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Objective: The research-oriented objective of this study was to document the effectiveness of online support for hearing aid (HA) users compared with traditional support., Design: This study is a randomised controlled trial with parallel group design. The research-oriented objectives were evaluated using the Hearing Handicap Inventory for the Elderly (HHIE) and the Communication Strategies Scale (CSS) at baseline and immediately postintervention., Study Sample: Selected clients at five different clinics were randomised to an intervention group ( n  = 78) that took part in online hearing support and a control group ( n  = 58) that received standard care., Results: The analyses (intention-to-treat) showed statistically significant improvements in the HHIE-total and Emotional subscale scores for the intervention group compared with the control group. The intervention group also showed significantly greater improvement in the CSS-total and Verbal and Nonverbal subscale scores. A subgroup analysis was performed including two groups: HA use <1 year and HA use >1 year . A statistically significant improvement was found for the HA users >1 year compared with HA use <1 year., Conclusions: It is effective to clinically include online hearing support for HA users when addressing self-perceived hearing difficulties and to sharpen communication strategy skills.

Objective: Internet interventions for hearing aid (HA) users have been shown to be effective in helping persons with hearing problems. As earlier research refers to objective data on these effects, little is known about how participants experience the Internet interventions subjectively. The aim of the present study was to explore participants' experiences of an Internet-based aural rehabilitation (IAR) program for HA-users, and to explore the possible subjective benefits of such a program., Design: A qualitative exploratory design was implemented involving semi-structured telephone interviews. The interviews were transcribed and analysed using content analysis., Study Sample: Interviews were conducted with 20 participants (9 men and 11 women) who had completed an IAR program for HA-users. The participants were 57-81 years old and had used HAs for 2-25 years., Results: The results are organised in three main categories: general experiences associated with participating in the program, knowledge obtained from the program and perceived impact of taking part in the program., Conclusions: The overall results indicate positive experiences of the IAR program, and an overreaching theme of increased self-esteem was identified. The findings provide some valuable information for developers of future IAR programs.

Purpose: 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., Method: 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., Results: 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., Conclusions: 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.

Purpose: The purpose of the two studies presented in this research forum article was to develop audiological rehabilitation programs for experienced hearing aid users and evaluate them in online versions. In this research forum article, the differences between the two studies are discussed., Method: Two randomized controlled trials (RCTs) were performed evaluating the efficacy of online rehabilitation, including professional guidance by an audiologist. In each RCT, the effects of the online programs were compared with the effects measured in a control group., Results: The results from the first RCT showed a significant increase in activity and participation for both groups with participants in the intervention group improving more than those in the control group. At the 6-month follow-up, after the study, the significant increase was maintained; however, amounts of increase in the two groups were no longer significantly different. The results from the second RCT showed significant increase in activity and participation for the intervention group, although the control group did not improve., Conclusions: The results from the RCTs provide evidence that the Internet can be used to deliver rehabilitation to hearing-aid users and that their problems are reduced by the intervention; however, the content of the online rehabilitation program requires further investigation.

Background: In audiologic practice, complementary information sources and access to the clinician between appointments improve information retention and facilitate adjustment behaviors. An Internet-based support system is a novel way to support information sharing and clinician access., Purpose: This research forum article describes the process of developing an Internet-based support system for audiologists and their first-time hearing aid clients., Method: The iterative development process, including revisions by 4 research audiologists and 4 clinical audiologists, is described. The final system is exemplified., Conclusion: An Internet-based support system was successfully developed for audiologic practice.

Objectives: There is strong evidence from other fields of health, and growing evidence in audiology, that characteristics of the process of intervention as perceived by the client (embodied narratives) can have significant effects on treatment outcomes, independent of the technical properties of the intervention itself. This phenomenon deserves examination because studies of technical interventions that fail to take account of it may reach erroneous conclusions and because clinical practice can put such effects to therapeutic use. The aim of this study was to test the idea that embodied narratives might affect outcomes in hearing aid fitting. This was achieved by carrying out experiments in which technical (acoustic) differences between alternative hearing aid fittings were absent, while providing test subjects with a strong contrast between the processes apparently applied to derive the fittings being compared. Thus, any effects of contrasting narratives could be observed, free of acoustical confounds. The hypothesis was that narrative effects would be observed., Design: A balanced crossover design was used, in which subjects received and evaluated two bilateral hearing aid fittings in succession. Subjects were deceived as to the true identical content of the hearing aid fittings being compared, but encouraged to believe that one fitting process was "interactive" and the other was "diagnostic" in character. Two almost identical experiments were undertaken: one with 24 experienced adult hearing aid users and another with 16 adult first-time users. Each hearing aid fitting was worn at home for 2 weeks, after which self-report outcome measures (Hearing Aid Performance Questionnaire, Hearing Handicap Inventory for the Elderly, and International Outcome Inventory for Hearing Aids) were administered. After the second test period, a short preference questionnaire was also completed., Results: Twenty of the 24 experienced users showed a clear preference for one or the other fitting, and their self-report scores reflected these preferences. Effect sizes were comparable with those typically observed for true acoustical contrasts. No order effect was seen in this group. In contrast, 13 of the 16 first-time users preferred the second fitting. Trends in the self-report measures were similar for this group but weaker than for the experienced users. In both groups, the reasons given for subjects' preference were predominantly related to sound, despite there being no acoustical differences., Conclusions: This study suggests that the narrative embodied in a given fitting process can have a substantial effect on the perceived benefit of the treatment, independent of any acoustical differences, at least for experienced users. For first-time users, acclimatization seems to overshadow the purely narrative effect of any fitting process. In the future, research study designs should include steps to avoid narrative effects when technical parameters of hearing aids are the intended object of study. In clinical practice, the narrative is part of the therapeutic context, and one may design it for maximum beneficial effect.

