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The Challenges of Adapting to a New Power Hearing Aid

Nassar, Greg AuD; Walker, Adam MSc; Weile, Julie Neel MA; Dawes, Piers DPhil

doi: 10.1097/01.HJ.0000511731.79453.52
Original Research
Free

From left: Dr. Nassar is the head of Audiology at Central Manchester Foundation Trust-Trafford Division in the U.K. Mr. Walker is a registered clinical scientist in Audiology and is the lead pediatric audiologist at Central Manchester Foundation Trust Trafford Hospitals Division, UK. Ms. Weile is a research audiologist at Oticon A/S in Demark, with the Centre of Applied Audiology Research. Dr. Dawes is a senior lecturer in Audiology at the University of Manchester.

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Figure.

Moving to a new hearing aid can be challenging, as high-powered hearing aid users can be highly dependent on and accustomed to a particular device. In this study, we interviewed users of high-powered hearing aids who had recently changed to a new hearing aid and asked the following: What was their experience of transitioning to a new device? Which factors were particularly problematic? And what factors supported the transition?

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METHODS

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Figure.

Figure.

Figure.

Users of power hearing aids were fitted with a new high power hearing aid that used a different signal processing strategy from one by another hearing aid producer. Of the 22 initial participants, 17 completed the study (12 men, five women) and five discontinued (three participants did not find the new hearing aid agreeable and two withdrew from the study). The average age of the final participants was 66 years old; 11 were retired, and the rest had full-time jobs. Participants mostly reported moderate benefit from their current hearing aid (mean International Outcome Inventory for Hearing Aids [IOI-HA] score was 20.6 SD 5.5, out of a possible total score of 35).

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Figure.

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After at least two weeks (of a two- to four-week range) of using the new hearing aid, participants completed a structured interview about their experience of adapting to the new hearing aid and completed a questionnaire of hearing aid benefit (IOI-HA). They were asked whether they wished to keep the new hearing aid or return to their previous hearing aid. Interviews were recorded, transcribed, and analyzed according to the qualitative content. The structured interview followed a topic guide, which covered the following:

  • the participants’ experiences of adjusting to the new hearing aid, including problematic and supportive factors when switching to a new device;
  • the role of the clinician in counseling during the transition;
  • the biggest difficulties and problems in adjusting to the new aid; and
  • the easiest things and areas that did not pose any problem in adjusting to the new aid.
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RESULTS

Figure 1.

Figure 1.

Figure 2.

Figure 2.

Participants reported a small increase in benefit on the IOI for four out of seven questions, with a statistically insignificant small improvement in overall IOI-HA score for the new hearing aid [t(17)= 0.91, p=0.37; 22.6 (SD 5.5) versus 22.1 (SD 5.7); Fig. 1]. The majority of participants (82%) chose to keep their new hearing aid at the completion of the study (Fig. 2).

Participants were mostly positive in their reports of the new hearing aid. Positive themes included general non-specific benefit (“I think they are a lot better,” said patient 7; “I'd say they're very good, if you can get them, go for it,” said patient 9), as well as specific benefits of improved speech recognition (“I was absolutely amazed at some of the things I could hear—I could hear speech from two rooms away,” said patient 5). Other commonly reported benefits included listening to television and music (patient 2 “found these ones were better actually when it comes to listening to the tele and listening to music.”) as well as environmental sounds (“Once I'd started with these I heard noises in my car I've never heard before,” said patient 9).

Several participants independently mentioned that the new hearing aids seemed more “powerful” and provided them with increased amplification relative to their current instruments. Patient statements include:

“These new aids are very powerful and noticeably so,” said patient 10.

“The aids are more powerful, I like the aids for that … I can hear people outside the room—rarely before I could pick up that, so it is a very, very, very powerful hearing aid,” said patient 3.

Most participants reported no problem with operating the new hearing aid although some reported difficulties with volume control (“The only thing I can't see properly is if I've moved the numbers, you can't see the number, unless it's my eyesight. The numbers on the wheel you can't see very clearly. It could be doing a little bit heavier, the color,” said patient 11; “In terms of the actual aids themselves, the wheel mechanism, always catching it, I just do that with my hair, it turns itself off, so it's really got quite a sensitive wheel on it,” said patient 4).

Users described how the volume control was an important feature for them to turn the amplification up or down in specific situations. Feedback associated with hearing aid was also a commonly reported difficulty, so was the short battery life.

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DISCUSSION

Most participants successfully made the transition to a new hearing aid and elected to keep the new device. This is a positive observation for a group of hearing aid users who are generally perceived by clinicians to have greater challenges when switching from one hearing aid to another.

The perceived benefit in speech recognition and general benefits were commonly reported. Several participants described the new hearing aids as more “powerful.” To hearing aid users with severe to profound hearing loss, the change from one gain setting to a new one, both in terms of the amount of amplification and frequency shape, may be perceivable. A new gain prescription may warrant the need for optimal seal and feedback prevention.

Figure 3.

Figure 3.

Difficulties adjusting to the new hearing aids included feedback and hard-to-use design features, particularly the volume wheel. These difficulties might be addressed at the clinical fitting session by giving increased attention to molds and sound leakage, and providing detailed instructions on how to handle the new hearing aid. In the present study, new molds were not made for the new hearing aids per the study protocol. The decision not to make new molds was based on wanting to compare the sound quality and signal processing of the current versus the new hearing aid without adding extra advantage or disadvantage to either hearing aid. The feedback experienced by almost half of the participants pointed to a need for new and better fitting ear molds and tubing. Many experienced feedback and less than satisfactory fit with the new hearing aids coupled with old ear molds and tubing. Based on observations from the interviews, new ear molds are needed when changing from one super power hearing aid to another to secure optimal conditions for feedback management and user comfort. Regarding the device's design, having the volume control on the ear caused issues for some users. Exploring other means of volume control may be beneficial for the adaptation of the new hearing aid. These practical issues of feedback and good fit may represent a more substantial challenge to the successful uptake of a new hearing aid than the actual listening experience.

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