IJCRR - 4(15), August, 2012
Pages: 30-36
Date of Publication: 15-Aug-2012
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SELF REPORTED HEARING AID OUTCOME MEASURES USING DISEASE SPECIFIC QUESTIONNAIRE IN HEARING IMPAIRED ADULTS
Author: Ayas Muhammed, Kanaka, Rajashekhar Bellur
Category: Healthcare
Abstract:Hearing impairment is one of the most frequent sensory deficits in human population, affecting more than 250 million people in the world. It affects the overall well being and cognition which results in depression and reduced quality of life (QOL).Hearing aids are used to rehabilitate these individuals and quantifying the results of a hearing aid fitting is often an overlooked aspect of the patient rehabilitation. Therefore self reported measures play a major role in assessing the outcomes in aural rehabilitation Objective: To assess the self reported hearing aid outcome using disease specific questionnaire, Abbreviated Profile of Hearing Aid Benefit (APHAB) in hearing impaired adults. Method: 15 subjects with age range of 18-60 years
were participated in the study to compare the pre and post (two months) amplification changes with the hearing aid. The outcome of hearing aid fitting was evaluated using APHAB. Results: There were significant changes in hearing aid related aspects and its use. However, it is reported that more benefit with the hearing aid is seen when the device is worn at least for a period of one year. Conclusion: The use of self reported measures in routine clinical settings helps the clinician to select an appropriate amplification device and also provide a scientifically defensible way to measure the real-life success of the hearing aid fitting program and thereby improving their overall quality of life
Keywords: Hearing impairment, self reported measures QOL, APHAB.
Full Text:
INTRODUCTION
Hearing impairment is one of the most frequent sensory deficits in human population, affecting more than 250 million people in the world [1]. According to the World Health Organization (WHO), hearing impairment and deafness are serious disabilities that can impose a heavy social and economic burden on individual‘s families. Hearing loss can occur at any age; it has grave consequences on adults, as most of them are employed and will face problems in working situations. The extent of auditory disability again depends upon the degree, the type of loss and the pattern of auditory configuration. Myklebust [2] suggested that hearing loss between 45 and 65 dBHL clearly affects the social interaction and the background information. Mulrow, Aguilar, Endicott, Tuley, Velez, Charlip, et al. [3] reported that the hearing impairment will affect the overall well being and cognition which results in depression. Dalton, Cruickshanks, Klein, Klein,Wiley and Nondahl [4] stated that the hearing loss is associated with reduced quality of life (QOL), hearing handicap and self-reported communication difficulties in older adults.
To overcome such difficulties, auditory rehabilitation is necessary and it can be achieved through hearing aids. It may be true to a certain degree that hearing aid technology has provided a much better performance but, still are not the same as biological ears. Therefore theses individuals face difficulties with the hearing aid when they use it for first time [5]. Therefore, it is important to know how well an individual is getting benefited with the hearing aid and how it contributes to his / her daily life [6]. Quantifying the results of a hearing aid fitting is often an overlooked aspect of the patient rehabilitation. However, quantification helps the clinicians to precisely assess the subjective benefit, a patient perceives from amplification. Cox [7] reported that the patient based outcomes have become increasingly important in evaluating the overall effectiveness of the treatment. The outcome of audiological rehabilitation involving hearing aid fitting is typically evaluated with the use of self-reported measures using standardized questionnaires such as disease specific questionnaires. These measures may include assessment of satisfaction with hearing aids, benefits from hearing aids and also reduction in client‘s perceived handicap due to the fact that they are wearing hearing aid. In the new era of consumer driven health care, the client‘s point of view is being increasingly accepted as a valid and important indicator in the success of treatment. Therefore in the long run, what the practitioner thinks may not matter very much if the client has a different opinion [8]. However until recently, these were given in informal discussions with non-professionals. Most of the professionals (Audiologists) often did not look at client‘s opinions [9] and they were not regarded as serious scientific data. Therefore, it is important to gather information from the patient‘s perspective regarding the hearing aid use or benefit.
Lack of published studies and research in hearing aid outcome measures in the Indian scenario has led to the present study. Mortensen [10] stated that the use of disease specific questionnaires, gives an overall understanding of QOL and hearing aid related information. Hence, in the present study, Abbreviated Profile of Hearing Aid Benefit (APHAB)[11], a disease specific questionnaire is administered on hearing aid users before and after two months of hearing aid use to assess the hearing aid benefit in order to understand the hearing impaired individuals as a whole.
MATERIALS AND METHODS
The study was carried out in the Department of Speech and Hearing, Manipal University. Fifteen participants were recruited for the study. A disease specific questionnaire-APHAB was administered before and two months after hearing aid fitting. All the subjects were explained about the potential importance and scientific benefit of reporting the data and consensus obtained. Participants were selected based on following criteria. They should have bilateral moderate senosri-neural hearing loss with an age range between 18 years to 60 years. All the participants were fitted with digital hearing aid monaurally and most importantly a first time user. People with congenital hearing loss and with past history of hearing aid usage were excluded from the study. Age, gender and duration of loss are noted in order to avoid its influence on the outcome of the study. APHAB is used to quantify everyday life problems associated with hearing impairment. It is a 24 item self-assessment inventory (table1).APHAB provides scores for 4 subscales. Each item contributes to only one subscale, and there are six items for each subscale, distributed randomly within the inventory. A higher APHAB score indicates more perceived difficulty in a particular situation and also certain items are written with a reversed logic (i.e., ?always‘ means fewer problems). This pattern is followed to maximize the validity and reliability of the data. Once the participants fulfil the selection criteria
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