International Journal of Audiology最新文献

Objectives: To investigate 1) the influence of electrical dynamic range (DR) in cochlear implants (CI) of children at 3 years of age on their speech perception, vocabulary, and health-related quality of life (HRQOL) at 9 years of age; and 2) changes in electrical stimulation levels and DR over the first 10 years of life.

Design: This is a prospective longitudinal study on outcomes of children with congenital hearing loss. Outcomes at 9 years were measured using standardised tests. Generalised linear models were used to examine the effects of DR in CIs at age 3 years on children's 9-year outcomes.

Study sample: One hundred and two children who received CIs before 3 years of age.

Results: On average, vocabulary and HRQOL were within the range of typically hearing peers. A wider DR at 3 years was associated with better self-rated HRQOL at 9 years of age. Parent-proxy ratings of HRQOL were higher for children with better vocabulary. Earlier CI activation was associated with better speech perception and vocabulary. DR was stable over time.

Conclusion: The findings lend support to early cochlear implantation and emphasise the importance of optimising stimulation levels and DR at a young age to maximise longer-term outcomes.

Objective: To conduct a systematic review of identified barriers and facilitators for ethnically diverse adults and children in accessing hearing health services.

Design: Searches were performed in electronic databases MEDLINE, EMBASE, CINAHL, Pychinfo, LLBA, and Scopus. The Strengthening of Reporting of Observational Studies in Epidemiology and Standards for Reporting Qualitative Research were used to assess quality of articles. Barriers and facilitators for ethnically diverse adults and children to access hearing services were summarised descriptively using Levesque et al.'s conceptual framework of access to healthcare.

Study sample: 25 articles met the inclusion criteria.

Results: Barriers and facilitators were identified for every domain of Levesque's framework for ethnically diverse adults, children, and their families. Personal barriers included health literacy, health beliefs, and stigma. Environmental barriers included language, limited cultural and interpreter training for clinicians, time constraints in appointments, direct and indirect costs. Facilitators included availability of translated and/or simplified information, cultural responsiveness training, outreach programs, and community health workers to engage with ethnically diverse communities.

Conclusion: With increasingly multicultural societies globally, there is an increased need to provide culturally responsive care and accessible hearing health services. Understanding current barriers and facilitators to accessibility would facilitate global sustainable development goals around reduced inequality, health, and wellbeing.

Lack of standardised information about hearing aid technologies presents a barrier to individuals seeking to understand and make informed choices about the hearing aid features they may benefit from.

Objectives: (1) To identify features in contemporary hearing aids as described in publicly available materials. (2) To develop a lexicon of hearing aid features that informs consumers about available technologies.

Design: A synthesis of published information on the features of contemporary hearing aids from six major manufacturers was conducted by a multidisciplinary research team. The analysis and categorisation of these findings was an iterative, agile process involving five distinct phases, Scoping, Extracting/Decoding, Mapping, Synthesising and Consulting.

Sample size: 119 documents/publications were included in this review. These materials comprised 14 product guides and specification data sheets, and 105 white papers and technical articles.

Results: We identified 253 unique features (e.g. Feedback Management) across 12 hearing aid devices (including both premium and entry-level models). This resulted in the development of a lexicon describing the core capabilities of modern hearing aids.

Conclusion: Data synthesis identified key features of contemporary hearing aids across device models and manufacturers to inform the design of a lexicon for use by consumers.

Objective: To assess the feasibility of a newly developed PC-based Korean digits-in-noise (K-DiN) test for categorising the degree of hearing loss in participants with normal hearing and various degrees of hearing loss.

Design: The results of the Korean matrix sentence test (K-matrix) were compared with the corresponding K-DiN test results. Correlation analysis examined the relationships between the K-DiN speech reception thresholds (SRTs), age, pure-tone average (PTA), and K-Matrix SRTs. Receiver operating characteristic curves were constructed to evaluate the discriminatory ability of K-DiN across different degrees of hearing loss.

