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 aids and tinnitus therapy: a 25-year experience

2008 ◽  
Vol 122 (10) ◽  
pp. 1052-1056 ◽  
Author(s):  
M I Trotter ◽  
I Donaldson
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
University Teaching ◽  
Digital Hearing Aids ◽  
Subjective Tinnitus ◽  
Before And After ◽  
Digital Hearing Aid ◽  
Tinnitus Therapy ◽  
The Impact

AbstractObjectives:(1) To assess the subjective tinnitus perception of patients with audiologically proven hearing loss presenting to a tinnitus clinic, both before and after hearing aid provision; (2) to investigate subjective tinnitus perception in patients with unilateral and bilateral hearing loss; and (3) to assess the impact on tinnitus perception, if any, of a digital hearing aid programme in patients provided with hearing aids.Design:Prospective data collection for patients attending a tinnitus clinic over a 25-year period (1980–2004).Setting:University teaching hospital otolaryngology department.Participants:A total of 2153 consecutive patients attending a consultant-delivered specialist tinnitus clinic.Main outcomes measures:A visual analogue scale was used to assess the degree of tinnitus perception improvement, if any, comparing before versus after unilateral or bilateral aiding (in those with audiometrically proven hearing loss). A further assessment compared the effect of digital hearing aid programme introduction on symptomatic tinnitus perception in patients provided with unilateral or bilateral aids.Results:A total of 1440 patients were given hearing aids (826 unilateral and 614 bilateral). There was little difference in tinnitus perception, comparing overall aiding results in unilaterally or bilaterally aided patients. Overall, 554 (67 per cent) of unilaterally aided patients and 424 (69 per cent) of bilaterally aided patients reported some improvement in their tinnitus perception following aiding. There was a statistically significant improvement in tinnitus perception, comparing analogue aids with digital hearing aids, following introduction of a digital hearing aid programme in 2000, in both unilaterally (p < 0.001) and bilaterally (p < 0.001) aided patients.Conclusions:Provision of hearing aids in patients with audiometrically demonstrable hearing loss can play a very important part in tinnitus control. The additional improvement in tinnitus control observed following introduction of programmable digital aids had a summative effect in the management of these patients.

scholarly journals How Successful is the Fitting of Digital Hearing Aids? Implications for the Allocation of Resources within National Health Systems

2017 ◽  
Vol 96 (3) ◽  
pp. E33-E38
Author(s):  
Petros V. Vlastarakos ◽  
Alastair I. Cameron ◽  
Thomas P. Nikolopoulos
Keyword(s):  
Health Systems ◽  
National Health ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Digital Hearing Aids ◽  
Patient Dissatisfaction ◽  
Speech In Noise ◽  
Continuous Delivery ◽  
Digital Hearing Aid

We conducted a retrospective study to determine the success rate of initial fittings in digital hearing aid (DHA) users. We also addressed the implications of national health systems’ continuing to provide access to these devices. We identified 1,597 consecutively presenting adults who had undergone a first fitting or a new fitting (i.e., an upgrade from an analogue hearing aid in the first or second ear) of a behind-the-ear DHA during the previous year. We further sought to identify all nominal reprogram appointments that had taken place within 6 months after the first or new fitting, we found 460 such appointments (28.8%). Of these, 419 appointments had been for typical reasons other than patient dissatisfaction with the fitting itself—for example, poor hearing, a further hearing loss, an uncomfortably loud hearing aid level, difficulty with speech in noise, an imbalance between bilateral hearing aids, and a faulty or lost hearing aid. Only 41 of the 1,597 first or new fittings (2.6%) were considered unsatisfactory by patients and necessitated a follow-up reprogramming appointment. Overall, DHA fittings were generally successful, as most patients (1,137/1,597 [71.2%]) did not require any follow-up appointment during the study period. Principles of cost-effectiveness demand the maximum practicable efficiency in the utilization of resources to ensure the continuous delivery of high-quality audiologic services through national health systems. This can be achieved by scheduling group appointments to reduce costs and to increase the time allocated to fitting and training patients.

