Hearing impairment (HI) is a growing health issue in today’s ageing society. Research has suggested that individuals with HI may experience increased levels of anxiety. Previous research has mainly focused on anxiety as a trait; recent research, however, has looked at state anxiety in the hearing impaired population. Cognitive anxiety is a state anxiety that occurs when people encounter a situation which does not lie within their construct system. As a result, they may experience anxiety as they are unable, or only partially able, to interpret the event meaningfully and are therefore unable to judge the implications of this event. The following study aimed to use the Cognitive Anxiety Scale to investigate relationships between cognitive anxiety and client variables in hearing impaired individuals, adding to the small amount of research currently available in this area. The following research questions were investigated: (1) Is there a relationship between cognitive anxiety level and (a) age, (b) gender, (c) audiometric variables, and (d) quality of life? (2) Is there a significant difference between the level of cognitive anxiety for the participants who purchased and kept hearing aids and those who did not? Twenty-five hearing impaired individuals who were consulting an audiologist for the first time participated in this study, with the cognitive anxiety interview conducted prior to the audiological assessment. The results indicated that cognitive anxiety was significantly related to an ability to understand speech in noise and quality of life, and that hearing aid adopters exhibited greater levels of cognitive anxiety than non-adopters. These results confirm that cognitive anxiety is indeed experienced by adults with HI, and suggest that it may be a factor which motivates people to adopt hearing aids. Further research is needed to confirm and further investigate the relationships with client variables. By listening for signs of cognitive anxiety, an audiologist may be able to gauge if a client is ready for rehabilitation, and encourage the process by exploring the effects of HI on communication situations, employing speech in noise testing, and including the significant other in the process.

Background: The consequences of hearing loss vary and can include both emotional and social impacts, such as social isolation and decreased self-confidence. Communication limitations resulting from hearing loss can also affect participation in social relationships, which can lead to social withdrawal. Previous research has shown that audiological rehabilitation can be an effective method to help individuals manage their hearing loss and increase their self-confidence. Studies have shown that women with hearing loss reported higher levels of stress and anxiety compared to men with hearing loss. Aim: The aim of the study was to investigate how perceived disability due to hearing impairment affected individuals socially and emotionally among men and women in the age group of 18-64 years. Furthermore, potential gender differences in this impact were examined, as well as the relationship between perceived benefits of audiological rehabilitation and the use of hearing aids. Method: Method: In this quantitative cross-sectional study, a questionnaire survey was conducted using the HHIE instrument, supplemented with demographic and background questions. The survey was distributed through HRF's associations, online forums, groups for individuals with hearing impairment, and informational pamphlets containing a QR code for the survey were distributed in the waiting areas of audiological clinics and the Audiological Clinic's Education Reception (AudU) in Örebro. Statistical software SPSS was employed for data analysis. Mann-Whitney U-test was utilized to investigate potential differences between men and women in their emotional and social experiences related to hearing impairment. To examine the correlation between perceived benefits of hearing aids, perceived benefits of rehabilitation, the social subscale, and the emotional subscale, Spearman's correlation was employed. Results: The results of the current study showed no significant difference between men and women in how they experience the impact of hearing impairment emotionally and socially. However, there was a significant positive correlation between perceived benefit of hearing aids, perceived benefit of rehabilitation, and the subscales in HHIE. These findings indicated a relationship between the perceived benefit of hearing aids and rehabilitation, leading to an improved emotional and social function among individuals with hearing impairment. Conclusions: The study found no significant difference between men and women regarding how hearing impairment affected them socially and emotionally. However, the