title: A home education program for older adults with hearing impairment and their significant others: A randomized trial evaluating short- and long-term effects A randomized, controlled trial of the short-term effects of complementing an educational program for hearing aid users with telephone consultations. The need for and development of an adaptive Listening and Communication Enhancement (LACE) Program. Short- and Long-Term Outcomes of Adult Audiological Rehabilitation Do group audiologic rehabilitation activities influence psychosocial outcomes? Analysis of prefitting versus postfitting hearing aid orientation using the Glasgow Hearing Aid Benefit Profile (GHABP). Evaluation of an audiological rehabilitation program for spouses of people with hearing loss. Can auditory and visual speech perception be trained within a group setting? Perceptual training improves syllable identification in new and experienced hearing aid users. Audiologist-Driven Versus Patient-Driven Fine Tuning of Hearing Instruments Formal auditory training in elderly hearing aid users. Rehabilitative online education versus internet discussion group for hearing aid users: a randomized controlled trial. The Effect of Telephone Intervention on Success with Amplification The effect of LACE DVD training in new and experienced hearing aid users. The active fitting (AF) programme of hearing aids: a psychological perspective. Teleaudiology: evaluation of teleconsultation efficacy for hearing aid fitting. Expectations, prefitting counseling, and hearing aid outcome. Hearing aid effectiveness after aural rehabilitation: individual versus group trial results. Behavioural hearing tactics: a controlled trial of a short treatment programme. A randomized, controlled trial of the efficacy of a communication course for first time hearing aid users. Reduced hearing, ownership, and use of hearing aids in elderly people in the UK–the MRC Trial of the Assessment and Management of Older People in the Community: a cross-sectional survey An evaluation of a behavioural treatment approach to hearing impairment. Development and validation of the effectiveness of [corrected] auditory rehabilitation scale. Behavioral counselling for subjects with acquired hearing loss. A new approach to hearing tactics. Teaching hearing-aid skills to elderly people: hearing tactics.
abstract: This paper addresses the development and effectiveness of a home education program . The program , design ed for hearing-impaired elders and their significant others ( SO ) , deals with communication strategies and speech reading . Participants were r and omly assigned to a training group ( hearing aid fitting + home education program ) or a control group ( hearing aid fitting ) . The training group included 24 hearing-impaired subjects and 24 SO 's . Controls were 24 affected individuals and 22 SO 's . Question naires addressing emotional response , communication strategies and the IOI-HA , IOI-AI and IOI-SO were used . A repeated measures analysis of variance was applied to test group differences between pre , post , and 6-months follow-up measures . Increased awareness of benefits of speech reading and improved interaction with the SO were observed in the training group only ( p < 0.05 ) . No group difference on ‘ emotional response ’ was found . IOI-AI and IOI-SO demonstrated favorable attitudes towards the program . Follow-up measures showed improved quality of life and satisfaction in the training group , while a decrease was observed among the controls ( p < 0.05 ) . Some effects differed between first-time and experienced hearing aid users . Addition of services to amplification and involvement of the SO are relevant in aural rehabilitation BACKGROUND Audiologic rehabilitation aims to improve communication for people with hearing impairment . Education is widely regarded as an integral part of rehabilitation , but the effect of the delivery method of an educational program on the experience of hearing problems has rarely been investigated in controlled trials . PURPOSE The purpose of this study was to examine the short-term effects of complementing an educational program for hearing aid users with telephone consultations , delivered through weekly discussion s with the subjects about information obtained from a book on hearing and hearing aids . RESEARCH DESIGN This study used a r and omized , controlled design . STUDY SAMPLE In total , 69 hearing aid users were r and omly assigned to an intervention group ( n = 33 ) or a control group ( n = 36 ) . INTERVENTION The intervention group had access to a book and received weekly topic-based reading instructions related to the different chapters of the book . Five telephone calls were made to the members of the intervention group . During the calls , an audiologist discussed new information with the participant as needed . The control participants also read the book , but they did not discuss the contents of the book with a professional . DATA COLLECTION AND ANALYSIS The Hearing H and icap Inventory for the Elderly ( HHIE ) , the Hospital Anxiety and Depression Scale ( HADS ) , and the International Outcome Inventory for Hearing Aids ( IOI-HA ) were used to measure the outcomes of this study . RESULTS Participants in the intervention group had a reduction in self-reported hearing h and icap , while there were no significant changes in the control group . In the intervention group , 45 % of the participants showed an improvement of ≥36 % on the HHIE , while only 17 % of the control group showed an improvement of ≥36 % . There were also improvements on the HADS total and the depression