The Relationship Between Hearing Loss Self-Management and Hearing Aid Benefit and Satisfaction

2019 ◽  
Vol 28 (2) ◽  
pp. 274-284 ◽  
Author(s):  
Elizabeth Convery ◽  
Gitte Keidser ◽  
Louise Hickson ◽  
Carly Meyer
Keyword(s):  
Decision Making ◽  
Hearing Loss ◽  
Hearing Aids ◽  
Clinical Decision Making ◽  
Hearing Aid ◽  
Well Being ◽  
Self Report ◽  
Self Management ◽  
Hearing Aid Benefit ◽  
The Relationship

Purpose Hearing loss self-management refers to the knowledge and skills people use to manage the effects of hearing loss on all aspects of their daily lives. The purpose of this study was to investigate the relationship between self-reported hearing loss self-management and hearing aid benefit and satisfaction. Method Thirty-seven adults with hearing loss, all of whom were current users of bilateral hearing aids, participated in this observational study. The participants completed self-report inventories probing their hearing loss self-management and hearing aid benefit and satisfaction. Correlation analysis was used to investigate the relationship between individual domains of hearing loss self-management and hearing aid benefit and satisfaction. Results Participants who reported better self-management of the effects of their hearing loss on their emotional well-being and social participation were more likely to report less aided listening difficulty in noisy and reverberant environments and greater satisfaction with the effect of their hearing aids on their self-image. Participants who reported better self-management in the areas of adhering to treatment, participating in shared decision making, accessing services and resources, attending appointments, and monitoring for changes in their hearing and functional status were more likely to report greater satisfaction with the sound quality and performance of their hearing aids. Conclusion Study findings highlight the potential for using information about a patient's hearing loss self-management in different domains as part of clinical decision making and management planning.

Research Participation Experiences of Informants of Suicide and Control Cases

Crisis ◽  
2010 ◽  
Vol 31 (5) ◽  
pp. 238-246 ◽  
Author(s):  
Paul W. C. Wong ◽  
Wincy S. C. Chan ◽  
Philip S. L. Beh ◽  
Fiona W. S. Yau ◽  
Paul S. F. Yip ◽  
...  
Keyword(s):  
Ethical Issues ◽  
Research Participation ◽  
Self Report ◽  
Initial Contact ◽  
Psychological Autopsy ◽  
Autopsy Study ◽  
The People ◽  
And Control ◽  
The Impact

Background: Ethical issues have been raised about using the psychological autopsy approach in the study of suicide. The impact on informants of control cases who participated in case-control psychological autopsy studies has not been investigated. Aims: (1) To investigate whether informants of suicide cases recruited by two approaches (coroners’ court and public mortuaries) respond differently to the initial contact by the research team. (2) To explore the reactions, reasons for participation, and comments of both the informants of suicide and control cases to psychological autopsy interviews. (3) To investigate the impact of the interviews on informants of suicide cases about a month after the interviews. Methods: A self-report questionnaire was used for the informants of both suicide and control cases. Telephone follow-up interviews were conducted with the informants of suicide cases. Results: The majority of the informants of suicide cases, regardless of the initial route of contact, as well as the control cases were positive about being approached to take part in the study. A minority of informants of suicide and control cases found the experience of talking about their family member to be more upsetting than expected. The telephone follow-up interviews showed that none of the informants of suicide cases reported being distressed by the psychological autopsy interviews. Limitations: The acceptance rate for our original psychological autopsy study was modest. Conclusions: The findings of this study are useful for future participants and researchers in measuring the potential benefits and risks of participating in similar sensitive research. Psychological autopsy interviews may be utilized as an active engagement approach to reach out to the people bereaved by suicide, especially in places where the postvention work is underdeveloped.