study did find a significant positive correlation between perceived benefits of hearing aids, audiological rehabilitation, and subscales in the HHIE instrument. / Bakgrund: Konsekvenserna av hörselnedsättning varierar och kan inkludera både emotionella och sociala påverkningar, såsom social isolering och minskat självförtroende. Begränsningar i kommunikationen till följd av hörselnedsättning kan också påverka delaktigheten i sociala relationer, vilket kan leda till socialt tillbakadragande. Det finns studier som har visat att kvinnor med hörselnedsättning rapporterade högre nivåer av stress och ångest jämfört med män med hörselnedsättning. Tidigare forskning har visat att audiologisk rehabilitering kan vara en effektiv metod för att hjälpa personer att hantera sin hörselnedsättning och öka deras självförtroende. Syfte: Syftet med studien var att undersöka hur upplevt funktionshinder på grund av hörselnedsättning bland män och kvinnor i åldersgruppen 18-64 år påverkade dem socialt och emotionellt. Vidare undersöktes eventuella könsskillnader i denna påverkan samt sambandet mellan upplevd nytta av audiologisk rehabilitering och upplevd nytta av hörapparaterna. Metod: I denna kvantitativa tvärsnittsstudie utfördes en enkätstudie som använde mätinstrumentet HHIE, kompletterat med demografiska och bakgrundsfrågor. Enkäten publicerades i HRF:s föreningar, online-forum, grupper för personer med hörselnedsättning samt informationsblad med en QR-kod till enkäten delades ut till audiologiska kliniken och audiologiska klinikens utbildningsmottagnings (AudU) väntrum i Örebro. För analys av resultaten användes statistikprogrammet SPSS. Mann-Whitney U-test användes för att undersöka eventuella skillnader mellan män och kvinnor i deras emotionella och sociala upplevelser av hörselnedsättning. För att undersöka om det fanns samband mellan upplevd nytta av hörapparaterna, upplevd nytta av rehabilitering, sociala delskalan och emotionella delskalan användes Spearmans korrelation. Resultat: Resultaten av den aktuella studien visade ingen signifikant skillnad mellan män och kvinnor i hur de upplever påverkan av hörselnedsättning emotionellt och socialt. Däremot fanns det en signifikant positiv korrelation mellan upplevd nytta avhörapparat/er, upplevd nytta av rehabilitering och delskalorna i HHIE. Dessa resultat indikerade att det fanns ett samband mellan upplevd nytta av hörapparat/er och rehabilitering, vilket ledde till en förbättrad emotionell och social funktion hos personer med hörselnedsättning. Slutsatser: Studien fann ingen signifikant skillnad mellan män och kvinnor gällande hur hörselnedsättningen påverkade dem socialt och emotionellt. Däremot fann studien att det fanns en signifikant positiv korrelation mellan upplevd nytta avhörapparat/er, audiologisk rehabilitering och delskalor i mätinstrumentet HHIE.

I Sverige beräknas 17 % av befolkningen ha en hörselnedsättning, vilket innebär att det är den vanligaste sensoriska funktionsnedsättningen. Idag finns det en mängd studier som visar att hörselnedsättning är relaterat till sämre psykisk hälsa. Acceptans av sin hörselnedsättning har visat sig vara positivt för hörselnedsatta och samvarierar med hjälpsökande. Acceptance and commitment therapy (ACT) är en transdiagnostisk behandling där psykopatologi antas bero på en hög grad av upplevelsemässigt undvikande och fusion med tankar. Målet i ACT är att öka psykologisk flexibilitet där acceptans är en betydande komponent. Denna explorativa studie undersökte förändringsprocesser i ACT för personer med hörselnedsättning där utfallet var känslomässig och social anpassning för hörselnedsättningen (HHIE-S). De förändringsprocesser som prövades var acceptans (HAQ), som tidigare visat på medierande effekt för ACT, samt två alternativa förändringsprocesser; self-efficacy (HSE-4) och upplevd stress (PSS-4). Behandlingen bestod av åtta internetadministrerade moduler givna med behandlarstöd där veckovisa mätningar av förändringsprocesser och utfall användes. Studiens resultat visar att behandlingsgruppen upplevde marginellt signifikant mindre problem med känslomässig och social anpassning för hörselnedsättningen (HHIE-S). Studiens resultat pekar på att hörselrelaterad acceptans (HAQ) och self- efficacy (HSE-4) medierar behandlingens effekt på deltagarnas känslomässiga och sociala anpassning för hörselnedsättning (HHIE-S). Således tillför denna studie ytterligare belägg för acceptans som förändringsprocess i ACT. Även self-efficacy kan vara en intressant mediator att beakta i fortsatt forskning.