subscale for the intervention group . No changes occurred on the IOI-HA . CONCLUSIONS Reading about hearing and hearing aids can reduce the hearing h and icap and reported anxiety in hearing aid users . In this study , discussing the content of the book that was provided with a professional during weekly telephone consultations and having weekly home assignments further improved emotional well-being , as demonstrated by the HHIE ( emotional scale ) and HADS ( depression scale ) , but these activities had no effect on hearing aid outcomes as measured by the IOI-HA Auditory training has long been advocated to enhance communication but has never been time or cost-effective . This article describes the concepts underlying the development of a home-based , interactive adaptive computer program design ed to engage the adult hearing-impaired listener in the hearing-aid-fitting process , provide listening strategies , build confidence , and address cognitive changes characteristic of the aging process . An investigation using a between-group , within-subject design with pre- and post-test objective and subjective measures was conducted at five clinical sites . Sixty-five subjects were r and omly placed into two groups , one receiving LACE ( Listening and Communication Enhancement ) immediately following baseline testing and one serving as a control for one month and then receiving training as a crossover group . Results showed statistically significant improvements for the trained subjects on all but one of the outcome measures . Barriers facing the widespread implementation of home-based aural rehabilitation are discussed Objective : To examine short- and long-term subjective benefits of providing a counseling-oriented audiological rehabilitation ( AR ) program as an adjunct to hearing aid intervention for individuals with adult-onset hearing loss . Design : One hundred six veterans ( 68 men and 38 women ) , fit binaurally with digitally programmable analog hearing aids , participated . The Communication Profile for the Hearing Impaired ( CPHI ; Demorest & Erdman , 1987 ) was administered to all participants before hearing aid fitting . Half the patients were r and omly assigned to receive hearing aids alone ( i.e. , control ) ; the other patients were assigned to participate in a 4-wk group AR program in conjunction with receiving hearing aids ( i.e. , HA+AR ) . At the end of the AR program , the CPHI was again administered to all participants to assess short-term benefit and at 6 mo and 1 yr after hearing aid fitting to assess long-term benefit . Results : A separate repeated- measures version of the general linear model was used to examine short- and long-term benefits for the CPHI factor scores ( communication importance , communication performance , adjustment , interaction , and reaction ) and for individual importance ratings and scale scores . Hearing aid use improved both short- and long-term self-perception of communication performance , with no additional benefits from participation in the AR program . Consistent with the goals of a counseling-oriented AR program , differential short-term treatment effects were found for communication strategy usage , which led to differential short-term benefits for the interaction and reaction factors . Although failing to reach strict criteria for statistical significance , there was an observable difference in short-term outcomes between the two groups for the adjustment factor , with greater improvements occurring for the HA+AR group . Over the course of the year , benefits measured for the HA+AR group remained stable , whereas scores for the control group continued to increase , result ing in no differences in factor scores between groups at 1 yr after intervention . Conclusions : The finding of a short-term differential treatment benefit for AR in terms of interaction and reaction , and possibly for adjustment , was important , as better outcomes in these areas may be important in the decision to keep hearing aids . If this is the case , then the data support the inclusion of a counseling-oriented AR program . Differential treatment effects in interaction and reaction appeared to result from communication strategy use , indicating that the AR program is meeting many of its goals in this area . The lack of long-term differential effects appeared as the result of continued changes in adjustment , interaction , and reaction with continued  hearing aid experience PURPOSE To attempt to determine whether group audiologic rehabilitation ( AR ) content affected psychosocial outcomes . METHOD A r and omized controlled trial with at least 17 participants per group was completed . The 3 treatment groups included a communication strategies training group , a communication strategies training plus psychosocial exercise group , and an informational lecture plus psychosocial exercise group . Evaluations were conducted preclass , postclass , and 6-months postclass ; they included hearing loss-related and generic quality of life scales , and a class evaluation form . RESULTS All treatment groups demonstrated short- and long-term improvement on the hearing loss-related quality of life scale . Minimal differences were measured across treatment groups . A significant difference was observed between the lecture plus psychosocial exercise group and the communication strategies training group for 1 hearing loss-related quality of life subscale . Better outcomes were measured for the 2 groups with psychosocial exercises versus the communication strategies training group on 1 generic quality of life subscale . The results for the class