International Journal of Audiology最新文献

Objective: To investigate the perspectives and experiences of adults with hearing loss (HL), their family members, and hearing care professionals on how they respond to the stigma of HL and hearing aids (HAs).

Design: Qualitative descriptive approach using semi-structured interviews.

Study sample: Three participant groups were recruited, including 20 adults over the age of 50 years with HL, 20 family members who had a close relationship to the adults with HL, and 25 hearing care professionals.

Results: Three themes described how adults with HL, family members, and hearing care professionals respond to the stigma of HL and HAs, namely: (1) some people tell others about their HL and HAs and some people don't; (2) telling or not telling depends on the situation; and (3) people deal with the stigma of HL and HAs in different ways.

Conclusions: This study revealed a range of volitional responses to the stigma of HL and HAs. People affected by HL may not tell others about their HL and/or HAs because of the stigma, and these volitional responses are influenced by situational cues. Adults with HL and family members manage the stigma of HL and HAs in different ways and require a person-centred approach.

Objective: We assessed the interaction between self-efficacy and joint problems and self-efficacy and visual problems on the risk of hearing aid abandonment in older adults.

Design: A retrospective cohort study comprising older adults who received hearing aids in Chile was conducted. Hearing aid self-efficacy was measured using the S-MARS-HA questionnaire, while joint and visual problems were assessed through self-reported questions. Survival regression models were conducted to investigate the interaction between self-efficacy and joint problems, as well as self-efficacy and visual problems.

Study sample: The study included 355 older adults who received hearing aids through the Chilean public health sector.

Results: A significant interaction effect indicated that the relationship between self-efficacy and the risk abandonment was influenced by joint problems (p < 0.05). In the subpopulation with joint problems, self-efficacy was associated with a reduced risk of hearing aid abandonment (HR = 0.81), whereas in the subpopulation without joint problems, the protective effect was more pronounced (HR = 0.52). The interaction between self-efficacy and visual problems was not significant.

Conclusions: The interaction between self-efficacy and joint problems was associated with the risk of abandonment. Addressing limitations associated with joint problems and individuals' confidence in using their hearing aids could reduce the abandonment.

Objective: To assess acceptability and benefit of a community-based hearing intervention delivered at no cost to lower-income older adults with untreated hearing loss in New Brunswick, Canada.

Design: Mixed method pre-post intervention study investigating aspects of communication function and social support at baseline and three months post-intervention.

Study sample: 124 of 175 independent-living older adults screened at the study site and in local community centres in low-income neighbourhoods were recruited into the study.

Results: In 70 (56.5%) participants self-identified as female and 54 (43.5%) as male, with mean age of 74.5 years, mean effect sizes measured from baseline to 3-months post-intervention were 0.99 (large) for HHIE-S, 0.58 (medium) for DSSI, and 1.02 (large) for LSEQ indicating significant improvement in self-perceived communication function, social support and listening self-efficacy, respectively.

Conclusion: The HEARS program is feasible to implement, despite Covid-19 pandemic related challenges, highly acceptable to participants, and associated with a range of benefits that include improved communication function, self-efficacy and social support. The success of HEARS in a new population in a second Canadian province indicates its adaptability and suitability for scaling to extend the reach of hearing services for older adults who may not otherwise access care.

Objective: Our primary purpose was evaluation of early benefits of lifestyle modification on symptoms of vestibular migraine. The secondary purpose was to determine if a patient's global sense of coping relates to outcomes with lifestyle modification.

Design: Prospective observational cohort. Participants completed questionnaires related to dizziness handicap, headache disability, and adherence to lifestyle modifications at baseline and weekly over 30 d. Sense of coping was measured pre-intervention.

Study sample: Thirty-eight patients with vestibular migraine diagnosed in tertiary care setting between 2022 and 2023.

Results: Symptoms were better at all four weeks post-intervention than pre-intervention (p < 0.01), with no difference across weeks two through four (p > 0.10) when symptoms were lowest and stable. By week two, 52% and 18.5% of participants had significant improvement in dizziness and headache compared to published critical difference scores, respectively. Sense of coping was inversely correlated with dizziness (R = -0.53, p < 0.00001) and headache (R = -0.64, p < 0.0001).

Conclusions: Lifestyle modification reduced dizziness and headache in many vestibular migraineurs in the first two weeks following intervention. Improvement in restful sleep was associated with improvement in symptoms. Sense of coping did not predict improvement but was inversely related to symptoms. Lifestyle modification could be considered as sole management or in addition to pharmacological intervention.

Objectives: To assess the effect of forward and omnidirectional microphone configurations in BiCROS versus monaural hearing aids on objective and subjective outcomes in different noise conditions.

Design: After fitting and a 4-week acclimatisation period, speech recognition and sound quality were measured using forward directional, omnidirectional, and unaided settings. Two noise configurations were used, surrounding noise and noise presented from the aided (better) ear. Subjective outcomes were assessed using the SSQ-b and BBSS questionnaires and participant interviews.

Study sample: Eighteen adult participants (mean: 74.6 y; range: 61-94 y; ten males, eight females) with mild to moderately severe SNHL in their better ear (PTA0.5-4khz > 20 dB HL) and limited usable hearing in their poorer ear (average PTA0.5-4khz > 100 dB HL).

Results: Significant improvement in speech recognition and sound quality for BiCROS and monaural directional settings over omnidirectional and unaided, in both noise configurations. There were no significant differences observed between monoaural and BiCROS directional settings.

