Singh Gurjit, Goy Huiwen, Wright-Whyte Kay, Chasteen Alison L, Pichora-Fuller M Kathleen
Sonova Canada, Kitchener, Ontario, Canada.
Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada.
Ear Hear. 2025;46(5):1149-1163. doi: 10.1097/AUD.0000000000001656. Epub 2025 Mar 28.
The purpose of this study was to evaluate the extent to which four different social factors (stigma, social network composition, social support, and loneliness) predict the purchase of hearing aids in a sample of older adults with impaired hearing who had not previously tried hearing aids and visited a hearing care clinic for the first time.
Data collection took place across 130 different hearing care clinics (Connect Hearing) in Canada. A total of 4630 participants were recruited for the study from notices in the waiting rooms of the clinics or by advertising in local newspapers. The final sample consisted of 753 adults (mean age = 69.2 years; SD = 9.0; 57.4% male) who were all recommended to try hearing aids. Clinical records were tracked for a minimum of 3 months and a maximum of 15 months after the appointment to determine if they obtained hearing aids. Participants completed a 56-item questionnaire before their appointment and then experienced standard care at the clinic (i.e., hearing evaluation, hearing rehabilitation if desired, etc.). Key factors assessed by the questionnaire included stigma related to age, stigma related to hearing aids, social network composition, perceived levels of social support, loneliness, self-reported hearing disability, and demographic information.
Data were analyzed using two methods, a penalized logistic regression and a classification tree analysis, to identify statistical predictors and meaningful clinical cutoff scores, respectively. Both models found that hearing aid adoption was best predicted by being older and having greater self-reported hearing disability. Hearing aid uptake was also predicted by social factors, but these predictors were less robust than age and self-reported hearing disability. Participants were more likely to adopt hearing aids if they reported less hearing aid stigma and had a social network that included at least 1 person with a suspected hearing loss. Loneliness and social support did not predict hearing aid adoption. Some model-specific variables also emerged.
Using a prospective research design, the study provides novel quantitative evidence of the role of different social factors regarding the uptake of hearing aids. The research findings may be used to better identify individuals more and less likely to obtain hearing aids, inform hearing rehabilitation, and motivate the use of interventions designed to lessen the impact of stigma on hearing rehabilitation.
本研究的目的是评估四种不同的社会因素（耻辱感、社会网络构成、社会支持和孤独感）在未曾尝试过助听器且首次前往听力保健诊所的听力受损老年人样本中，对购买助听器的预测程度。
数据收集在加拿大的130家不同的听力保健诊所（Connect Hearing）进行。通过诊所候诊室的公告或在当地报纸上刊登广告，共招募了4630名参与者参与该研究。最终样本由753名成年人组成（平均年龄 = 69.2岁；标准差 = 9.0；男性占57.4%），他们均被建议尝试使用助听器。在预约后至少跟踪临床记录3个月，最多跟踪15个月，以确定他们是否购买了助听器。参与者在预约前完成了一份56项的问卷，然后在诊所接受标准护理（即听力评估、如有需要进行听力康复等）。问卷评估的关键因素包括与年龄相关的耻辱感、与助听器相关的耻辱感、社会网络构成、感知的社会支持水平、孤独感、自我报告的听力残疾以及人口统计学信息。
使用两种方法对数据进行分析，即惩罚逻辑回归和分类树分析，分别用于识别统计预测因素和有意义的临床临界分数。两个模型均发现，年龄较大和自我报告的听力残疾程度较高最能预测助听器的采用情况。社会因素也能预测助听器的使用情况，但这些预测因素不如年龄和自我报告的听力残疾那么有力。如果参与者报告的助听器耻辱感较低且其社会网络中至少有1人疑似听力损失，那么他们更有可能采用助听器。孤独感和社会支持并不能预测助听器的采用情况。还出现了一些特定于模型的变量。
该研究采用前瞻性研究设计，提供了关于不同社会因素在助听器采用方面作用的新的定量证据。研究结果可用于更好地识别更有可能和不太可能获得助听器的个体，为听力康复提供信息，并推动使用旨在减轻耻辱感对听力康复影响的干预措施。
