A Preliminary Evaluation of the Active Communication Education Program in a Sample of 87-Year-Old Hearing Impaired Individuals

2014 ◽  
Vol 25 (02) ◽  
pp. 219-228 ◽  
Author(s):  
Marie Öberg ◽  
Therese Bohn ◽  
Ulrika Larsson ◽  
Louise Hickson

Background: Previous research suggests that audiological rehabilitation for older adults could include group communication programs in addition to hearing aid fitting or as an alternative to hearing aid fitting for those people who do not wish to proceed with hearing aids. This pilot study was a first attempt to evaluate a Swedish version of such a program, Active Communication Education (ACE), which had been developed and previously evaluated in Australia (Hickson et al, 2007a). Purpose: The aim of the study was to explore the use of the ACE program in an older-old population of people aged 87 yr in Sweden. Research Design: A within-subject intervention study. Study Sample: The participants were recruited from the Elderly in Linköping Screening Assessment (ELSA), a population-based study of the functional abilities of all inhabitants of the city of Linkoping aged 85 yr in 2007. Participants who responded to the hearing related items in the ELSA study were approached for this study; 29 people agreed to undertake ACE, and 23 (79%) completed three or more sessions. Intervention: The ACE program consists of five weekly 2 hr group sessions with six to ten participants per group. Data Collection and Analysis: Self-report measures of communication strategy use, activity and participation, health-related quality of life, and depression were obtained preprogram, 3 wk postprogram, and 6 mo postprogram. Within-group changes and effect sizes were calculated. In addition, outcomes were measured postprogram using the International Outcome Inventory—Alternative Interventions (IOI-AI; Noble, 2002) and a modified version of the Client Oriented Scale of Improvement (COSI; Dillon et al, 1997; Hickson et al, 2007b), and qualitative feedback was obtained. Results: The effect size of ACE was small (0.03–0.27), and, in the sample of 23 included in this pilot study, differences in pre- and postprogram assessments were not statistically significant. Results from the IOI-AI and the modified COSI indicated that these elderly participants found the program to be beneficial, and 90% stated that the course had increased their ability to deal with hearing loss and the problems it creates. Conclusions: This preliminary investigation indicates the potential benefits of ACE for older adults, and further research is needed with larger numbers of participants in different age groups to draw conclusions about the effectiveness of the ACE program for a general Swedish population.

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e043364
Author(s):  
Judith Watson ◽  
Elizabeth Coleman ◽  
Cath Jackson ◽  
Kerry Bell ◽  
Christina Maynard ◽  
...  

ObjectiveTo establish the acceptability and feasibility of delivering the Active Communication Education (ACE) programme to increase quality of life through improving communication and hearing aid use in the UK National Health Service.DesignRandomised controlled, open feasibility trial with embedded economic and process evaluations.SettingAudiology departments in two hospitals in two UK cities.ParticipantsTwelve hearing aid users aged 18 years or over who reported moderate or less than moderate benefit from their new hearing aid.InterventionsConsenting participants (along with a significant other) were to be randomised by a remote, centralised randomisation service in groups to ACE plus treatment-as-usual (intervention group) or treatment-as-usual only (control group).Primary outcome measuresThe primary outcomes were related to feasibility: recruitment, retention, treatment adherence and acceptability to participants and fidelity of treatment delivery.Secondary outcome measuresInternational Outcomes Inventory for Hearing Aids, Self-Assessment of Communication, EQ-5D-5L and Short-Form 36. Blinding of the participants and facilitator was not possible.ResultsTwelve hearing aid users and six significant others consented to take part. Eight hearing aid users were randomised: four to the intervention group; and four to treatment-as-usual only. Four significant others participated alongside the randomised participants. Recruitment to the study was very low and centres only screened 466 hearing aid users over the 15-month recruitment period, compared with the approximately 3500 anticipated. Only one ACE group and one control group were formed. ACE could be delivered and appeared acceptable to participants. We were unable to robustly assess attrition and attendance rates due to the low sample size.ConclusionsWhile ACE appeared acceptable to hearing aid users and feasible to deliver, it was not feasible to identify and recruit participants struggling with their hearing aids at the 3-month posthearing aid fitting point.Trial registration numberISRCTN28090877.