evaluation did not discriminate among the treatment groups . CONCLUSIONS Class content had only a minimal influence on treatment outcomes . Recommended AR class content includes a mix of interventions including information , training , and psychosocial exercises Results of this study demonstrate the advantages of both pre- and postfitting hearing aid orientation ( HAO ) sessions . This study demonstrated that HAO counseling is helpful in expediting hearing aid benefit and satisfaction through the education of our clients and that this benefit and satisfaction is age dependent as measured by the Glasgow Hearing Aid Benefit Profile ( GHABP ) ( Gatehouse , 1997 ) . Patients with greater initial disability  , as identified by item 1 of the GHABP , receive significant benefit from prefitting and /or postfitting counseling as compared to patients receiving no counseling . Implication s of these findings are discussed BACKGROUND Since the psychosocial effects of hearing loss are different in the spouse ( SP ) than in the person with hearing loss ( PHL ) , it seems reasonable that rehabilitation programs design ed for PHLs may need to be adapted to benefit SPs . PURPOSE To evaluate the effectiveness of training in communication strategies and psychosocial exercises for SPs of PHLs by determining whether SPs who completed the group class had improved mood , reduced stress , improved marital communication , and greater awareness of their partners ' hearing loss-related quality of life ( HL-QOL ) in comparison with SPs who did not participate in a group class . Additionally , to determine whether PHLs of SPs who participated in a  group audiological rehabilitation ( AR ) class had significantly improved mood , reduced stress , improved marital communication , and better HL-QOL scores in comparison with PHLs whose SPs did not participate in a group class . RESEARCH DESIGN A r and omized controlled study . STUDY SAMPLE A total of 72 individuals participated in the study , 36 PHLs and 36 SPs . The PHLs were hearing aid users or cochlear implant users ; the SPs had normal or near normal hearing . INTERVENTION PHLs in the control group participated in a traditional group AR program while their SPs received no treatment .  PHLs in the experimental group also participated in a traditional group AR program while their SPs participated in a treatment program design ed for SPs of PHLs . Classes consisted of 90 min sessions meeting once a week for four weeks . DATA COLLECTION AND ANALYSIS All participants completed question naires measuring HL-QOL ( the SPs filled out third-party reports of HL-QOL ) , stress , mood ( positive affect and negative affect ) , and communication in the marriage . Scales were completed three times : prior to the AR program , within two weeks after completing the AR program , and 6 mo later . SP awareness of their PHL 's HL-QOL was measured by comparing preclass and 6 mo scores with reported critical difference values . Preclass , postclass and 6 mo data were examined with repeated measures ANOVAs . RESULTS All SPs reported significant improvements in third-party HL-QOL between the preclass and postclass visit . At the 6 mo visit , these reports remained consistent in the control SPs but declined in the experimental SPs . Awareness of HL-QOL in PHLs was improved in SPs who participated in AR classes and remained consistent in SPs who did not . All SPs demonstrated a trend ( moderate effect sizes ) for decreased stress and decreased negative affect after they and /or their partners completed the AR program . All PHLs demonstrated significant improvements in HL-QOL , significant reductions in stress , significant decreases in negative affect , and significant improvements in marital communication . There were no differences in outcome across the experimental and control PHLs . CONCLUSIONS When PHLs participate in an AR program , they receive significant improvements in QOL ( quality of life ) . Congruence ( as defined by similar scores ) between SP and PHL assessment s of HL-QOL improved in the experimental group , suggesting that the principal impact of the AR program on SPs was improved underst and ing of PHL experiences with hearing loss PURPOSE This study attempted to determine whether auditory-only and auditory-visual speech perception could be trained in a group format . METHOD A r and omized controlled trial with at least 16 participants per group was completed . A  training-only group completed at least 5 hr of group speech perception training ; a training plus psychosocial group  completed at least 5 hr of group speech perception training and psychosocial exercises ; and a control group did not receive training . Evaluations were conducted before and after training and included analytic and synthetic measures of speech perception , hearing loss-related and generic quality of life scales , and a class evaluation form . RESULTS No significant group changes were measured on any of the analytic auditory-only or auditory-visual measures of speech perception , yet the majority of training participants ( regardless of training group ) reported improvement in auditory and auditory-visual speech perception . The training participants demonstrated a significant reduction on the emotional subscale of the hearing loss-related quality of life scale , while the control participants did not demonstrate a change on this subscale . CONCLUSIONS Benefits of group audiologic rehabilitation classes may not result from an actual improvement in auditory or visual speech perception abilities , but participants still perceive training in these areas as useful We assessed