Hearing loss in Norwegian adults with achondroplasia.

BACKGROUND: Achondroplasia is the most common form of disproportionate skeletal dysplasia. The condition is caused by a mutation in the FGFR3 gene, affecting endochondral bone growth, including the craniofacial anatomy. Recurrent otitis media infections, chronic middle ear effusion, and hearing loss are common in children with achondroplasia, but few studies have investigated hearing loss in adults with this condition. OBJECTIVES: This population-based study investigated the prevalence, severity, and type of hearing loss in Norwegian adults with achondroplasia. METHODS: We collected data on 45 adults with genetically confirmed achondroplasia: 23 men and 22 women, aged 16-70 years. All participants underwent a comprehensive audiologic assessment, including medical history, pure-tone audiometry, speech audiometry, and impedance audiometry. According to the Global Burden of Disease classification, pure-tone average ≥ 20 decibel hearing level (dB HL) was considered clinically significant hearing loss. RESULTS: Insertion of ventilation tubes had been performed in 44% (20/45) of the participants, 49% (22/45) had a history of adenoidectomy, while 20% (9/45) used hearing aids. Hearing loss in at least one ear was found in 53% (24/45) of the participants; in 57% (13/23) of the men and 50% (11/22) of the women. In the youngest age group (age 16-44 years), 50% (14/28) had hearing loss, although predominantly mild (20-34 dB HL). An abnormal tympanometry (Type B or C) was found in 71% (32/45) of the participants. The majority (15/24) had conductive hearing loss, or a combination of conductive and sensorineural hearing loss (8/24). CONCLUSIONS: Adults with achondroplasia are at increased risk of early hearing loss. Our findings underline the importance of a regular hearing assessment being part of standard care in achondroplasia, including adolescents and young adults. In adult patients diagnosed with hearing loss, an evaluation by an otolaryngologist should be considered, and the need for hearing aids, assistive listening devices, and workplace and educational accommodations should be discussed. Clinical trial registration ClinicalTrials.gov identifier NCT03780153.

An Evaluation of Motivational Interviewing for Increasing Hearing Aid Use: A Pilot Study.

BACKGROUND: Motivational interviewing (MI) has been used in consultation settings to motivate hearing aid users to increase hearing aid usage. However, the effect of MI on those who use their hearing aids only rarely or not at all has not been explored. PURPOSE: The aims of this pilot study were to evaluate the effect of MI counseling with elderly hearing aid recipients found to have low hearing aid use at a six-month follow-up appointment and to describe clients' subjective assessments of their perceived need for hearing aids three months after MI counseling. RESEARCH DESIGN: The study had a within-subjects pretest-posttest design. STUDY SAMPLE: Forty seven hearing aid recipients who had used their new hearing aids, an average of <90 min/day, were recruited at a follow-up appointment six months after hearing aid fitting. INTERVENTION: Thirty minutes of MI counseling was provided at the six-month follow-up appointment. If needed, hearing aid adjustments and technical support were also provided. DATA COLLECTION AND ANALYSIS: The effect of MI counseling in combination with adjustments and technical support was assessed in relation to datalogged hearing aid use, which was assessed immediately before (at the six-month follow-up) and three months after (at the nine-month follow-up) the intervention. Hearing aid experiences were also assessed three months after MI. RESULTS: Thirty seven participants (79%) returned for the nine-month follow-up visit and had modest but significant increases in datalogged hearing aid use in the three months following MI counseling. Of the 37 participants who returned, 51% had increased their hearing aid use to at least 2 h/day after the MI counseling. Most of the 37 participants who attended the nine-month follow-up reported increased need for (59%) or increased benefit and contentment with (57%) their hearing aid three months after MI; these participants also had significantly higher datalogged hearing aid use following MI. CONCLUSIONS: These findings suggest that follow-up appointments using MI counseling in conjunction with technical support may be useful for increasing hearing aid usage among low-users, and a randomized controlled trial is warranted.

Hearing loss and work participation: a cross-sectional study in Norway.

OBJECTIVE: To study work participation of persons with hearing loss, and associations with hearing disabilities, self-reported workability, fatigue and work accommodation. DESIGN: Cross-sectional internet-based survey. STUDY SAMPLE: A total of 10,679 persons with hearing loss within working-age were invited to answer the survey, where 3330 answered (35.6%). RESULTS: Degree of hearing loss was associated with low workability, fatigue and work place accommodation, while sick leave was associated with fatigue. Degree of hearing loss was positively associated with being unemployed (p < .001) and having part-time work (p < .01) (often combined with disability benefits) for women. Work place accommodation was more frequently provided among respondents working with sedentary postures, high seniority, long-term sick leave or low workability. Additional unfavourable sensory conditions were associated with decreased employment (p < .001) and workability, and an increase in sick leave (p < .01) and fatigue (p < .001). CONCLUSIONS: Hearing loss seemed to influence work participation factors negatively; particularly, for moderate hearing loss and for women, even though the degree of employment was high. A lack of work place accommodation when there was a need for such was found. This implies increased attentiveness towards individual needs concerning the experienced disability a hearing loss may produce. A more frequent use of hearing disability assessment is suggested.

Older adults' experiences and issues with hearing aids in the first six months after hearing aid fitting.