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / According to Ministério da Saúde is there the necessity to survey of the Country situation in relation to the hearing impairment, between the many aspects it is the hearing aid supply and the results after the act of receiving it, what it would make possible an improvement of the actions planning in Auditory Health Attention. Some research have been carried through with hearing aid users, meantime in the specialized literature, studies related with fitted users saw in the Sistema Único de Saúde, had not been found. Thus being, this study has like aims: to verify the difficulties related to the use and battery manipulation and ear molds and to the characteristics of the amplification in this group of study; and to compare the intervention results from self-assessment questionnaires in patients with and without related complaints with the characteristics of the amplification. In this way, the study consisted of individuals with symmetrical bilaterally hearing losses, sensorineural or mixed, from moderate to moderately severe degrees, between 12 and 77 years age, all hearing aid users of digital or hibrid for a minimum period of three months. Initially, it was carried through an interview with topics related to the experience and the use and battery manipulation, ear molds and hearing aids in the 31 individuals of the study. After, they had been applied in 25 individuals, the evaluations with self-assessment questionnaires HHIE-S (Hearing Handicap Inventory will be the Elderly Screening Version) or HHIA (Hearing Handicap Inventory will be Adult) and APHAB (Abbreviated Profile of Hearing Aid Benefit), which had allowed to verify the difficulties tried in the daily life communication situations in individuals without (Group 1) and with complaints related to the amplification characteristics (Group 2). Of the 31 interviewed individuals, 21 users had presented some kind of complaint related to hearing aids characteristics. Already in relation to the evaluations with self-assessment qestionnaires, applied in 25 of them, there was not found significant difference statistical among the studied groups in relation to questionnaires HHIE-S and HHIA, and about the APHAB significant difference statistical only in communication favorable situations of was evidenced, having Group 1 gotten benefit better. In HHIE-S and HHIA, the means values of hearing handicap was 34,71% for Group 1 and 45,82% for Group 2, indicating a bigger perception for the group with complaints. The values of benefit in the APHAB for Group 1 was 68,62% (FC), 37,12% (RA), 48,38 (RV) and -9,25 (AS) and in Group 2, it verified 39,59% (FC), 38,12% (RA), 39,88% (RV) and -28,18% (AS), evidencing a significant reduction of the hearing disabilities with the use of the hearing aids in communication favorable situations (FC), in reverberant environments (RV) and in the ambient noise presence (RA) for both groups. In negative situations of perception of the ambient sounds (AS), the performance with the use of the hearing aid was worse for both groups, confirmed for the negative values of benefit. Finnaly, the critical appreciation of the results allowed to conclude that 12.90%, 58,06% and 67,74% of the interviewed individuals (N=31) had presented difficulties related to the battery, to the ear molds or capsules and to the amplification characteristics, respectively; and significant differences between the groups studied (N=25) in the HHIE-S and HHIA protocols, as well as in the APHAB had not been found, except in sub-scale favorable communication situations, where Group 1 (without complaints) got benefit better. / Segundo o Ministério da Saúde há a necessidade de se realizar um levantamento da situação do País em relação à deficiência auditiva, entre os vários aspectos está o fornecimento da prótese auditiva e os resultados da protetização após o recebimento, o que possibilitaria uma melhoria do planejamento das ações em Atenção à Saúde Auditiva. Várias pesquisas têm sido realizadas com usuários de próteses auditivas, entretanto não foram encontrados na literatura especializada estudos relacionados com usuários adaptados via Sistema Único de Saúde. Assim sendo, este estudo teve como objetivos: verificar as dificuldades relacionadas ao uso e manuseio de pilhas e moldes auriculares e às características da amplificação neste grupo de estudo; e comparar os resultados da protetização a partir de questionários de auto-avaliação em pacientes com e sem queixas relacionadas às características da amplificação. Deste modo, o estudo constituiu-se de portadores de perdas auditivas bilaterais simétricas, neurossensoriais ou mistas, de graus moderado a moderadamente severo, entre 12 e 77 anos de idade, todos usuários de próteses auditivas com rocessamento do sinal digital ou analógico programável via computador por um período mínimo de três meses. Inicialmente, foi realizada uma entrevista com tópicos relacionados à experiência e ao uso e manuseio das pilhas, moldes e próteses auditivas nos 31 indivíduos