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Purpose: This study examined how adults with untreated hearing loss respond to surveys about their self-efficacy, personality traits, and affective states when assessed "in general" and in listening-related contexts. We also explored the associations between hearing aid self-efficacy (HASE) and listening-related personality traits and affective states., Method: Sixty-two adults with self-reported hearing difficulties and no experience with hearing aids (HAs) participated in this descriptive study. Participants self-reported their self-efficacy, personality, and affective states in general and in listening-related contexts. Paired t tests and repeated measures with Holm-Šídák corrections were performed to explore differences between reports of patient traits in different contexts. Multiple regression analyses were conducted to explore significant associations., Results: On average, there were no significant differences between general and listening-related self-efficacy or personality traits. However, our participants indicated significantly more negative affective states in listening-related situations compared to in general. There was a small positive association between HASE and reported affective states in "General" and "Listening at Home" contexts., Conclusions: This study confirms that context-specific measures are not required to accurately assess self-efficacy and personality traits in the initial stages of the hearing health journey. However, reported affective states were listening dependent for this sample. Although reported affective states were related to HASE, context-dependent measures did not provide additional insight into participants' self-efficacy for successful HA use. This suggests that rehabilitation protocols designed to promote HASE and positive affect in general and listening-related situations could facilitate HA success.

Objectives: Modern hearing aid (HA) devices include a collection of acoustic signal-processing features designed to improve listening outcomes in a variety of daily auditory environments. Manufacturers market these features at successive levels of technological sophistication. The features included in costlier premium hearing devices are designed to result in further improvements to daily listening outcomes compared with the features included in basic hearing devices. However, independent research has not substantiated such improvements. This research was designed to explore differences in speech-understanding and listening-effort outcomes for older adults using premium-feature and basic-feature HAs in their daily lives., Design: For this participant-blinded, repeated, crossover trial 45 older adults (mean age 70.3 years) with mild-to-moderate sensorineural hearing loss wore each of four pairs of bilaterally fitted HAs for 1 month. HAs were premium- and basic-feature devices from two major brands. After each 1-month trial, participants' speech-understanding and listening-effort outcomes were evaluated in the laboratory and in daily life., Results: Three types of speech-understanding and listening-effort data were collected: measures of laboratory performance, responses to standardized self-report questionnaires, and participant diary entries about daily communication. The only statistically significant superiority for the premium-feature HAs occurred for listening effort in the loud laboratory condition and was demonstrated for only one of the tested brands., Conclusions: The predominant complaint of older adults with mild-to-moderate hearing impairment is difficulty understanding speech in various settings. The combined results of all the outcome measures used in this research suggest that, when fitted using scientifically based practices, both premium- and basic-feature HAs are capable of providing considerable, but essentially equivalent, improvements to speech understanding and listening effort in daily life for this population. For HA providers to make evidence-based recommendations to their clientele with hearing impairment it is essential that further independent research investigates the relative benefit/deficit of different levels of hearing technology across brands and manufacturers in these and other real-world listening domains.

Purpose: We evaluated 2 measures of listening effort (a self-report measure and a word recall measure) regarding their suitability for inclusion in a comprehensive audiologic testing protocol. The relationship between the 2 measures was explored, and both measures were examined with regard to validity, sensitivity, and effect on speech intelligibility performance., Method: Thirty adults with normal hearing participated. Speech intelligibility performance was evaluated at 4 signal-to-noise ratios by using keywords embedded in both high- and low-context sentences. Listening effort was evaluated at set intervals throughout the speech intelligibility task., Results: Results obtained with the 2 measures were consistent with expected changes in listening effort. However, data obtained with the self-report method demonstrated greater sensitivity to these changes. The 2 measures were uncorrelated. Under certain conditions, speech intelligibility performance was more negatively affected when the word recall measure was used. Exploration of additional theoretical and practical considerations supported a conclusion that the self-report measure was preferable for measuring listening effort simultaneously with speech intelligibility., Conclusion: The results of this study provide a rationale for preferring the self-report measure of listening effort over the word recall measure when testing audiologic outcomes.

