Kawaguchi Lauren, Wu Yu-Hsiang, Miller Christi
Department of Speech and Hearing Sciences, University of Washington, Seattle.
Department of Communication Sciences and Disorders, The University of Iowa, Iowa City.
Am J Audiol. 2019 Sep 13;28(3):572-582. doi: 10.1044/2019_AJA-18-0120. Epub 2019 Jul 11.
Objectives The aim of this study was to evaluate listening self-efficacy ratings between aided and unaided conditions in different communication environments and to determine what patient- and device-centered variables were associated with individual differences. Method An observational, cross-sectional study design was used to evaluate 165 older adults with mild to moderately severe sensorineural hearing loss who wore hearing aids at least 8 hr per week. Listening self-efficacy for both unaided and aided listening was measured using the Listening Self-Efficacy Questionnaire (LSEQ; Smith, Pichora-Fuller, Watts, & La More, 2011), consisting of a global score and subscales of Dialogue in Quiet, Directed Listening, and Complex Listening. Metrics to explain variability in the degree of improvement in LSEQ ratings with aided listening included patient-centered variables of age, pure-tone average, and personality and device-centered variables of hearing aid use, speech intelligibility index, directionality, and noise reduction. The NEO Five-Factor Inventory (Costa & McCrae, 1985) was used to measure 5 personality traits (neuroticism, extraversion, openness, agreeableness, and conscientiousness). Associations were evaluated between LSEQ ratings and patient- and device-centered variables using a linear mixed-model analysis. Results Statistically significant improvements in LSEQ ratings were found for aided conditions (relative to unaided conditions), easier listening environments, lower pure-tone averages, and lower levels of neuroticism. Furthermore, the improvement in listening self-efficacy with hearing aids did not depend on the listening environment but did alter with severity of hearing loss, length of hearing aid use, and levels of conscientiousness. Conclusions Results of this study suggest that wearing hearing aids is associated with improved listening self-efficacy in a variety of communication environments. Aural rehabilitation and counseling may focus on improving listening self-efficacy to address the challenges of consistent hearing aid use and reduced quality of life related to hearing loss.
目的 本研究旨在评估不同交流环境下佩戴助听器与未佩戴助听器时的听力自我效能评分,并确定哪些以患者和设备为中心的变量与个体差异相关。方法 采用观察性横断面研究设计,对165名轻度至中度重度感音神经性听力损失的老年人进行评估,这些老年人每周佩戴助听器至少8小时。使用听力自我效能量表(LSEQ;Smith、Pichora-Fuller、Watts和La More,2011年)测量未佩戴助听器和佩戴助听器时的听力自我效能,该量表包括一个总体得分以及安静环境下对话、定向听力和复杂听力的子量表。用于解释佩戴助听器时LSEQ评分改善程度差异的指标包括以患者为中心的年龄、纯音平均听阈和性格变量,以及以设备为中心的助听器使用情况、言语可懂度指数、方向性和降噪变量。使用NEO五因素人格量表(Costa和McCrae,1985年)测量5种人格特质(神经质、外向性、开放性、宜人性和尽责性)。使用线性混合模型分析评估LSEQ评分与以患者和设备为中心的变量之间的关联。结果 发现佩戴助听器(相对于未佩戴助听器)、听力环境较轻松、纯音平均听阈较低以及神经质水平较低时,LSEQ评分有统计学显著改善。此外,佩戴助听器时听力自我效能的改善并不取决于听力环境,但会随着听力损失的严重程度、佩戴助听器的时长和尽责性水平而变化。结论 本研究结果表明,在各种交流环境中,佩戴助听器与听力自我效能的提高相关。听觉康复和咨询可侧重于提高听力自我效能,以应对持续使用助听器的挑战以及与听力损失相关的生活质量下降问题。