Outcomes of an audiologic rehabilitation programme for working adults with hearing impairment who do not wear amplification

Abstract

Hearing impairment is a chronic health condition that affects increasingly younger age groups. Prevalence rates in the working population are estimated to be between four and nine percent when defined by audiometric loss, and between 30 – 40% when using self-report of hearing problems. Hearing impairment can limit and threaten the social functioning of the affected person. It interferes with oral communication, causing activity limitations and participation restrictions. Additionally, a stigma is attached to hearing loss that can lead to feelings of embarrassment, guilt, anxiety and social exclusion. The stigma also poses a threat to the identity of the hearing impaired person who, in return, manages this threat by concealing or disclosing their hearing impairment depending on the social implications. As a consequence, help–seeking is delayed by a considerable amount of time. Although proven to be an effective intervention, amplification is often rejected by working adults. Another available effective intervention is participating in audiologic rehabilitation (AR) programmes. These programmes focus on stigma reduction and communication strategies. Most existing programmes target an elderly population that had been fitted with hearing aids. No programme for working adults who do not wear amplification is published in the literature. The new AR programme “See it! Hear it! Say it!” had been designed for adults who do not wear amplification and previously trialled in the USA. The purpose of this study was to evaluate the short and mid-term outcomes of a version adapted for the New Zealand context, specifically changes in health related quality of life (HRQoL) and cognitive anxiety. Thirteen participants in two groups participated in the study. The design was a quasi–randomised pre-test/post-test/follow-up test with waitlist design. Outcomes were measured with the International Outcome Inventory – Alternative Interventions (IOI-AI), the Hearing Handicap Inventory for Adults (HHIA), the Cognitive Anxiety Scale (CAS) and a non-standardised online questionnaire. Results demonstrated statistically significant differences between pre-group and follow-up assessment outcomes. Effect sizes ranged between 0.606 and 2.114. Participants reported implementing communication strategies in a number of adverse listening environments. These findings provide evidence that the New Zealand specific version of “See it! Hear it! Say it!” is effective in improving HRQoL and reducing cognitive anxiety.