Performance Improvement of Digital Hearing Aid Systems

2015 ◽  
Vol 1 ◽  
pp. 27
Author(s):  
Isiaka Ajewale Alimi
Keyword(s):  
Noise Reduction ◽  
Hearing Aids ◽  
Digital Signal Processor ◽  
Speech Intelligibility ◽  
Communication Systems ◽  
Hearing Aid ◽  
Spectral Subtraction ◽  
Residual Spectrum ◽  
Digital Hearing Aids ◽  
Digital Hearing Aid

Digital hearing aids addresses the issues of noise and speech intelligibility that is associated with the analogue types. One of the main functions of the digital signal processor (DSP) of digital hearing aid systems is noise reduction which can be achieved by speech enhancement algorithms which in turn improve system performance and flexibility. However, studies have shown that the quality of experience (QoE) with some of the current hearing aids is not up to expectation in a noisy environment due to interfering sound, background noise and reverberation. It is also suggested that noise reduction features of the DSP can be further improved accordingly. Recently, we proposed an adaptive spectral subtraction algorithm to enhance the performance of communication systems and address the issue of associated musical noise generated by the conventional spectral subtraction algorithm. The effectiveness of the algorithm has been confirmed by different objective and subjective evaluations. In this study, an adaptive spectral subtraction algorithm is implemented using the noise-estimation algorithm for highly non-stationary noisy environments instead of the voice activity detection (VAD) employed in our previous work due to its effectiveness. Also, signal to residual spectrum ratio (SR) is implemented in order to control the amplification distortion for speech intelligibility improvement. The results show that the proposed scheme gives comparatively better performance and can be easily employed in digital hearing aid system for improving speech quality and intelligibility.

A Follow-Up Study of the CROS Hearing Aid

1972 ◽  
Vol 37 (1) ◽  
pp. 113-117 ◽  
Author(s):  
Hedda Aufricht
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Unilateral Hearing Loss ◽  
Conversational Speech ◽  
Noisy Environment ◽  
Follow Up Study ◽  
Speech Distortion ◽  
Male Veterans ◽  
The Mean

A recent development in hearing aids, the contralateral routing of signals (CROS), makes it possible to provide amplification for persons with unilateral hearing loss. In 1967, a CROS eyeglass hearing aid was placed on government contract and made available to veterans. To study the efficiency of the CROS, a follow-up questionnaire was sent to 60 male veterans who had been fitted with this aid. All had demonstrated unilateral hearing losses, and the mean threshold for the speech frequencies (500–2000 Hz) in the good ear was 24 dB. The 54 replies (90%) indicated that 85% wore the aid, liked it, and derived benefit from it; 15% neither liked nor wore the aid. The CROS appeared to be most helpful in listening to conversational speech and at work, and most disturbing in a noisy environment. The complaints about the aid fell into major categories: 33% objected to its poor fit and construction and 11% were disturbed by speech distortion. The CROS aid has been a useful addition to the hearing-aid stock at the clinic reported here. It has expanded the program by providing amplification to veterans who could not be fitted with the conventional stock of aids.

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.

Prevalence and association of discrimination and bullying and the impact on mental health in an occupational setting

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Elizabeth Stratton ◽  
Michael J. Player ◽  
Ariane Dahlheimer ◽  
Isabella Choi ◽  
Nicholas Glozier
Keyword(s):  
Mental Health ◽  
Well Being ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Content Type ◽  
Occupational Setting ◽  
Male Dominated ◽  
Relationship Of ◽  
The Impact