Study sample: K-DiN testing was conducted on 73 individuals with normal hearing and 166 individuals with hearing loss. Subsequently, 93 individuals were subjected to the K-Matrix.

Results: The K-DiN SRTs exhibited significant correlations with the PTA thresholds and K-Matrix SRTs. For detecting mild hearing loss, the K-DiN test demonstrated 90% sensitivity and 98% specificity with a -4 dB signal-to-noise ratio cut-off, accompanied by an area under the curve (AUC) of 0.98. Furthermore, the more severe the hearing loss, the lower the AUC value.

Conclusions: The findings from this study highlight the K-DiN test's excellent discriminative ability for differentiating normal hearing from hearing loss and for categorising individuals into distinct hearing-loss groups.

Objective: Co-design interventions with GPs to increase referrals from general medical practice to hearing care.

Design: In phase one of this intervention design study, three focus groups informed by the Theoretical Domains Framework (TDF) were conducted to explore perceived barriers and enablers to audiology referral for Australian GPs. In phase two, interventions aimed at addressing barriers and strengthening enablers were co-designed by GPs and the research team during three workshops.

Study sample: Twenty GPs in Victoria, Australia, participated in three focus groups and one co-design workshop.

Results: Key barriers to referral were a lack of knowledge of costs/funding; low trust in audiologists, a reliance on patients raising hearing concerns, negative beliefs about hearing rehabilitation, and competing clinical priorities. Key enablers were good relationships and communication between GPs and local audiologists, awareness of the impacts and co-morbidities of hearing loss and the social impacts of interventions, and having specified ages for comprehensive health checks (including hearing). Two interventions were proposed: a digital software prompt to encourage GPs to refer suitable older patients, and an online resource package including a digital referral form.

Conclusions: We identified high-priority barriers and enablers to be addressed by theory-informed interventions in clinical practice.

Objective: Measuring vestibular rehabilitation progress with questionnaires can be difficult in time-limited clinical settings. We developed and tested a new brief tool: Client Oriented Scale of Improvement for Dizziness and Imbalance (COSIDI), based on validated client-oriented scales for hearing aids (COSI) and for tinnitus (COSIT), and on wider evidence for involving patients in specifying the goals for rehabilitation.

Design: We developed the COSIDI with patient and clinician feedback and validated it through comparison with Dizziness Handicap Inventory (DHI) and Vestibular Rehabilitation Benefit Questionnaire (VRBQ) during normal clinical appointments.

Study sample: 91 outpatients in three clinical settings in Cardiff, Swansea and Southampton.

Results: COSIDI improvement scores showed comparable effect size with DHI and VRBQ (Cohen's d = 1.1 vs 1.2 and 0.64) and correlated highly with the existing measures (r = 0.73). Clinicians found COSIDI to be useful and appropriate for rehabilitation measurement, due to its patient-focus, brevity and support for goal-setting.

Conclusions: COSIDI is a valid tool for assessing vestibular rehabilitation, used alone or as complementary to other tools, which clinicians indicated provide useful prompts for patients to consider.

Objectives: Two methods, paired comparisons and ratings, were investigated when comparing two hearing-aid programs in live group conversations.

Design: Two conversation scenarios were staged in an ordinary office setting. During the conversations, the participants either switched between two hearing-aid programs or used a fixed program. After each conversation, they rated hearing-aid function, ease to hear and speak, and the flow of the conversation.

Study sample: Experienced hearing-aid users (n = 27) with moderate hearing loss who were fitted with binaural hearing aids with two directionality programs.

Results: The methods showed consistent results: the program preferred in paired comparisons also received the highest function ratings when used as a fixed program. On a population level, the paired comparisons method was slightly more effective in finding differences between the programs. On an individual level, only the paired comparisons method revealed a difference between the hearing-aid programs. Conversation flow ratings were generally high for both methods.