Objective: This study investigated the perspectives of adults with hearing impairment on hearing help-seeking and rehabilitation., Design: Individual semi-structured interviews were completed., Study Sample: In total, 34 adults with hearing impairment in four countries (Australia, Denmark, UK, and USA) participated. Participants had a range of experience with hearing help-seeking and rehabilitation, from never having sought help to being satisfied hearing-aid users., Results: Qualitative content analysis identified four main categories ('perceiving my hearing impairment', 'seeking hearing help', 'using my hearing aids', and 'perspectives and knowledge') and, at the next level, 25 categories. This article reports on the densest categories: they are described, exemplified with interview quotes, and discussed., Conclusions: People largely described hearing help-seeking and rehabilitation in the context of their daily lives. Adults with hearing impairment rarely described clinical encounters towards hearing help-seeking and rehabilitation as a connected process. They portrayed interactions with clinicians as isolated events rather than chronologically-ordered steps relating to a common goal. Clinical implications of the findings are discussed.

Self-reports of subjective hearing difficulties by people with hearing loss may be a useful complement to audiometry in hearing aid rehabilitation. To be useful, such self-reports need to be reliable. This study investigated the reliability and the validity of the Swedish Hearing Handicap Inventory for the Elderly (Screening Version; HHIE-S). Sixty-nine participants completed a questionnaire before hearing aid rehabilitation. Of these individuals, 49 completed hearing aid rehabilitation (aged between 23 and 94 years), and 41 of these 49 participants completed the questionnaire after completing the rehabilitation. The Swedish HHIE-S exhibited good internal consistency (Cronbach's alpha coefficient of .77). The questionnaire was effective for evaluating hearing aid rehabilitation, and a statistically significant reduction in hearing difficulties was observed. The clinicians found the questionnaire easy to administer and effective in hearing aid rehabilitation. The findings from the study support the use of the HHIE-S in clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this article is to highlight the importance of hearing health care beyond the clinic for older people with impaired hearing. Method: This article emphasizes factors affecting the success of audiologic rehabilitation for older people and describes practical clinical and community-based strategies for promoting successful hearing health care. Results: Older people are not always aware of the extent of their hearing loss, may not always expect to benefit from using a hearing aid, and often have low self-efficacy for managing to learn to use hearing aids. Increased knowledge and support from other health professionals, family caregivers, and significant others could optimize older peoples' participation in everyday activities. Conclusion: Further work is needed to develop new interventions for older people with impaired hearing and to increase collaboration with general practitioners as well as other health care professionals. [ABSTRACT FROM AUTHOR]

Objective: Previous research shows that the internet can be used in the rehabilitation of hearing-aid users. By further developing the online program, it might be possible to foster behavioral changes that will positively affect hearing-aid users. Design: A randomized controlled study with two groups of participants. The intervention group underwent a five-week online intervention while the control group was referred to a waiting list. Questionnaires were used as outcome measures. Study sample: Seventy-six experienced hearing-aid users participated in the study, ranging in age from 26 to 81 years (mean 69.3 years). Results: The findings showed significant improvements in the intervention group after the intervention, measured by the hearing handicap inventory for the elderly. The effects were maintained and improved at the follow-up. Furthermore, the results indicated that the participants in the intervention group improved at two items of the international outcome inventory for hearing aids, and the effects were partly maintained at the follow-up. Finally, significant improvements in the domain of psychosocial wellbeing were found at the follow-up. Conclusions: This study provides further evidence that the internet can be used to deliver intervention of rehabilitation to hearing-aid users. [ABSTRACT FROM AUTHOR]

