task without error, the provision of knowledgeable support by trained personnel, rather than a fellow layperson, would most certainly increase the proportion of users who are able to achieve success. Refinements to the instructions and the physical design of the hearing aid may also serve to improve the success rate. Further evaluation of the range of self-fitting hearing aids that are now on the market should be undertaken.

scholarly journals Socioeconomic differences in hearing among middle-aged and older adults: cross-sectional analyses using the Health Survey for England

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e019615 ◽  
Author(s):  
Shaun Scholes ◽  
Jane Biddulph ◽  
Adrian Davis ◽  
Jennifer S. Mindell
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Health Survey ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Community Dwelling ◽  
Middle Aged ◽  
Cross Sectional ◽  
Hearing Aid Use ◽  
Health Survey For England

BackgroundHearing loss impacts on cognitive, social and physical functioning. Both hearing loss and hearing aid use vary across population subgroups. We examined whether hearing loss, and reported current hearing aid use among persons with hearing loss, were associated with different markers of socioeconomic status (SES) in a nationally representative sample of community-dwelling middle-aged and older adults.MethodsHearing was measured using an audiometric screening device in the Health Survey for England 2014 (3292 participants aged 45 years and over). Hearing loss was defined as >35 dB HL at 3.0 kHz in the better-hearing ear. Using sex-specific logistic regression modelling, we evaluated the associations between SES and hearing after adjustment for potential confounders.Results26% of men and 20% of women aged 45 years and over had hearing loss. Hearing loss was higher among men in the lowest SES groups. For example, the multivariable-adjusted odds of hearing loss were almost two times as high for those in the lowest versus the highest income tertile (OR 1.77, 95% CI 1.15 to 2.74). Among those with hearing loss, 30% of men and 27% of women were currently using a hearing aid. Compared with men in the highest income tertile, the multivariable-adjusted odds of using a hearing aid nowadays were lower for men in the middle (OR 0.50, 95% CI 0.25 to 0.99) and the lowest (OR 0.47, 95% CI 0.23 to 0.97) income tertiles. Associations between SES and hearing were weaker or null among women.ConclusionsWhile the burden of hearing loss fell highest among men in the lowest SES groups, current hearing aid use was demonstrably lower. Initiatives to detect hearing loss early and increase the uptake and the use of hearing aids may provide substantial public health benefits and reduce socioeconomic inequalities in health.

Relationship of Acoustic Gain to Aided Threshold Improvement in Children

1978 ◽  
Vol 43 (3) ◽  
pp. 348-352 ◽  
Author(s):  
Robert E. Jirsa ◽  
Thomas W. Norris
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Hearing Impaired ◽  
Variable Volume ◽  
Relationship Of ◽  
Impaired Children ◽  
Hearing Impaired Children

Aided threshold improvement obtained by 12 hearing-impaired children was compared to the acoustic gain of their hearing aids using both the traditional 2-cc coupler and a variable volume coupler designed to approximate real ear volume in children. Results indicated that acoustic gain determined in the 2-cc coupler underestimated aided threshold improvement by approximately 8.7 dB. Use of the variable volume coupler to determine acoustic gain, however, adequately predicted aided improvement at comfort setting. Use of the variable volume coupler in hearing-aid fittings for children is discussed with special emphasis on preventing over-amplification.

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