the effects of perceptual training of syllable identification in noise on nonsense syllable test ( NST ) performance of new ( Experiment 1 ) and experienced ( Experiment 2 ) hearing aid ( HA ) users with sensorineural hearing loss . In Experiment 1 , new HA users were r and omly assigned to either immediate training ( IT ) or delayed training ( DT ) groups . IT subjects underwent 8 weeks of at-home syllable identification training and in-laboratory testing , whereas DT subjects underwent identical in-laboratory testing without training . Training produced large improvements in syllable identification in IT subjects , whereas spontaneous improvement was minimal in DT subjects . DT subjects then underwent training and showed performance improvements comparable with those of the IT group . Training-related improvement in NST scores significantly exceeded improvements due to amplification . In Experiment 2 , experienced HA users received identical training and testing procedures as users in Experiment 1 . The experienced users also showed significant training benefit . Training-related improvements generalized to untrained voices and were maintained on retention tests . Perceptual training appears to be a promising tool for improving speech perception in new and experienced HA users Two methods of fine tuning the initial setting s of hearing aids were compared : An audiologist-driven approach––using real ear measurements and a patient-driven fine-tuning approach––using feedback from real-life situations . The patient-driven fine tuning was conducted by employing the Amplifit ® II system using audiovideo clips . The audiologist-driven fine tuning was based on the NAL-NL1 prescription rule . Both setting s were compared using the same hearing aids in two 6-week trial periods following a r and omized blinded cross-over design . After each trial period , the setting s were evaluated by insertion-gain measurements . Performance was evaluated by speech tests in quiet , in noise , and in time-reversed speech , presented at 0 ° and with spatially separated sound sources . Subjective results were evaluated using extensive question naires and audiovisual video clips . A total of 73 participants were included . On average , higher gain values were found for the audiologist-driven setting s than for the patient-driven setting s , especially at 1000 and 2000 Hz . Better objective performance was obtained for the audiologist-driven setting s for speech perception in quiet and in time-reversed speech . This was supported by better scores on a number of subjective judgments and in the subjective ratings of video clips . The perception of loud sounds scored higher than when patient-driven , but the overall preference was in favor of the audiologist-driven setting s for 67 % of the participants UNLABELLED It is of paramount importance to install hearing rehabilitation programs for the elderly . AIM To check the efficacy of a forma auditory training program for elderly patients fitted with hearing aids for at least three months , by means of speech recognition tests and self- assessment question naires . METHODS Longitudinal contemporary cohort study . We selected 13 elderly hearing aid users , using intra-canal hearing aids in both ears , from both genders , with average age of 65.3 years . This group was r and omly divided in Experiment Group and Control Group . The Experiment Group underwent seven formal auditory training sessions , aim ing at stimulating their hearing skills for hearing closing , memory , attention , background figure and binaural integration . The participants were assessed by three behavioral tests and one self assessment question naire . RESULTS The elderly from the Experiment Group had significantly better performance in the assessment s after auditory training in comparison to the Control Group . CONCLUSION The formal auditory training program in a soundproof booth , associated with the use of hearing aids , improves speech recognition performance and reduces the perception of auditory h and icap for the elderly who use intra-canal hearing aids BACKGROUND By using the Internet in the audiological rehabilitation process , it might be possible in a cost-effective way to include additional rehabilitation components by informing and guiding hearing aid users about such topics as communication strategies , hearing tactics , and how to h and le hearing aids . PURPOSE To evaluate the effectiveness of an online education program for adult experienced hearing aid users including professional guidance by an audiologist and compare it with the effects of participation in an online discussion forum without any professional contact . RESEARCH DESIGN A r and omized controlled study with two groups of participants . Repeated measures at pre study , immediate follow-up , and a 6 mo follow-up . STUDY SAMPLE Fifty-nine experienced hearing aid users participated in the study , ranging in age from 24 to 84 yr ( mean 63.5 yr ) . INTERVENTION The intervention group ( N = 29 ) underwent a five-week rehabilitative online education in which activities for each week included information , tasks , and assignments , and contact with a professional audiologist was included . The participants in the control group ( N = 30 ) were referred to an online discussion forum without any audiologist contact . DATA COLLECTION AND ANALYSIS A set of question naires administered online were used as outcome measures : ( 1 ) Hearing H and icap Inventory for the Elderly , ( 2 ) International Outcome Inventory for Hearing Aids , ( 3 ) Satisfaction with Amplification in Daily Life , and ( 4 ) Hospital Anxiety and Depression Scale . RESULTS Significant improvements measured by the Hearing H and icap Inventory for the Elderly were found in both groups of participants , and the effects were maintained at the 6 mo follow-up . The results on the Hospital Anxiety and Depression Scale showed that the participants in the intervention group showed reduced symptoms of depression immediately/6 mo after the intervention . At the 6 mo follow-up participants in the control group reported fewer symptoms of anxiety than they did before the intervention started . CONCLUSIONS This study provides preliminary evidence that the Internet can be used to deliver education to experienced hearing aid users who report residual hearing problems such that their problems are reduced by the intervention . The study also suggests that online discussion forums could be used in rehabilitation . A combination of online professional supervised education and online informal discussion s could be a promising rehabilitation tool The purpose of this study was to determine whether periodic clinician-initiated telephone contact would reduce the number of unresolved complaints and increase satisfaction , use , and perceived benefit at 4 mo postfitting . Thirty subjects were contacted at 6 , 9 , and 12 wk postfitting to address questions and to encourage them to return to the clinic to resolve hearing aid-related problems . A control group of 30 subjects was encouraged to contact the center if problems arose at the time of dispensing only . All subjects were interviewed at 4 mo following receipt of the aids , and were sent the Hearing H and icap Inventory for the Elderly at the same time as well as at the time of dispensing . Results revealed a significant reduction in perceived h and icap in general , but no significant difference between groups on measures of satisfaction , use , or benefit . There was no significant difference between groups in the number of unresolved complaints at the time of the interview ; however , a trend toward fewer complaints in the experimental group was noted . A significantly greater number of complaints were raised for the first time in the control group than in the experimental group at the time of the interview , indicating that more problems remained unaddressed in the absence of clinician-initiated intervention . Therefore , the continued investigation of aggressive , and efficient , postfitting management schemes is warranted BACKGROUND Numerous studies have demonstrated that improving the ability to underst and speech in noise can be a difficult task for adults with hearing aids ( HAs ) . If HA users want to improve their speech underst and ing ability , specific training may be needed . Auditory training ( AT ) is one type of intervention that may enhance speech recognition abilities for adult HA users . PURPOSE The purpose of this study was to examine the behavioral effects of an AT program called Listening and Communication Enhancement ( LACE ) in the DVD format in new and experienced HA users . While some research has been conducted using the computer version of this program , no research to date has been conducted on the efficacy of the DVD version of the LACE training program in both new and experienced HA users . RESEARCH DESIGN An experimental , prospect i ve repeated measures group design , with r and om assignment . STUDY SAMPLE Twenty-nine adults with hearing loss were assigned to one of three groups : new HA plus training , experienced HA plus training , or control ( new HA users with no training during the study but provided with training afterward ) . New HA aid users were r and omly assigned to either the training or control group . INTERVENTION Participants in the training groups completed twenty 30 min training lessons from the LACE DVD program at home over a period of 4 wk . DATA COLLECTION Participants in both training groups were evaluated at baseline , after 2 wk of training and again after 4 wk of training . Participants in the control group were evaluated at baseline and after 4 wk of HA use . Several objective listening measures were administered including speech in noise , rapid speech , and competing sentences tasks . Subjective measures included evaluating the participants ' perception of the intervention as well as their perceptions of functional listening abilities . RESULTS Findings indicate that both new and experienced users improved their underst and ing of speech in noise , underst and ing of competing sentences , and communication function after training in comparison to a control group . Effect size calculations suggested that a larger training effect was observed for new HA users compared to experienced HA users . New HA users also reported greater benefit from training compared to experienced users . AT with the LACE DVD format should be encouraged , particularly among new HA users , to improve underst and ing in difficult listening conditions Rehabilitation of the majority of hearing h and icapped in Sweden consists of hearing aid fitting , provision of technical devices and information during about four visits to a Hearing Centre . Generally there is no structured guidance of the hearing h and icapped on how to proceed with the hearing aid at home between appointments . A programme of active fitting ( AF ) of hearing aids , with a task-oriented diary , ' Try Your Hearing Aid ' as a basic part , was therefore developed . We conducted a series of studies from 1985 to 1988 with the aim of investigating the benefit and applicability of the programme . A total of 128 new hearing aid c and i date s participated in