Department of Communication Disorders, The University of Canterbury, Christchurch, New Zealand.
Advanced Bionics-Asia Pacific, Sydney, Australia.
Ear Hear. 2019 May/Jun;40(3):529-544. doi: 10.1097/AUD.0000000000000632.
The main aim of this study was to collect information on music listening and music appreciation from postlingually deafened adults who use hearing aids (HAs). It also sought to investigate whether there were any differences in music ratings from HA users with different levels of hearing loss (HL; mild, versus moderate to moderately-severe, versus severe or worse.
An existing published questionnaire developed for cochlear implant recipients was modified for this study. It had 51 questions divided into seven sections: (1) music listening and music background; (2) sound quality; (3) musical styles; (4) music preferences; (5) music recognition; (6) factors affecting music listening enjoyment; and (7) music training program. The questionnaire was posted out to adult HA users, who were subsequently divided into three groups: (i) HA users with a mild HL (Mild group); (ii) HA users with a moderate to moderately-severe HL (Moderate group); and (iii) HA users with a severe or worse (Severe group) HL.
One hundred eleven questionnaires were completed; of these, 51 participants had a mild HL, 42 had a moderate to moderately-severe loss, and 18 a severe or worse loss. Overall, there were some significant differences noted, predominantly between the Mild and Severe groups, with fewer differences between the Mild and Moderate groups. The respondents with the greater levels of HL reported a greater reduction in their music enjoyment as a result of their HL and that HAs made music sound significantly less melodic for them. It was also observed that the Severe group's mean scores for both the pleasant rating as well as the combined rating for the six different musical styles were lower than both the Mild and Moderate groups' ratings for every style, with just one exception (pop/rock pleasantness rating). There were significant differences between the three groups for the styles of music that were reported to sound the best with HA(s), as well as differences between the ratings on more specific timbre rating scales used to rate different elements of each style. In rating the pleasantness and naturalness of different musical instruments or instrumental groups, there was no difference between the groups. There were also significant differences between the Mild and Severe groups in relation to musical preferences for the pitch range of music, with the Severe group significantly preferring male singers and lower pitched instruments.
The overall results indicated little difference in music appreciation between those with a mild versus moderate loss. However, poorer appreciation scores were given by those with a severe or worse HL. This would suggest that HAs or HL have a negative impact on music listening, particularly when the HL becomes more significant. There was a large degree of variability in ratings, though, with music listening being satisfactory for some listeners and largely unsatisfactory for others, in all three groups. Music listening preferences also varied significantly, and the reported benefit (or otherwise) provided by the HA for music was also mixed. The overriding variability in listening preferences and ratings leads to the question as to the benefit and effectiveness of generic, manufacturer-derived music programs on HAs. Despite the heterogeneity in the listening habits, preferences, and ratings, it is clear that music appreciation and enjoyment is still challenging for many HA users and that level of HL is one, but not the only factor that impacts on music appreciation.
本研究的主要目的是收集使用助听器(HA)的后天失聪成年人的音乐聆听和欣赏信息。它还试图调查听力损失(HL)程度不同的 HA 用户的音乐评分是否存在差异(轻度、中度至中度重度、重度或更差)。
为这项研究修改了为人工耳蜗植入者开发的现有已发表问卷。它有 51 个问题,分为七个部分:(1)音乐聆听和音乐背景;(2)音质;(3)音乐风格;(4)音乐偏好;(5)音乐识别;(6)影响音乐聆听享受的因素;(7)音乐培训计划。问卷寄给成年 HA 用户,随后将他们分为三组:(i)轻度 HL 的 HA 用户(轻度组);(ii)中度至中度重度 HL 的 HA 用户(中度组);(iii)重度或更差 HL 的 HA 用户(重度组)。
共完成了 111 份问卷;其中,51 名参与者有轻度 HL,42 名有中度至中度重度 HL,18 名有重度或更差 HL。总体而言,注意到一些显著差异,主要是在轻度和重度组之间,而在轻度和中度组之间差异较小。听力损失程度较大的受访者报告说,他们的听力损失导致他们对音乐的享受程度降低,并且 HA 使音乐听起来明显缺乏旋律。还观察到,重度组对六种不同音乐风格的愉快评分和综合评分的平均得分均低于轻度和中度组对每种风格的评分,只有一个例外(流行/摇滚愉悦评分)。三组在报告与 HA 搭配效果最佳的音乐风格方面存在显著差异,在用于评分每种风格不同元素的更具体音色评分量表上的评分也存在差异。在对不同乐器或乐器组的愉悦度和自然度进行评分时,三组之间没有差异。轻度组和重度组在音乐偏好的音域方面也存在显著差异,重度组明显更喜欢男性歌手和音域较低的乐器。
总体结果表明,轻度与中度听力损失者在音乐欣赏方面几乎没有差异。然而,听力损失更严重的人给出的评分较差。这表明 HA 或 HL 对音乐聆听有负面影响,尤其是当 HL 变得更严重时。不过,评分存在很大程度的可变性,尽管所有三组都有一些听众对音乐聆听感到满意,而另一些听众则不太满意。音乐聆听偏好也存在显著差异,HA 对音乐的报告益处(或其他方面)也各不相同。听力偏好和评分的这种可变性导致了一个问题,即通用的、制造商提供的 HA 音乐程序是否具有益处和有效性。尽管听力习惯、偏好和评分存在异质性,但很明显,音乐欣赏和享受对许多 HA 用户来说仍然具有挑战性,而 HL 水平是影响音乐欣赏的一个因素,但不是唯一因素。