2014 ◽  
Vol 25 (09) ◽  
pp. 848-858 ◽  
Author(s):  
Marie Öberg ◽  
Therese Bohn ◽  
Ulrika Larsson

Background: In Sweden, there is a lack of evidence-based rehabilitation programs for hearing loss. The Active Communication Education program (ACE) has successfully been used in Australia and was translated and evaluated in a Swedish pilot study. The pilot study included 23 participants (age 87 yr). No statistically significant effects were found, but the qualitative assessments indicated that this population found the program to be beneficial. The participants requested more focus on the psychosocial consequences of hearing loss, and the modules in the original ACE program were modified. Purpose: The aim of this study was to explore the effects of a modified Swedish version of the ACE program in a population aged 39–82 yr old. Research Design: Design was a between-group and within-group intervention study. Study Sample: The participants were recruited from the hearing health clinic in Linköping during 2010 and 2012. A total of 73 participants agreed to undergo the ACE, and 67 (92%) completed three or more sessions. Intervention: The ACE program consists of five weekly 2 hr group sessions with 6 to 10 participants per group. Data Collection and Analysis: The outcomes were measured before initiation of the program, 3 wk after program completion, and 6 mo after program completion and included communication strategy use, activity and participation, health-related quality of life, and anxiety and depression. In addition, outcomes were measured after program completion using the International Outcome Inventory–Alternative Interventions, a modified version of the Client Oriented Scale of Improvement, and qualitative feedback was obtained about the response to the program and actions taken as a result of participation. The treatment effects were examined using repeated-measures analyses of variance. Results: Statistically significant effects were found for communication strategy use, activity and participation, and psychosocial well-being. Statistically significant effects were found for gender and degree of hearing loss, indicating that women and those with mild hearing loss significantly improved communication strategies. Conclusions: It is suggested that the program be implemented as part of regular audiological rehabilitation and offered in an early stage of rehabilitation.


2020 ◽  
Vol 16 (2) ◽  
pp. 124-132
Author(s):  
Donghoon Kang ◽  
So Hyun Kim ◽  
Dajung Yun ◽  
Junghwa Bahng

Purpose: The present study examines auditory training outcomes in terms of speech perception in noise, working memory, reasoning ability, and subjective hearing aid satisfaction. Methods: Ten older adults who wear hearing aids (mean age: 71.6) voluntarily participated in the study. For the training material, 78 sentence sets composed of 3 to 5 sentences were used. During the auditory training, participants tried to remember the order of sentences. Among the 78 sentence sets, 45 contained clues and the rest did not. Each participant underwent assessments including speech perception in noise and digit spans and reasoning test and completed a self-report hearing aid satisfaction questionnaire both pre- and post-auditory training. The participants completed eight sessions of the auditory training. Results: The results showed a statistically significant increase in speech recognition ability in noise, short-term memory, and working memory, as well as satisfaction with hearing aid use. Despite a slight increase on the reasoning test, there was no statistically significant improvement.Conclusion: The results of this study suggested that the auditory training in remembering the order of sentences improved speech perception in noise, sensory and working memory, and subjective satisfaction with hearing aids. Future research can investigate more effective auditory training tools to improve the various cognitive skills and communication ability of older adults who wear hearing aids.


2021 ◽  
Author(s):  
Jack A Holman ◽  
Graham Naylor ◽  
Avril Drummond

People with hearing loss experience fatigue, and it is unknown whether this is alleviated by treatment with hearing aids. The objective of this study was to address this issue, and to investigate the possible concomitant effect of hearing-aid fitting on activity levels. An intervention group (n=53) who were due to be fitted with their first ever hearing aid(s) and a control group (n=53) who had hearing loss but no change in hearing aid status completed a battery of self-report outcome measures four times: once before fitting, and at two weeks, three months and six months post fitting. Self-report outcome measures at each assessment captured fatigue, listening effort, hearing handicap, auditory lifestyle, social participation restrictions and work, social and physical activity levels. Hearing-aid fitting led to a significant reduction in listening-related fatigue, but not general fatigue, in the intervention group compared to the control group. Additionally, social activity level increased and social participation restriction decreased significantly after hearing aid fitting in the intervention group compared to the control group. No significant interaction was found between working status and change in listening-related fatigue score. This study is the first to make longitudinal measurement of fatigue before and after first-ever hearing aid fitting and to identify an increase in social activity level after hearing aid fitting. These findings have important implications for future research and the clinical practice of hearing aid fitting.


BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e021502 ◽  
Author(s):  
Nicholas J Thyer ◽  
Jude Watson ◽  
Cath Jackson ◽  
Louise Hickson ◽  
Christina Maynard ◽  
...  

IntroductionUp to 30% of hearing aids fitted to new adult clients are reported to be of low benefit and used intermittently or not at all. Evidence suggests that additional interventions paired with service-delivery redesign may help improve hearing aid use and benefit. The range of interventions available is limited. In particular, the efficacy of interventions like the Active Communication Education (ACE) programme that focus on improving communication success with hearing-impaired people and significant others, has not previously been assessed. We propose that improved communication outcomes associated with the ACE intervention, lead to an increased perception of hearing aid value and more realistic expectations associated with hearing aid use and ownership, which are reported to be key barriers and facilitators for successful hearing aid use. This study will assess the feasibility of delivering ACE and undertaking a definitive randomised controlled trial to evaluate whether ACE would be a cost-effective and acceptable way of increasing quality of life through improving communication and hearing aid use in a public health service such as the National Health Service.Methods and analysisThis will be a randomised controlled, open feasibility trial with embedded economic and process evaluations delivered in audiology departments in two UK cities. We aim to recruit 84 patients (and up to 84 significant others) aged 18 years and over, who report moderate or less than moderate benefit from their new hearing aid. The feasibility of a large-scale study and the acceptability of the ACE intervention will be measured by recruitment rates, treatment retention, follow-up rates and qualitative interviews.Ethics and disseminationEthical approval granted by South East Coast-Surrey Research Ethics Committee (16/LO/2012). Dissemination of results will be via peer-reviewed research publications both online and in print, conference presentations, posters, patient forums and Trust bulletins.Trial registration numberISRCTN28090877.


2019 ◽  
Vol 28 (2) ◽  
pp. 274-284 ◽  
Author(s):  
Elizabeth Convery ◽  
Gitte Keidser ◽  
Louise Hickson ◽  
Carly Meyer

Purpose Hearing loss self-management refers to the knowledge and skills people use to manage the effects of hearing loss on all aspects of their daily lives. The purpose of this study was to investigate the relationship between self-reported hearing loss self-management and hearing aid benefit and satisfaction. Method Thirty-seven adults with hearing loss, all of whom were current users of bilateral hearing aids, participated in this observational study. The participants completed self-report inventories probing their hearing loss self-management and hearing aid benefit and satisfaction. Correlation analysis was used to investigate the relationship between individual domains of hearing loss self-management and hearing aid benefit and satisfaction. Results Participants who reported better self-management of the effects of their hearing loss on their emotional well-being and social participation were more likely to report less aided listening difficulty in noisy and reverberant environments and greater satisfaction with the effect of their hearing aids on their self-image. Participants who reported better self-management in the areas of adhering to treatment, participating in shared decision making, accessing services and resources, attending appointments, and monitoring for changes in their hearing and functional status were more likely to report greater satisfaction with the sound quality and performance of their hearing aids. Conclusion Study findings highlight the potential for using information about a patient's hearing loss self-management in different domains as part of clinical decision making and management planning.


2020 ◽  
Vol 29 (3) ◽  
pp. 419-428
Author(s):  
Jasleen Singh ◽  
Karen A. Doherty