Background: Hearing loss is one of the most common chronic health conditions of older people. Hearing aids are the customary treatment and they improve quality of life in older adults. Even so, relatively few older adults with uncomplicated, mild to moderate, adult-onset, sensorineural hearing loss use hearing aids. One reason for this is a belief that hearing aids do not provide sufficient value to justify their expense. Although modern hearing aids are available at several price points, there is minimal evidence about the relative benefits of premium-level versus basic-level hearing aid technologies., Objective: This research was designed to demonstrate the relative effectiveness of premium hearing aids compared with basic hearing aids in improving speech understanding and quality of life., Methods: 25 participants, including both new and experienced hearing aid users, completed blinded month-long field trials with each of four pairs of hearing aids: two basic and two premium level. Outcomes were laboratory speech understanding tests, standardized questionnaires and open-ended diary items., Results: Participants reacted very positively to all the hearing aids. Both everyday speech understanding and quality of life were substantially improved with hearing aids. RESULTS for both new and experienced users were consistent with a conclusion that there were no statistically significant or clinically important differences in improvement between the premium- and basic-level hearing aids., Conclusions: It should not be assumed that more costly hearing aids always produce better outcomes. With contemporary hearing aids from two major manufacturers, the subjects obtained as much improvement in speech understanding and quality of life from lower-cost basic-level instruments as from higher-cost premium-level instruments. Regardless of technology level, comprehensive best-practice fitting protocols should be followed to optimize results for every patient., (© 2014 S. Karger AG, Basel.)

Objectives: This study had two purposes. The first was to assess the prevalence of cochlear dead regions (DRs) among listeners with moderate to severe hearing loss that is typical of a large proportion of adult hearing aid wearers. The second was to determine whether subjects who tested positive for DRs differed from those without DRs in their ability to utilize high-frequency speech cues in a laboratory test., Design: One hundred and seventy adults (307 ears) were tested for DRs at frequencies from 0.5 to 4 kHz using the threshold equalizing noise (HL) test. Speech recognition ability was measured for high-frequency emphasis (HFE) stimuli and for low-pass filtered HFE (HFE-LP) stimuli using the Quick Speech In Noise test. Results obtained from the HFE and HFE-LP conditions were compared to examine changes in word recognition when more speech cues were provided above 2.5 kHz. Possible effects of audiogram differences between DR-no and DR-yes groups were examined by estimating the change in audibility for the two Quick Speech In Noise conditions using calculated differences in Speech Intelligibility Index for each condition for every subject., Results: Thirty-one percent of subjects (23% of ears) were found to have a DR at one or more test frequencies. Sixty-eight percent of subjects who tested positive for DR had DRs in one ear only. DRs were most prevalent at frequencies above 1.5 kHz. Comparison of word recognition scores obtained with the HFE and HFE-LP conditions revealed that, on average, both groups scored significantly better when more high-frequency cues were provided. The magnitude of the benefit was small for both groups, but the computed effect size was larger for listeners without DRs than for those with DRs. Further, subjects with contiguous DRs at 2 to 3 frequencies obtained less benefit than subjects with DRs at isolated frequencies. It was determined that the improved audibility of high-frequency cues in the HFE condition was significantly less for listeners with DRs, and this accounted for some, but not all, of the difference in effect sizes., Conclusions: Although about one-third of listeners with flat or sloping moderate to severe hearing losses tested positive for at least one DR, there was no evidence to support a proposal for reducing high-frequency gain in hearing aid fittings for these types of listeners. Making high frequencies more audible was helpful, on average, regardless of DR status. It is recommended that field trials be undertaken in which subjects with and without DRs wear hearing aids in daily life. This type of study would produce higher level evidence about best practice in hearing aid fitting for patients with flat or sloping moderate to severe hearing loss who test positive for DRs.

Purpose: This study evaluated the feasibility of using wearable sensors to assess listening-related stress in varying listening difficulties. The results were compared to listening effort assessed using laboratory-grade physiological measures. We hypothesized that these wearable sensors could accurately measure listening-related stress and that the results would be in the same direction as those observed with laboratory-grade equipment. Method: A within-subject repeated-measures study was conducted on 16 young adults with typical hearing ability. Participants wore three commercially available sensors to record heart rate (HR), respiration rate (RR), and galvanic skin response (GSR). Participants' listening-related stress was assessed using self-report, wearable sensors, and laboratory-grade physiological measures while listening to sentences in noise. Listening conditions were manipulated in terms of signal-to-noise ratios (SNRs; -4, 0, +4, and +8 dB SNR), sentence predictability (high and low), and stress-inducing negative feedback (flash of light and monetary punishers). Results: On average, participants reported higher arousal and task load with decreasing SNR, for low predictability, and with negative feedback. Participants had significantly higher HR and RR in difficult listening conditions, when measured with wearable sensors. However, no significant differences were observed for skin conductance. There was a good agreement between the measures for HR but not for RR and GSR. Conclusions: Although wearable sensors have potential in reflecting changes in listening effort, the results were not consistent with laboratory-grade measures. Methodological choices in both measures and design appear to affect outcomes. Future studies should focus on crafting designs appropriate to wearable devices to reflect changes in listening-related stress. [ABSTRACT FROM AUTHOR]