Conclusions: Both psychophysical methods worked well for evaluating hearing-aid settings during live group conversations, and the results of the two methods generally agreed. The paired comparison method was slightly more effective in finding differences between the two hearing-aid settings. Ratings of conversation flow were generally high for both methods.

Objective: This study investigated the relationship between audiovisual (AV) integration and acoustic change complex (ACC) responses in cochlear implant (CI) users.

Design: A cross-sectional design was employed. AV integration was assessed with the McGurk paradigm under auditory-only, visual-only, congruent (e.g., auditory /ba/-visual /ba/), and incongruent (e.g., auditory /ba/-visual /ga/) AV conditions. ACC responses were recorded using the /ui/ stimulus. Group comparisons and correlations between AV performance and ACC latencies were analysed.

Study sample: The study included 25 normal-hearing (NH) adults and 50 CI users (prelingual and postlingual) matched for age and cortical maturation.

Results: NH participants outperformed CI users in auditory-only, congruent, and incongruent AV conditions (p < .05), while visual-only performance was similar (p > .05). CI users showed greater reliance on visual cues and fewer fusion responses under incongruent conditions. ACC latencies were consistently shorter in NH than in CI groups (p < .05). Correlations between ACC latencies and AV performance were observed only in the prelingual CI group, where shorter latencies reflected higher auditory-only accuracy.

Conclusions: CI users exhibited limitations in AV integration and prolonged ACC latencies. Moreover, ACC measures mainly reflect auditory discrimination capacity rather than direct multisensory integration, providing complementary insights into the neural mechanisms underlying speech perception in CI users.

Objective: Age-related hearing loss may induce negative views of ageing, which can predict decreased physical, cognitive, and mental health over time. How hearing loss influences views of ageing, and whether its potential impact is solely negative, remains largely unexplored. This study explored how older adults with hearing loss perceive their ageing experience, using the Awareness of Age-Related Change (AARC) framework.

Design: Semi-structured interviews were analysed using deductive thematic analysis guided by the five AARC domains.

Study sample: Fifteen older adults (mean age = 70.8, 60% male) with objectively assessed mild-to-severe age-related hearing loss (mean pure tone average = 38.6 dBHL).

Results: Participants described a wide range of ageing experiences across 17 codes, spanning all five AARC domain and cross-domain themes. While loss-related ageing experiences such as social withdrawal were common, we also identified novel gain-related experiences, including adopting advocacy roles for peers and enhanced feelings of control and stability through proactive hearing management. Two overarching themes shaped experiences across all domains: knowledge-informed adaptation and social comparison.

Conclusions: Our findings highlight the multifaceted nature of ageing with hearing loss. Applying the AARC framework provides novel insights into psychosocial adaptation, with implications for person-centred interventions that support healthy ageing among people experiencing hearing loss.

Objective: Listening in a conversation has numerous demands not addressed by traditional speech-intelligibility tests. We here examine the utility of an alternative way to assess conversational listening, the just-follow conversation (JFC) test, namely its reproducibility and sensitivity to stimulus changes, as well as what it can tell us about conversational demands.

Design: Participants repeatedly adjusted the overall level of one monologue, one dialogue and two simultaneous monologues in the front hemifield until they could just follow the speech. Speech was presented in surrounding fixed-level café and same-spectrum noise backgrounds.

Study sample: Fifty-four adults, including 27 bilateral hearing-aid (HA) users, participated. HA users adjusted aided and unaided in separate blocks; non-users repeated each condition to evaluate reproducibility.

Results: JFCs were greater for dialogues than monologues, but not greater for two simultaneous monologues than dialogues. Individual JFCs correlated with self-reported speech understanding as well as pure-tone threshold averages. Aiding did not have a significant effect on results. Measures of reproducibility were comparable to more traditional speech-intelligibility tests.

Conclusion: The current results show that the JFC test is a relatively quick, repeatable measure that invokes both subjective and objective components of speech understanding, but it may be of limited use in evaluating amplification.