PurposeDiscrimination and bullying contribute to mental ill-health in the workplace. At face value, they would seem linked but are often dealt with by different legislations. Workplace studies generally focus on bullying and population studies on discrimination. The authors aimed to evaluate the prevalence and relationship of discrimination and bullying in a male-dominated workforce, associated factors and relative impact on mental ill-health.Design/methodology/approachAn online cohort survey was conducted amongst employees of an Australian mining company, measuring discrimination, bullying, demographics and workplace and health factors over two months. Cross-sectional and prospective analyses assessed the prevalence of each, their association and their effects on depression and anxiety.FindingsA total of 580 employees (82% male) participated. There was no association between workplace bullying (n = 56, 9.7%) and discrimination (n = 160, 27.6%). Discrimination, but not bullying, was associated with higher depression, anxiety and suicidal ideation and lower well-being and resilience. After controlling for demographic, workplace and health and well-being factors, depression had the main effect on discrimination ß = 0.39, p = 0.003. Discrimination predicted an increase in depression scores at follow-up F (1, 129) = 4.88, p = 0.029.Originality/valueIn this male-dominated industry, discrimination was more prevalent than bullying. Discrimination, but not bullying, was associated with poorer mental health both cross sectionally and prospectively. Supporting the need to assess and manage discrimination and bullying in the workplace independently and the need for interventions to reduce a broader range of adverse interpersonal behaviours.

scholarly journals Sentence Recognition in Noise and Perceived Benefit of Noise Reduction on the Receiver and Transmitter Sides of a BICROS Hearing Aid

2013 ◽  
Vol 24 (10) ◽  
pp. 980-991 ◽  
Author(s):  
Kristi Oeding ◽  
Michael Valente
Keyword(s):  
Noise Reduction ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Background Noise ◽  
Signal To Noise Ratio ◽  
Hearing Aid ◽  
Directional Microphones ◽  
Sentence Recognition ◽  
Clinically Significant ◽  
The Impact

Background: In the past, bilateral contralateral routing of signals (BICROS) amplification incorporated omnidirectional microphones on the transmitter and receiver sides and some models utilized noise reduction (NR) on the receiver side. Little research has examined the performance of BICROS amplification in background noise. However, previous studies examining contralateral routing of signals (CROS) amplification have reported that the presence of background noise on the transmitter side negatively affected speech recognition. Recently, NR was introduced as a feature on the receiver and transmitter sides of BICROS amplification, which has the potential to decrease the impact of noise on the wanted speech signal by decreasing unwanted noise directed to the transmitter side. Purpose: The primary goal of this study was to examine differences in the reception threshold for sentences (RTS in dB) using the Hearing in Noise Test (HINT) in a diffuse listening environment between unaided and three aided BICROS conditions (no NR, mild NR, and maximum NR) in the Tandem 16 BICROS. A secondary goal was to examine real-world subjective impressions of the Tandem 16 BICROS compared to unaided. Research Design: A randomized block repeated measures single blind design was used to assess differences between no NR, mild NR, and maximum NR listening conditions. Study Sample: Twenty-one adult participants with asymmetric sensorineural hearing loss (ASNHL) and experience with BICROS amplification were recruited from Washington University in St. Louis School of Medicine. Data Collection and Analysis: Participants were fit with the National Acoustic Laboratories’ Nonlinear version 1 prescriptive target (NAL-NL1) with the Tandem 16 BICROS at the initial visit and then verified using real-ear insertion gain (REIG) measures. Participants acclimatized to the Tandem 16 BICROS for 4 wk before returning for final testing. Participants were tested utilizing HINT sentences examining differences in RTS between unaided and three aided listening conditions. Subjective benefit was determined via the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire between the Tandem 16 BICROS and unaided. A repeated measures analysis of variance (ANOVA) was utilized to analyze the results of the HINT and APHAB. Results: Results revealed no significant differences in the RTS between unaided, no NR, mild NR, and maximum NR. Subjective impressions using the APHAB revealed statistically and clinically significant benefit with the Tandem 16 BICROS compared to unaided for the Ease of Communication (EC), Background Noise (BN), and Reverberation (RV) subscales. Conclusions: The RTS was not significantly different between unaided, no NR, mild NR, and maximum NR. None of the three aided listening conditions were significantly different from unaided performance as has been reported for previous studies examining CROS hearing aids. Further, based on comments from participants and previous research studies with conventional hearing aids, manufacturers of BICROS amplification should consider incorporating directional microphones and independent volume controls on the receiver and transmitter sides to potentially provide further improvement in signal-to-noise ratio (SNR) for patients with ASNHL.

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