participantes do estudo. Após, foram aplicados em 25 indivíduos, os questionários de auto-avaliação HHIE-S (Hearing Handicap Inventory for the Elderly Screening Version) ou HHIA (Hearing Handicap Inventory for Adult) e APHAB (Abbreviated Profile of Hearing Aid Benefit), os quais permitiram verificar as dificuldades experimentadas nas situações de comunicação em atividades diárias nos indivíduos sem (Grupo 1) e com queixas relacionados às características da amplificação (Grupo 2). Dos 31 indivíduos entrevistados, 21 usuários apresentaram algum tipo de queixa relacionado ao funcionamento das próteses auditivas. Já em relação aos questionários de auto-avaliação, aplicados em 25 deles, não se encontrou diferença estatisticamente significante entre os grupos estudados em relação aos questionários HHIE-S e HHIA, e quanto ao APHAB constatou-se diferença estatisticamente significante apenas em situações favoráveis de comunicação, tendo o Grupo 1 obtido melhor benefício. No HHIE-S e HHIA, o índice percentual médio do handicap auditivo foi 34,71% para o Grupo 1 e 45,82% para o Grupo 2, indicando uma maior percepção do handicap auditivo pelo grupo com queixas. Encontraram-se valores de benefício no APHAB para o Grupo 1 de 68,62% (FC), 37,12% (RA), 48,38% (RV) e -9,25% (AS) e no Grupo 2, verificou-se índices de 39,59% (FC), 38,12% (RA), 39,88% (RV) e -28,18% (AS), evidenciando uma redução significativa da incapacidade auditiva com o uso das próteses em situações favoráveis de comunicação (FC), em ambientes reverberantes (RV) e na presença de ruído ambiental (RA) para ambos os grupos. Em situações negativas de percepção dos sons ambientais, o desempenho com o uso das próteses auditivas foi pior para ambos os grupos, confirmado pelos índices negativos de benefício na sub-escala AS. Ao término deste estudo, a apreciação crítica dos resultados permitiu concluir que 12,90%, 58,06% e 67,74% dos indivíduos entrevistados (N=31) apresentaram dificuldades relacionadas às pilhas, aos moldes ou cápsulas auriculares, e às características da amplificação, respectivamente; e diferenças significantes entre os grupos estudados (N=25) nos protocolos HHIE-S e HHIA, bem como no APHAB não foram encontradas, exceto na sub-escala facilidade de comunicação, onde o Grupo 1 (sem queixas) obteve melhor benefício.

AIMS: This study investigated the perception of generic and disease-specific Health-Related Quality of Life (HRQoL) for adults living with hearing impairment (HI) in Aotearoa/New Zealand (NZ). This study aimed to answer three questions: (1) What is the perception of HRQoL amongst adults with hearing impairment in NZ? (2) How do these perceptions compare to adults with HI living in other countries for which we have data? (3) What are the demographic and audiometric variables related to device ownership? METHOD: HRQoL, demographic, and audiometric information was collected from 126 adults in NZ. The following demographic information was collected: age, relationship length, hours worked per week, income, ancestry, sex, level of education, city size, and sexual orientation. The following audiologic information was also collected: ownership of hearing aids (HA), ownership of hearing assistance technology (HAT), better-ear pure-tone average (BEPTA), worse-ear pure-tone average (WEPTA), and signal-to-noise ratio loss (SNR loss). HRQoL information was collected using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36; Ware & Sherbourne, 1992), and the Hearing Handicap Inventory (HHI) for both elderly (HHIE) and adults (HHIA; Ventry & Weinstein, 1982; Newman, Weinstein, Jacobson, & Hug, 1991). Variables discriminating HA and HAT owners from non-owners were also analysed. RESULTS: The relationship between demographic variables and HRQoL scores revealed that only age and income were significant. Audiometric variables had significant relationships with disease-specific HRQoL scores, as well as HA and HAT ownership. Finally, disease-specific HRQoL scores and all audiometric variables differentiated HA owners from non- owners, but demographic variables did not. Generic HRQoL scores and all audiometric variables differentiated HAT owners from non-owners. CONCLUSIONS: These results suggest that the negative impacts of HI on HRQoL as reported overseas are also present in NZ, and that not only do audiometric variables including SNR loss are related to HRQoL, but HRQoL is a significant predictor for HA and HAT ownership. Further QoL research is warranted amongst the HI population in NZ to identify and understand any causal relationships present amongst these variables. Furthermore, HRQoL instruments and a test of speech understanding in noise have been shown to provide additional meaningful information, and therefore clinicians might consider including them during consultation.