Purpose The aim of the study was to assess how the use of a mild-gain hearing aid can affect hearing handicap, motivation, and attitudes toward hearing aids for middle-age, normal-hearing adults who do and do not self-report trouble hearing in background noise. Method A total of 20 participants (45–60 years of age) with clinically normal-hearing thresholds (< 25 dB HL) were enrolled in this study. Ten self-reported difficulty hearing in background noise, and 10 did not self-report difficulty hearing in background noise. All participants were fit with mild-gain hearing aids, bilaterally, and were asked to wear them for 2 weeks. Hearing handicap, attitudes toward hearing aids and hearing loss, and motivation to address hearing problems were evaluated before and after participants wore the hearing aids. Participants were also asked if they would consider purchasing a hearing aid before and after 2 weeks of hearing aid use. Results After wearing the hearing aids for 2 weeks, hearing handicap scores decreased for the participants who self-reported difficulty hearing in background noise. No changes in hearing handicap scores were observed for the participants who did not self-report trouble hearing in background noise. The participants who self-reported difficulty hearing in background noise also reported greater personal distress from their hearing problems, were more motivated to address their hearing problems, and had higher levels of hearing handicap compared to the participants who did not self-report trouble hearing in background noise. Only 20% (2/10) of the participants who self-reported trouble hearing in background noise reported that they would consider purchasing a hearing aid after 2 weeks of hearing aid use. Conclusions The use of mild-gain hearing aids has the potential to reduce hearing handicap for normal-hearing, middle-age adults who self-report difficulty hearing in background noise. However, this may not be the most appropriate treatment option for their current hearing problems given that only 20% of these participants would consider purchasing a hearing aid after wearing hearing aids for 2 weeks.


1986 ◽  
Vol 51 (4) ◽  
pp. 362-369 ◽  
Author(s):  
Donna M. Risberg ◽  
Robyn M. Cox

A custom in-the-ear (ITE) hearing aid fitting was compared to two over-the-ear (OTE) hearing aid fittings for each of 9 subjects with mild to moderately severe hearing losses. Speech intelligibility via the three instruments was compared using the Speech Intelligibility Rating (SIR) test. The relationship between functional gain and coupler gain was compared for the ITE and the higher rated OTE instruments. The difference in input received at the microphone locations of the two types of hearing aids was measured for 10 different subjects and compared to the functional gain data. It was concluded that (a) for persons with mild to moderately severe hearing losses, appropriately adjusted custom ITE fittings typically yield speech intelligibility that is equal to the better OTE fitting identified in a comparative evaluation; and (b) gain prescriptions for ITE hearing aids should be adjusted to account for the high-frequency emphasis associated with in-the-concha microphone placement.


Author(s):  
Yu-Hsiang Wu ◽  
Elizabeth Stangl ◽  
Octav Chipara ◽  
Anna Gudjonsdottir ◽  
Jacob Oleson ◽  
...  

Abstract Background Ecological momentary assessment (EMA) is a methodology involving repeated surveys to collect in-situ self-reports that describe respondents' current or recent experiences. Audiology literature comparing in-situ and retrospective self-reports is scarce. Purpose To compare the sensitivity of in-situ and retrospective self-reports in detecting the outcome difference between hearing aid technologies, and to determine the association between in-situ and retrospective self-reports. Research Design An observational study. Study Sample Thirty-nine older adults with hearing loss. Data Collection and Analysis The study was part of a larger clinical trial that compared the outcomes of a prototype hearing aid (denoted as HA1) and a commercially available device (HA2). In each trial condition, participants wore hearing aids for 4 weeks. Outcomes were measured using EMA and retrospective questionnaires. To ensure that the outcome data could be directly compared, the Glasgow Hearing Aid Benefit Profile was administered as an in-situ self-report (denoted as EMA-GHABP) and as a retrospective questionnaire (retro-GHABP). Linear mixed models were used to determine if the EMA- and retro-GHABP could detect the outcome difference between HA1 and HA2. Correlation analyses were used to examine the association between EMA- and retro-GHABP. Results For the EMA-GHABP, HA2 had significantly higher (better) scores than HA1 in the GHABP subscales of benefit, residual disability, and satisfaction (p = 0.029–0.0015). In contrast, the difference in the retro-GHABP score between HA1 and HA2 was significant only in the satisfaction subscale (p = 0.0004). The correlations between the EMA- and retro-GHABP were significant in all subscales (p = 0.0004 to <0.0001). The strength of the association ranged from weak to moderate (r = 0.28–0.58). Finally, the exit interview indicated that 29 participants (74.4%) preferred HA2 over HA1. Conclusion The study suggests that in-situ self-reports collected using EMA could have a higher sensitivity than retrospective questionnaires. Therefore, EMA is worth considering in clinical trials that aim to compare the outcomes of different hearing aid technologies. The weak to moderate association between in-situ and retrospective self-reports suggests that these two types of measures assess different aspects of hearing aid outcomes.


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