Conclusion: Speech in noise recognition and sound quality scores demonstrated a significant directional benefit for both BiCROS and monaural directional fitting settings over omnidirectional and unaided conditions. Unique BiCROS-specific experiences were identified in a patient-oriented approach. These can inform the development of BiCROS-tailored tools.

Objective: To investigate the effects of earplug type and noise exposure level on textile workers' personal attenuation rating (PAR).

Design: Initial and follow-up visits were conducted at a 17-month interval. At each visit, a baseline HPD fit test was performed using either a 3M foam or pre-molded earplug, as chosen by the workers. Workers who failed to meet targeted levels were trained and retested. Once they failed again, the other earplug was selected, and training was provided until they achieved the PAR target.

Study sample: 192 textile workers into three noise exposure level groups (low, medium, high).

Results: The median baseline PAR was 10 dB at the initial visits and 13 dB at the follow-up visits, and obtained by foam earplug users was 20 dB, which was higher than that obtained by pre-molded earplug users [12 dB (95% CI, 10-15 dB)]. The highest median baseline PAR was obtained by the high noise level group, followed by the median and low noise level groups. Training significantly increased the PAR.

Conclusions: Multiple types of earplugs need to be offered to workers to deal with individual differences in attenuation, preferences, and exposure levels. Training and stricter compliance policies can improve HPD use and fitting, contributing to better hearing health.

Background: Hearing-dementia research mainly focuses on determining the causal direction of this association. Little is known about the prevalence of cognitive problems in a representative audiology patient population.

Aim: To examine the occurrence of self-reported cognitive complaints (SCC) and dementia risk factors (RF) in an audiology patient population.

Materials and methods: Patients visiting audiology clinics (n = 1100, 51% female and avg. age 61yrs) were administered an online intake tool based on the International Classification of Functioning Disability and Health. Domains extracted for analyses were memory and concentration (SCC) and loneliness, depression, sleep and vision (dementia RF) and self-reported hearing problems (SHP). Prevalence rates and associations with demographic variables and SHP were examined.

Results: SCC were highly prevalent, with over half of the patients reporting memory or concentration problems. Regarding dementia RF, 68% reported sleeping problems and > 50% reported sadness, anxiety or depressed mood. SHP correlated significantly with self-reported memory problems, loneliness, and vision problems.

Conclusion: This descriptive cohort-study suggests a high risk of cognitive issues within the audiology clinic population, indicated by the high prevalence of SCC and some dementia RF. Our findings underscore the importance of considering closer cooperation between care pathways like audiology and neurology and use of a holistic patient-centered approach.

Objective: To explore the process of paediatric cochlear implant assessment, from referral to implantation, from the perspective of parents, cochlear implant professionals, and through observations of clinics.

Design: Qualitative approach, using grounded theory methodology.

Study sample: Twelve families with children under 5 years with permanent hearing loss referred for a cochlear implant or received an implant in the past year, and six professionals who refer or assess children for cochlear implants. Data collection involved interviews and ethnographic observations of assessment clinics.

Results: The core theme derived from interview and observation data related to the work of the cochlear implant assessment for families. The relationship between the work generated by the assessment process and capacity of parents to do the work provides a model to examine access to early implantation, consistent with the Burden of Treatment theory. We identified variation in terms of workload, relating to factors such as a child's additional needs or number of appointments required, and in terms of capacity, relating to factors such as social circumstances or health literacy. Social, peer and professional support and information helped families manage the workload.

Conclusions: Findings have implications for delivery of paediatric cochlear implant services.

Objective: This study investigated a previously evaluated self-adjustment procedure with respect to its applicability for asymmetrical hearing loss (AHL). Self-adjusted settings were evaluated for speech recognition in noise and sound preference.

Design: Participants were given the possibility to adjust the left and right hearing aid separately using a two-dimensional user interface. Two different adjustment sequences were tested. Realistic everyday sound scenes in a laboratory environment were presented. The difference between the ears regarding their speech recognition in noise was tested with two spatial conditions, unaided as well as with the prescriptive formula and the self-adjusted setting.

Study sample: Nineteen experienced hearing aid users (median age 76 years) with different degrees of AHL were invited to participate in this study.

Results: Participants adjusted a higher gain slope across frequency in the worse ear than in the better one. The two adjustment sequences resulted in significantly different adjustment durations and gain settings. The difference between the ears regarding speech recognition in noise did not change with the self-adjustment. Overall, group-mean effect sizes were small compared to the parameter space.

Conclusions: The adjustment procedure can be used also by hearing aid users with AHL to find a possibly preferred gain setting.

Objective: To compare the performance of a selection of machine learning algorithms, trained to label peaks I, III, and V of the auditory brainstem response (ABR) waveform. An additional algorithm was trained to provide a confidence measure related to the ABR wave latency estimates.

Design: Secondary data analysis of a previously published ABR dataset. Five types of machine learning algorithm were compared within a nested k-fold cross-validation procedure.

Study sample: A set of 482 suprathreshold ABR waveforms were used. These were recorded from 81 participants with audiometric thresholds within normal limits.

Results: A convolutional recurrent neural network (CRNN) outperformed the other algorithms evaluated. The algorithm labelled 95.9% of ABR waves within ±0.1 ms of the target. The mean absolute error was 0.025 ms, averaged across the outer validation folds of the nested cross-validation procedure. High confidence levels were generally associated with greater wave-labelling accuracy.

Conclusions: Machine learning algorithms have the potential to assist clinicians with ABR interpretation. The present work identifies a promising machine learning approach, but any algorithm to be used in clinical practice would need to be trained on a large, accurately labelled, heterogeneous dataset and evaluated in clinical settings in follow-on work.