WS Audiology, Erlangen, Germany.
Institute of Acoustics, Technische Hochschule Lübeck, Lübeck, Germany.
Ear Hear. 2024;45(4):985-998. doi: 10.1097/AUD.0000000000001490. Epub 2024 Mar 22.
When using ecological momentary assessment (EMA) to compare different hearing aid programs, it is usually assumed that for sufficiently long study durations similar situations will be experienced in both programs. However, conscious or subconscious adaptation of situations to one's hearing ability (e.g., asking a conversation partner to speak up, increasing TV volume)-which might be different across the time spent in different hearing aid programs-may challenge this assumption. In the present study, we investigated how test participants modify their acoustic environment and if these modifications depend on the hearing program.
Twenty-nine experienced hearing aid users were provided with hearing aids containing two hearing programs differing in directionality and noise reduction (NR). The hearing programs called NR-on and NR-off changed each day automatically. Over the course of 3 weeks, participants were asked to answer a questionnaire every time they encountered an acoustic situation they modified or would have liked to modify to improve the listening situation. Objective data on sound pressure level and classification of the acoustic situation were collected from the hearing aids. At the beginning of the study participants recollected modifications of the acoustic environments they typically do when using their own hearing aids and reported on the frequency of this behavior.
During the field trial, participants reported on average 2.3 situations per day that they modified or would have liked to modify. Modifications were usually performed quickly after the onset of the situation and significantly improved the pleasantness of the listening situation. While the number of the reported situations did not differ between the programs, modifications increasing the volume of the target signal and increasing the hearing aid volume were more frequent for the NR-on hearing program. Changes in the objective data at the time of the modification were consistent with the reported modifications. Further, the usage time as well as the distribution of the acoustic situations over the entire study period differed between the two hearing programs.
The large improvement in pleasantness due to the modification might explain the generally positive ratings observed in EMA studies. Furthermore, the results found here suggest that caution is needed when comparing ratings of audiological attributes in EMA, because the different modification behavior across hearing programs may lead to an underestimation of hearing problems and reduced sensitivity when comparing two technologies.
当使用生态瞬时评估（EMA）来比较不同的助听器方案时，通常假设在足够长的研究时间内，两个方案中会出现相似的情况。然而，对自身听力能力的有意识或无意识的适应（例如，要求对话伙伴提高音量、增加电视音量）——这可能因在不同的助听器方案中花费的时间而异——可能会对这一假设提出挑战。在本研究中，我们调查了测试参与者如何调整他们的声学环境，以及这些调整是否取决于助听器方案。
为 29 名经验丰富的助听器使用者配备了两款助听器，这两款助听器在方向性和降噪（NR）方面有所不同。NR-on 和 NR-off 这两个听力程序每天自动切换。在 3 周的时间里，参与者被要求在每次遇到他们修改或希望修改以改善听力环境的声学环境时回答一份问卷。从助听器中收集了有关声压级和声学环境分类的客观数据。在研究开始时，参与者回忆起他们在使用自己的助听器时通常会对声学环境进行的修改，并报告了这种行为的频率。
在实地试验期间，参与者平均每天报告了 2.3 种他们修改或希望修改的情况。修改通常是在情况发生后立即进行的，并且显著提高了听力环境的舒适度。虽然两个程序报告的情况数量没有差异，但增加目标信号音量和增加助听器音量的修改在 NR-on 听力程序中更为频繁。修改时的客观数据变化与报告的修改一致。此外，两个助听器方案的使用时间以及整个研究期间的声学环境分布也有所不同。
由于修改而导致的舒适度的大幅提高可能解释了 EMA 研究中观察到的总体积极评价。此外，这里的结果表明，在 EMA 中比较听力属性的评价时需要谨慎，因为不同助听器方案之间的修改行为可能会导致对听力问题的低估和在比较两种技术时的敏感性降低。