three studies at the Sahlgrens hospital and at four other hearing centres in smaller Swedish towns . In a controlled study the AF group was more positive to their hearing aids and to the fitting period after 10 months . They used their hearing aids more frequently and felt psychologically more secure with them . It was established that the AF programme could well be applied in the clinical routine for a majority of new hearing aid patients . Old age per se was not found to be a relevant exclusion criterion . The positive outcome of the AF programme has stimulated the Swedish Institute of the H and icapped to print ' Try Your Hearing Aid ' with a manual , and to introduce it to all hearing centres in Sweden PURPOSE To evaluate teleconsultation 's efficacy for hearing aid fitting . METHODS Fifty hearing impaired individuals with ages ranging from 39 to 88 years and mean audiometric thresholds between 30 and 68.75 dBHL participated in this study . Participants were divided into two groups ( stratified r and omization ) : control group ( n=25 ) , su bmi tted to face-to-face procedures , and experimental group ( n=25 ) , su bmi tted to synchronous teleconsultation with interactive video and remote applicative control . The hearing aids were programmed and verified ( with microphone probe ) , and the subjects received instructions regarding use and care for the device . Time taken for the procedures was measured . Following the consultations , an evaluator ( blind to the groups ) applied the Hearing in Noise Test ( HINT-Brazil ) . Approximately one month after consultations , the daily time of hearing aid use was verified , and the International Outcome Inventory for Hearing Aids ( IOI-HA ) was administered . RESULTS A greater time for programming and verification and a smaller time for orientation were observed for the experimental group . No difference was found between groups for the total consultation time . The real ear measures ' matching to their respective targets was similar for both groups . No difference was observed between groups for the HINT results ( silence and noise ) , the daily amount of use of hearing aids in hours , and the IOI-HA scores . CONCLUSION Teleconsultation is an efficient procedure for hearing aid programming , verification and fitting when face-to-face services are not available BACKGROUND Data suggest that having high expectations about hearing aids results in better overall outcome . However , some have postulated that excessively high expectations will result in disappointment and thus poor outcome . It has been suggested that counseling patients with unrealistic expectations about hearing aids prior to fitting may be beneficial . Data , however , are mixed as to the effectiveness of such counseling , in terms of both changes in expectations and final outcome . PURPOSE The primary purpose of this study was to determine whether supplementing prefitting counseling with demonstration of real-world listening can ( 1 ) alter expectations of new hearing aid users and ( 2 ) increase satisfaction over verbal-only counseling . Secondary goals of the study were to examine ( 1 ) the relationship between prefitting expectations and postfitting outcome , and ( 2 ) the effect of hearing aid fine-tuning on hearing aid outcome . RESEARCH DESIGN Sixty new hearing aid users were fitted binaurally with Beltone Oria behind-the-ear digital hearing aids .  Forty participants received prefitting counseling and demonstration of listening situations with the Beltone AVE ( Audio Verification Environment ) system ;  20 received prefitting counseling without a demonstration of listening situations . Hearing aid expectations were measured at initial contact and following prefitting counseling . Reported hearing aid outcome was measured after eight to ten weeks of hearing aid use . STUDY SAMPLE Sixty new hearing aid users aged between 55 and 81 years with symmetrical sensorineural hearing loss . INTERVENTION Participants were r and omly assigned to one of three experimental groups , between which the prefitting counseling and follow-up differed : Group 1 received prefitting counseling in combination with demonstration of listening situations . Additionally , if the participant had complaints about sound quality at the follow-up visit , the hearing aids were fine-tuned using the Beltone AVE system . Group 2 received prefitting counseling in combination with demonstration of listening situations with the Beltone AVE system , but no fine-tuning was provided at follow-up . Group 3 received prefitting hearing aid counseling that did not include demonstration of listening , and the hearing aids were not fine-tuned at the follow-up appointment . RESULTS The results showed that prefitting hearing aid counseling had small but significant effects on expectations . The two forms of counseling did not differ in their effectiveness at changing expectations ; however , anecdotally , we learned from many participants that that they enjoyed listening to the auditory demonstrations and that they found them to be an interesting listening exercise . The data also show that positive expectations result in more positive outcome and that hearing aid fine-tuning is beneficial to the user . CONCLUSIONS We conclude that prefitting counseling can be advantageous to hearing aid outcome and recommend the addition of prefitting counseling to address expectations associated with quality of life and self-image . The data emphasize the need to address unrealistic expectations prior to fitting hearing aids cautiously , so as not to decrease expectations to the extent of discouraging and