OBJECTIVES: This study describes older adults' experiences with a new hearing aid (HA) during the first 6 months after fitting. DESIGN: In a longitudinally designed study, experiences and issues with HA use were assessed at a six-month follow-up appointment in individual structured interviews lasting 30 min. Associations between HA experiences and demographic factors, degree of hearing loss, and an objective measure of HA use (datalogging) were also examined. STUDY SAMPLE: 181 HA recipients (≥60 years) attending a six-month follow-up appointment. RESULTS: Participants reported an average of 1.4 issues (range 0-5, median = 1, mode = 1) with HA use, the most common pertaining to the earmold (26.5%), sound quality (26.0%) and handling (25.5%). Participants who reported at least one issue had fewer hours of use per day, but were not more likely to be non-users (<30 min/day). Non-users (15.5%) were more likely to report no need for a HA and handling issues. CONCLUSIONS: Most older adults use their HAs regardless of reported issues. However, handling issues and no perceived need may interfere with HA usage among some adults with hearing impairment. Moreover, reported issues were associated with less frequent HA use. Follow-up support is thus important to address issues that may interfere with optimal use.

Hearing aid use in the elderly as measured by datalogging and self-report.

OBJECTIVES: The primary aim was to compare the objective and the subjective assessments of hearing aid use among elderly people at a 6-month follow-up after fitting. A secondary aim was to determine whether advanced knowledge of follow-up impacts hearing aid use. DESIGN: Hearing aid use was assessed by datalogging (objective) and self-report (subjective) 6 months after initial fitting. Participants were also randomised to an intervention (informed of 6-month follow-up at fitting) or control group (informed just prior to follow-up). STUDY SAMPLE: A total of 181 hearing aid recipients ≥60 years (mean age = 79.2 years). RESULTS: Daily hearing aid use based on datalogging (mean = 6.12 h, SD = 4.94) was significantly less than self-reports (mean = 8.39 h, SD = 5.07). More severe hearing impairment and prior hearing aid experience were associated with increased hearing aid use. Advanced knowledge of the follow-up had no significant impact on use, which did not differ between intervention (n = 93) and control (n = 88) groups. CONCLUSIONS: Elderly people typically use their hearing aids for a substantial part of the day in the 6 months after fitting, but tend to overestimate their usage. Datalogging is recommended to identify those who do not use or rarely use their aids so that appropriate rehabilitation and support can be provided.

Lack of ear care knowledge in nursing homes.

BACKGROUND: Rising life expectancy means an increase in the number of elderly people with hearing loss in the population. Many elderly people live in nursing homes, with varying care needs. A substantial proportion of these people will need help with their hearing aids and other hearing devices. OBJECTIVE: The objective of the study has been to assess the knowledge, experience, skills, competence, and need for information of staff at nursing homes in relation to residents' hearing loss and hearing aids. MATERIALS AND METHODS: One hundred and ninety-five employees at seven nursing homes participated in the study. The main approach was a descriptive study, using questionnaires. RESULTS: The main findings are that 73% of informants found that many residents need help with their hearing aids. Only one-tenth report that they know enough about the residents' hearing aids. Almost four out of five informants find that the residents become socially isolated as a result of hearing loss. Seventy-eight percent agree to some extent that more residents would benefit from hearing aids. CONCLUSION: Staff at nursing homes have insufficient knowledge about hearing loss and hearing aids. Increased focus on the elderly with hearing impairment in nursing homes is needed. Contact between nursing homes and audiological specialists should be improved to best followup hearing loss and hearing aids.

Daily life consequences of hearing loss in the elderly.

PURPOSE: To assess the daily life consequences of hearing loss in older adults and to explore the influences of hearing loss, subjective assessment of health and general life satisfaction, gender, age and marital status. METHOD: Eighty-four participants, each older than 65 years, were consecutively recruited from a hospital waiting list for outpatient hearing aid fitting. All participants were assessed by pure-tone audiometry. Daily life consequences of hearing loss were measured using the Hearing Disability and Handicap Scale, which assesses perceived activity limitation and participation restriction. Another questionnaire was used to measure self-assessed health and life satisfaction. RESULTS: Adjusted linear regression analysis showed that activity limitation was significantly associated with increased hearing loss (p = 0.028) and decreased health (p = 0.009), and participation restriction with lower estimated life satisfaction (p ≤ 0.001). Gender, age and marital status were not determinant factors for perceived activity limitation or participation restriction. CONCLUSIONS: Daily life consequences of hearing loss, health conditions and general life satisfaction are closely related. These findings indicate that health factors and psychosocial aspects should be emphasised as a natural part of audiological rehabilitation.

Preconceptions and expectations of older adults about getting hearing aids.

AIM: The objectives of this study were to describe preconceptions and expectations of older adults about getting hearing aids and to explore the influence of hearing loss (HL), hearing aid experience, gender, age, and marital status on these preconceptions and expectations. METHODS: A total of 174 participants aged above 65 years were randomly selected from a waiting list for hearing aid fitting. Hearing threshold was tested using pure tone audiometry. A self-report questionnaire with a specific focus on preconceptions and expectations about getting hearing aids, external influences, and the psychosocial problems associated with HL and the use of a hearing aid was administered. RESULTS: A FACTOR ANALYSIS REVEALED THREE FACTORS: positive expectations, barriers, and social pressure. Cronbach's α was 0.847 for positive expectations and 0.591 for barriers. Cronbach's α was not statistically applicable to the social pressure factor, as it consisted of only one item. Adjusted linear regression analysis revealed that participants with moderate to severe HL and hearing aid experience had a significant increase in positive expectations. Male gender was associated with fewer barriers to hearing aids. Age and marital status had no influence on the three factors. CONCLUSION: Less positive expectations and more problem-oriented preconceptions among subjects with mild HL may explain why hearing aids are scarcely used. Additionally, lower estimated need and modest plans for regular use among this group could mean hearing aids are not used. Rehabilitation should focus on investment of time, continuity of use, realistic expectations, and follow-up support.