Motivational engagement in first-time hearing aid users: a feasibility study

Objective: To assess (1) the feasibility of incorporating the Ida Institute’s Motivation Tools into a UK audiology service, (2) the potential benefits of motivational engagement in first-time hearing aid users, and (3) predictors of hearing aid and general health outcome measures. Design: A feasibility study using a single-centre, prospective, quasi-randomized controlled design with two arms. The Ida Institute’s Motivation Tools formed the basis for motivational engagement. Study sample: First-time hearing aid users were recruited at the initial hearing assessment appointment. The intervention arm underwent motivational engagement (M+, n = 32), and a control arm (M-, n = 36) received standard care only. Results: The M+ group showed greater self-efficacy, reduced anxiety, and greater engagement with the audiologist at assessment and fitting appointments. However, there were no significant between-group differences 10-weeks post-fitting. Hearing-related communication scores predicted anxiety, and social isolation scores predicted depression for the M+ group. Readiness to address hearing difficulties predicted hearing aid outcomes for the M- group. Hearing sensitivity was not a predictor of outcomes. Conclusions: There were some positive results from motivational engagement early in the patient journey. Future research should consider using qualitative methods to explore whether there are longer-term benefits of motivational engagement in hearing aid users

The Efficacy of Auditory Perceptual Training for Tinnitus: A Systematic Review

Auditory perceptual training affects neural plasticity and so represents a potential strategy for tinnitus management. We assessed the effects of auditory perceptual training on tinnitus perception and/or its intrusiveness via a systematic review of published literature. An electronic database search using the keywords ‘tinnitus and learning’ or ‘tinnitus and training’ was conducted, updated by a hand search. The ten studies identified were reviewed independently by two reviewers, data were extracted, study quality was assessed according to a number of specific criteria and the information was synthesised using a narrative approach. Nine out of the ten studies reported some significant change in either self-reported or psychoacoustic outcome measures after auditory training. However, all studies were quality rated as providing low or moderate levels of evidence for an effect. We identify a need for appropriately randomised and controlled studies that will generate high-quality unbiased and generalisable evidence to ascertain whether or not auditory perceptual training has a clinically relevant effect on tinnitus

Providing support to school children with hyperacusis

Hyperacusis is a condition associated with irritation and discomfort from environmental sounds. A person with hyperacusis is bothered by sounds that are generally acceptable to others. Hyperacusis has been reported with people various pathologies as well as for people with no hearing loss or health condition. It is a common condition in children, especially children with Williams Syndrome, autistic spectrum disorder and tinnitus. The exact mechanisms underlying hyperacusis are unknown. However, it has been hypothesised that it may be a consequence of abnormally high gain applied by the central auditory system. Adverse emotional and behavioural reactions to the various sounds in the classroom may be experienced by school age children with hyperacusis. Audiological assessment and management of hyperacusis are briefly discussed in this article. </jats:p

Feasibility of conducting a randomised controlled trial on the effect of motivational interviewing in facilitating hearing aid use

The aim of this study was to investigate the feasibility of conducting a randomised controlled trial (RCT) on the effect of motivational interviewing (MI) in facilitating hearing aid use. Methods used and their results are presented in the 3 sections below: (1) A cross-sectional survey where a questionnaire, including the International Outcome Inventory for Hearing Aids was posted to all patients fitted with hearing aids at the Royal Surrey County Hospital, Guildford, between 2011 and 2012 (N=1874). 1023 questionnaires were completed and returned (response rate of 55%). 29% of responders did not use their hearing aids on a regular basis (i.e., used them less than 4 hours per day). (2) 220 patients who reported using their hearing aid(s) less than 4 hours per day in the above survey were invited to take part in a pilot single-blind RCT. 37 were enrolled and randomised to MI combined with hearing aid adjustments (n=20) or hearing aid adjustments only (n=17). The results showed that it was feasible to deliver MI for facilitating hearing aid use. Hearing aid use as measured via data logging 1 month after interventions favoured the MI group. (3) A qualitative enquiry embedded in the above pilot RCT was conducted. 34 out of 37 participants underwent in-depth interviews. Interviews were transcribed and thematically analysed. Five themes were identified in relation to participants’ perspectives about the key components of the research programme which influenced their decision about using their hearing aids. Conclusion: Conducting an RCT on the effect of MI in facilitating hearing aid use in people who do not use their hearing aids is feasible and that MI combined with audiology standard care may have positive effects on hearing aid use

Patient-centered tinnitus management tool: a clinical audit.

PURPOSE: To evaluate the impact of an educational poster describing treatment options available to patients experiencing tinnitus. METHOD: A patient-centered tinnitus management tool (PCTMT) was developed in the form of an educational poster that encouraged patients to decide how they wanted to deal with their tinnitus from the following options: (a) ignore the tinnitus and forget about it, (b) use a sound generator, (c) undertake tinnitus counseling with an expert, or (d) deal with the tinnitus using hearing aids (in the case of tinnitus and hearing loss). Fifty-five patients who were referred to the audiology department of a London hospital from the ENT department for tinnitus counseling were asked to read the PCTMT and to choose the option(s) that suited them the best. RESULTS: Forty-two percent of the patients wished to undertake counseling, 9% decided to try to ignore their tinnitus without help, 26% wanted to deal with their tinnitus with the help of a sound generator, and 24% decided to use hearing aids. CONCLUSIONS: The PCTMT reduced the number of patients who would otherwise have been referred for tinnitus counseling by 58%. This reduced the length of the waiting list and increased the time available for counseling of those patients who wanted it