Objectives: This descriptive summary of the literature provides an overview of the available studies (published between January 1980 and January 2009) on correlates of help-seeking behavior for hearing loss, hearing-aid uptake, hearing-aid use, and satisfaction with the device. Methods: Publications were identified by structured searches in Pubmed and Cinahl and by inspecting the reference lists of relevant articles. The articles covered different stages that a person with hearing impairment may go through: prior to hearing aid fitting, the period covering the fitting and the period post hearing aid fitting. Inclusion of articles occurred according to strict inclusion and exclusion criteria. Data were extracted by two independent researchers. Thirty-nine papers were included that identified 31 factors examined in relation to the four outcome measures. These covered personal factors (e.g., source of motivation, expectation, attitude), demographic factors (e.g., age, gender) and external factors (e.g., cost, counseling). Only two studies covered the actual fitting process. There was only one factor positively affecting all four outcome variables. This was self-reported hearing disability. The vast majority of studies showed no relationship of age and gender with any of the outcome domains. Discussion and conclusion: Whereas research of the last 28 years yielded valuable information regarding relevant and irrelevant factors in hearing aid health care, there are still many relevant issues that have never been investigated in controlled studies. These are discussed. [ABSTRACT FROM PUBLISHER]

The objective of the study was to evaluate the effects of an individual pre-fitting intervention for first-time hearing aid users. Thirty-eight hearing impaired adults were randomly assigned to a sound awareness pre-fitting intervention (n=19) or to a control group (n=19). The purpose of the sound awareness training was to facilitate the users' acclimatization to amplified sound. The pre-fitting intervention consisted of three visits and was followed by conventional hearing aid fitting that was identical for both groups. Standardized questionnaires were administered before and after the pre-fitting intervention, after the conventional hearing aid fitting, and at a one-year follow-up. The follow-up also included a clinical assessment by means of a telephone interview performed by an independent audiologist. The pre-intervention did not result in any major improvement over and above the control group. However, improvements were found for both groups following hearing aid fitting. In addition, most participants were considered as successful users in the interview. Future research should target individuals in need of extended hearing aid rehabilitation. [ABSTRACT FROM AUTHOR]

The main aim of this study was to collect descriptive data and to evaluate the psychometric properties of a range of self-report questionnaires in a Swedish population. Other aims were to investigate the correlations between these measures and the higher order factorial structure of the included questionnaires. One hundred and sixty-two first-time hearing aid users completed four standardized hearing specific questionnaires: the Hearing Handicap Inventory for the Elderly (HHIE); the Satisfaction with Amplification in Daily Life (SADL); the Communication Strategies Scale (CSS); and the International Outcome Inventory for Hearing Aids (IOI-HA). In addition, two psychosocial questionnaires were completed: the Sense of Coherence scale (SOC); and the Hospital Anxiety and Depression Scale (HADS). All measures were administered at one year post hearing aid fitting. Mean scores for the questionnaires were in agreement with previous studies. The questionnaires were found to be reliable and acceptable for further clinical use. Correlations were seen across different hearing specific questionnaires, and between hearing aid use and satisfaction. Psychosocial variables were more strongly associated with participation restriction and satisfaction than with the demographic variables, confirming the importance of subjective measures. The factor analysis extracted four factors: psychosocial well-being, hearing aid satisfaction, adaptive communications strategies, and residual participation restriction, and indicated that the number of questionnaires could be reduced. It is concluded that psychosocial factors are important to consider in hearing aid rehabilitation and their possible role should be further investigated in future studies. [ABSTRACT FROM AUTHOR]

A clinical trial of the Oticon DigiFocus hearing aid was performed. The test aid was evaluated on 33 subjects with several years' experience as users of modern analog hearing aids. These aids were used as reference for the 1-month-long trial. The Abbreviated Profile of Hearing Aid Benefit (APHAB) showed a mean difference in benefit with superior ratings for the test aid concerning ease of communication, speech in reverberation and speech in background noise. The subjects' own aids were rated somewhat better concerning aversiveness of sounds, but this difference was not statistically significant. The Gothenburg Profile showed a statistically significant difference between the test aid and the reference aids in favour of the test aid. The difference was most evident with regard to speech communication and the effects of hearing loss on social interactions. Sound quality ratings concerning clearness were significantly higher for the test aid. Speech recognition thresholds in noise were on average 0.7 dB better for the test aids when tested at speech levels 60 and 75 dB. The difference was statistically significant only at 75 dB. There was a significant interaction between general preference and hearing aid type, indicating that overall sound quality was an important factor affecting the general preference for either the test aid or the reference aid. Twenty-three subjects generally preferred the test aid, six preferred their own aid and four stated no difference. [ABSTRACT FROM AUTHOR]