demotivating the patient . Data also show that positive expectations regarding the impact hearing aids will have on psychosocial well-being are important for successful hearing aid outcome We design ed this noninferiority r and omized trial to determine ( 1 ) if group hearing aid fitting visits and group hearing aid follow-up visits were at least as effective as individual visits in terms of hearing-related function ( measured with the Inner Effectiveness of Auditory Rehabilitation [ EAR ] scale ) and adherence , and ( 2 ) if group visits were less costly over the 6 mo post-fitting period . For 644 participants r and omized to receive their hearing aid visits in an individual or group format at the Department of Veterans Affairs Puget Sound Health Care System , 6 mo outcomes showed no significant differences in Inner EAR scores between individual and group fitting ( p = 0.53 ) or follow-up ( p = 0.11 ) , or in the number of hours per day hearing aids were worn between individual and group fitting ( p = 0.90 ) or follow-up ( p = 0.24 ) . We found significantly higher cost for individual compared with group fitting ( p < 0.001 ) and follow-up ( p < 0.001 ) . We conclude that outcomes for group hearing aid fitting and hearing aid follow-up visits were not inferior to individual hearing aid fitting and follow-up visits , with group fitting and follow-up visits yielding cost savings Nineteen elderly hearing impaired subjects participated in an experimental treatment study and received either behavioural hearing tactics or served as untreated controls . Treatment was supplied in the form of a self-help treatment manual supplied with telephone contacts during 4 consecutive weeks . The treatment manual included applied relaxation , communication strategies training , advice to relatives , information , and coping skills . Assessment s ( pre-post ) were conducted in a structured interview measuring coping behaviour . In order to evoke behavioural compensation small acoustic provocations were included in the interview . Pre-post assessment s also included question naires , daily registered hearing problems , and hours of daily hearing aid use . Results showed significant beneficial effects in favour of the treatment in terms of self-assessed problems and behaviour change Many centres include a communication course as part of their auditory rehabilitation . These usually take the form of a small group and include discussion of the effects of hearing loss , use of the hearing aid , hearing tactics and lip reading . To investigate the efficacy of such a rehabilitation programme a r and omized , controlled trial of a communication course was undertaken . All subjects were first time hearing aid users ;  h and icap was measured using the Quantified Denver Scale of Communication Function ( QDS ) at the time of hearing aid fitting , and then 13 weeks later . All subjects had a hearing aid follow-up appointment , but the treatment group ( n = 22 ) also underwent a four-week communication course , while the control group ( n = 25 ) had no further rehabilitation . The reduction in h and icap measured by the change in QDS was significantly greater for the treatment group than for the control group ( Mann Whitney U test , tied p value = 0.014 ) . This indicates that such a communication course is efficacious in reducing h and icap . Further research is required to identify the population s that will benefit most from such a course BACKGROUND Reduced hearing in elderly people is important because it is disabling and potentially treatable . We aim ed to assess the prevalence of reduced hearing in elderly people and levels of ownership of hearing aids and use . METHODS We have done a cross-sectional survey of people aged at least 75 years in 106 family practice s in the UK . We obtained self-reported data on hearing difficulties for 32,656 people and gave 14,877 a whispered voice test ( response rate 78 % ) . FINDINGS 2537 ( 8 % ) of 32,656 participants reported a lot of difficulty hearing and 13,630 ( 42 % ) a little or a lot of difficulty . 3795 ( 26 % ) of 14877 participants who completed the whispered voice test ( 95 % CI 23 - 29 ) failed the test , the proportion rising sharply with age . Following wax removal , 343 passed a retest , leaving 3452 ( 23 % , 20 - 26 ) who failed the test , even after wax removal if present . 998 ( 46 % ) of 2180 people wearing a hearing aid at the time of testing failed the whispered voice test . More than half the people who failed the test did not own a hearing aid . 2200 ( 60 % ) of 3846 people who owned a hearing aid said they used it regularly . Level of use was strongly related to perceived benefit . INTERPRETATION Reduced hearing is common and provision of hearing aids inadequate in elderly people . Many people who own a hearing aid do not use it regularly , and even when wearing their aid many still have socially disabling levels of hearing loss . A major source of morbidity in elderly people could be alleviated by improvements in detection and management of reduced hearing Twenty-four elderly hearing impaired Ss participated in an experimental treatment study and received either behavioural group treatment or served as untreated controls . The treatment package included applied relaxation , video self-modelling , exposure , information and various coping skills . Assessment s ( pre-post ) were conducted using a structured video-interview measuring coping behaviour . In order to evoke behavioural compensation small acoustic provocations were included in the interview . The edited videos were then rated blindly by two trained observers . Pre-post assessment s also included daily registered hearing problems on visual analogue scales and a question naire . Finally , a one month follow-up blind telephone interview was conducted . Results showed significant beneficial effects in favour of the treatment package and support the implementation of a behavioural approach in audiological rehabilitation research OBJECTIVE To develop a new scale of hearing-related function and quality of life in patients with hearing aids that addresses overlooked concerns , such as hearing-aid comfort , convenience , and cosmetic appearance , that may influence hearing-aid adherence while maintaining brevity and sensitivity to clinical change . DESIGN Prospect i ve , multicenter instrument validation . SETTING Four diverse sites in Washington State , including 2 private practice s , 1 university setting , and 1 Veterans Affairs hospital . PATIENTS Seventy-eight patients with hearing aids . INTERVENTIONS We created 2 modules in the Effectiveness of Auditory Rehabilitation ( EAR ) scale . The first module ( Inner EAR ) covers intrinsic hearing issues such as hearing in quiet and hearing in noise and is administered both before and after treatment . The second module ( Outer EAR ) covers extrinsic ( hearing-aid related ) issues such as comfort , appearance , and convenience and is administered after hearing-aid fitting . MAIN OUTCOME MEASURES Both scales were developed and vali date d in 3 stages . Stage 1 used a qualitative approach from multiple data sources to develop preliminary instruments . Stage 2 used approaches from classic test theory to reduce the number of items and psychometrically vali date the instruments . Stage 3 examined the responsiveness or sensitivity to clinical change . RESULTS A 10-item Inner EAR module and a 10-item Outer EAR module were created and vali date d. Internal consistency of individual domains ( Cronbach alpha = 0.85 and 0.72 , respectively ) and test-retest reliability ( intraclass correlation coefficients = 0.76 and 0.81 , respectively ) were excellent . Evidence of construct validity included concurrent validity with other hearing scales and global visual analog scales , discriminant validity with dizziness h and icap , correlation with hearing-aid adherence , and confirmatory factor analyses . Both scales had strong evidence of responsiveness ( sensitivity to change ) , with higher effect sizes and Guyatt responsiveness statistics than the 2 widely used hearing scales in this study . The scales took an average of 5 minutes to complete . CONCLUSIONS The EAR scale is a valid and reliable measure of the effectiveness of amplification in the treatment of sensorineural hearing loss . It addresses the range of issues that are of importance to hearing-aid patients . The scales have excellent psychometric properties , are more responsive than several widely used hearing scales , and are minimally burdensome for patients to complete . The EAR may be a valuable outcome measure in future studies of both existing hearing aids and newer hearing-aid technologies , such as bone-anchored aids or middle ear implants Effects of behavioral counselling of subjects with an acquired hearing loss were evaluated in an experimental design . The study included a group of 20 hearing-impaired subjects who were assessed and r and omly allocated to a treatment or control group . Behavioural counselling , individualized according to the results of functional analysis , was then given to 10 subjects and included the teaching of ' hearing tactics ' . The groups were measured three times , pre-counselling and post-counselling and at a 15-month follow-up , after which treatment results were analysed . Significant ( time x treatment ) interactions were followed by post-hoc testing revealing that the treated group had improved in several areas of functioning while controls had not . These results were in agreement with interview data . The findings indicate that a behavioural counselling approach to hearing tactics is beneficial in the underst and ing and rehabilitation of hearing loss , especially over time The effect of a short instructional session on people 's knowledge of hearing tactics was tested on a sample of hearing-aid users 65 years of age and over . They had had their hearing aids for 3 months . A  question  naire was administered before and after the instruction session and the difference in score taken as a measure of the effect of instruction . A high score on the question naire indicated a lack of appropriate knowledge . Only those who scored incorrectly on one or more questions were given instruction . People were allocated at r and om either into an instructed group or a control group not so instructed . A substantial proportion ( 45 % ) had low initial scores on the question naire . The instruction significantly improved the scores of the experimental groups . The differences in score changes within age groups were not significant but men tended to improve more than women . The re source implication s of the instructional methods are discussed
target: Satisfaction and speech perception were frequent secondary outcomes .
  There was diversity in measures used to report patient outcomes .
  Outcome categories other than patient health status and behavior were rarely reported .
  This review has highlighted considerable diversity in patient-reported outcome measurements in r and omized control trials in the context of adult auditory rehabilitation .
background: OBJECTIVES This review documented the range and nature of reported outcome measures in the context of adult auditory rehabilitative research .