Some factors influencing choice of type of hearing aid in the UK: behind-the-ear or in-the-ear.

Questioning potential users of National Health Service behind-the-ear (BTE) hearing aids indicated that for some the perception of stigma associated with visible aids is a powerful deterrent to acceptance and use. To investigate further the role of stigma in hearing aid acceptance, 184 individuals who had been fitted with NHS BTE hearing aids and who had also purchased in-the-ear (ITE) hearing aids through a discounted price scheme at Withington Hospital were asked why they had made the decision to purchase, and what they perceived as the benefits of the ITE aid relative to the BTE model. The primary factor both in terms of reason for purchase and perceived benefit was the greater cosmetic acceptability of the smaller aids. Comfort in wear was the second perceived benefit. Sound quality was ranked only third. Ease of use with spectacles was the second most common reason given for purchase. These studies suggest that in a small but significant percentage of hearing aid candidates the perception of stigma is a powerful deterrent to take-up and use. This perception needs to be recognized and addressed if the most effective service is to be provided to the hearing impaired.