Singh Jasleen, Doherty Karen A
The Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois.
Department of Communication Sciences and Disorders, Syracuse University, Syracuse, New York.
J Am Acad Audiol. 2023 Feb;34(1-02):28-37. doi: 10.1055/s-0044-1789598. Epub 2024 Oct 15.
The introduction of over-the-counter hearing aids (HA) has resulted in a new hearing-health-care pathway.
The aim of this study was to assess if individuals could navigate four steps in a direct-to-consumer (DTC) HA delivery model, which include self-identification of hearing difficulties and risk for ear disease, self-selection of device, self-fitting and programming of device, and self-management.
Fifty-two participants self-reported their degree of hearing loss and risk for ear disease. Participants were provided with three preselected DTC-HA Web sites and asked to select a device. Using the manufacturer's instructions, they then self-fit and programmed the device they chose. Participants' HA use and handling skills were evaluated using the Practical HA Skills Test-Revised (PHAST-R) and the Measure of Audiologic Rehabilitation Self-efficacy for Hearing Aids (MARS-HA). Real-ear verification was completed to determine how closely they programmed their device to NAL-NL2 targets. Agreement between self-reported degree of hearing loss and ear disease was determined from an audiological and ear disease risk assessment, respectively.
Seventy-five percent of participants reported that their perceived hearing loss was in the mild-to-moderate range. Ninety-three percent of participants who were identified to be at risk for ear disease did not self-report being at risk. PHAST-R scores ranged from 45 to 100% and were significantly impacted by manufacturer instructions. Only 24% of fittings were within the accepted tolerances for prescriptive targets.
No participant was able to successfully navigate all four steps in the proposed DTC-HA model. Participants with hearing thresholds ≤ 25 dB HL and participants who were identified as being at risk for ear disease, but did not self-report the risk, both said they would purchase a DTC-HA as a treatment option. Manufacturer instructional materials can impact setup and programming of a DTC device. DTC models of hearing-health care may require additional consumer support.
非处方助听器（HA）的引入带来了一种新的听力保健途径。
本研究的目的是评估个体是否能够在直接面向消费者（DTC）的HA交付模式中完成四个步骤，这包括自我识别听力困难和耳部疾病风险、自行选择设备、自行对设备进行验配和编程以及自我管理。
52名参与者自行报告了他们的听力损失程度和耳部疾病风险。为参与者提供了三个预先选定的DTC-HA网站，并要求他们选择一款设备。然后，他们根据制造商的说明，自行对所选设备进行验配和编程。使用修订后的实用助听器技能测试（PHAST-R）和助听器听觉康复自我效能测量量表（MARS-HA）对参与者使用HA的情况和操作技能进行评估。完成真耳验证，以确定他们将设备编程到NAL-NL2目标的接近程度。分别通过听力和耳部疾病风险评估来确定自我报告的听力损失程度和耳部疾病之间的一致性。
75%的参与者报告称他们感知到的听力损失处于轻度至中度范围。被确定有耳部疾病风险的参与者中，93%并未自行报告有风险。PHAST-R分数范围为45%至100%，并受到制造商说明的显著影响。只有24%的验配符合规定目标的可接受公差范围。
没有参与者能够在提议的DTC-HA模式中成功完成所有四个步骤。听力阈值≤25dB HL的参与者以及被确定有耳部疾病风险但未自行报告风险的参与者均表示他们会购买DTC-HA作为一种治疗选择。制造商的指导材料会影响DTC设备的设置和编程。听力保健的DTC模式可能需要额外的消费者支持。
