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Daily communication may be effortful due to poor acoustic quality. In addition, memory demands can induce effort, especially for long or complex sentences. In the current study, we tested the impact of memory task demands and speech-to-noise ratio on the time-specific components of effort allocation during speech identification in noise. Thirty normally hearing adults (15 females, mean age 42.2 years) participated. In an established auditory memory test, listeners had to listen to a list of seven sentences in noise, and repeat the sentence-final word after presentation, and, if instructed, recall the repeated words. We tested the effects of speech-to-noise ratio (SNR; −4 dB, +1 dB) and recall (Recall; Yes, No), on the time-specific components of pupil responses, trial baseline pupil size, and their dynamics (change) along the list. We found three components in the pupil responses (early, middle, and late). While the additional memory task (recall versus no recall) lowered all components' values, SNR (−4 dB versus +1 dB SNR) increased the middle and late component values. Increasing memory demands (Recall) progressively increased trial baseline and steepened decrease of the late component's values. Trial baseline increased most steeply in the condition of +1 dB SNR with recall. The findings suggest that adding a recall to the auditory task alters effort allocation for listening. Listeners are dynamically re-allocating effort from listening to memorizing under changing memory and acoustic demands. The pupil baseline and the time-specific components of pupil responses provide a comprehensive picture of the interplay of SNR and recall on effort. [ABSTRACT FROM AUTHOR]

Background: The uptake and use of hearing aids is low compared to the prevalence of hearing impairment. People who seek help and take part in a hearing aid rehabilitation process participate actively in this process in several ways. Purpose: In order to gain more knowledge on the challenges of hearing help-seeking and hearing aid use, this qualitative study sought to understand the ways that people with hearing impairment describe themselves as active participants throughout the hearing aid rehabilitation process. Research Design: In this qualitative interview study we examined the hearing rehabilitation process from the perspective of the hearing impaired. In this article we describe how the qualitative interview material was interpreted by a pragmatic qualitative thematic analysis. The analysis described in this article focused on the efforts, initiatives, actions, and participation the study participants described that they had engaged in during their rehabilitation. Study Sample: Interviews were conducted with people with hearing impairment in Australia, Denmark, the United Kingdom, and the United States. The 34 interview participants were distributed equally between the sites, just as men and women were almost equally represented (56% women). The average age of the participants was 64. All participants had a hearing impairment in at least one ear. The participants were recruited to represent a range of experiences with hearing help-seeking and rehabilitation. Data Collection and Analysis: With each participant one qualitative semistructured interview ranging between 1 and 2 hr was carried out. The interviews were transcribed verbatim, read through several times, and themes were identified, defined, and reviewed by an iterative process. Results: From this thematic focus a concept called "client labor" has emerged. Client labor contains nine subthemes divided into three overarching groups: cognitive labor, emotional labor, and physical labor. The participants' experiences and meaning-making related to these conceptual types of efforts is described. Conclusions: The study findings have implications for the clinical encounter between people with hearing impairment and hearing health-care professionals. We suggest that a patient-centered approach that bears in mind the client's active participation could help toward improving clinical dispensing, fitting, and counseling practices with the end goal to increase hearing aid benefit and satisfaction. [ABSTRACT FROM AUTHOR]

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.