Aim: To evaluate an audiologic rehabilitation program previously piloted in the U.S. (Kelly-Campbell, in review) for unaided hearing-impaired working adults that was also modified to include their significant others. <p> <p> Method: In this quasi-randomised repeated measures waitlist design, forty-eight participants (24 hearing-impaired adults and their 24 normal hearing significant others) aged 50-64 years were randomised into either a non-waitlist group (immediate treatment), or a waitlist group (treatment after 12-weeks). In these groups, participant couples attended three weekly 2-hour group sessions and completed health-related quality of life (HRQOL) assessments. Treatment outcomes for hearing-impaired adults (HIAs) were measured from self and significant other (SO) proxy reports of the Communication Profile for the Hearing Impaired (CPHI; Demorest & Erdman, 1986; 1987). Treatment outcomes for SOs were measured from self-reports of the Significant Other Scale for Hearing Disability (SOS-HEAR; Scarinci, Worrall & Hickson, 2009b). An investigation of the effect of treatment on the congruence of SO-proxy versus HIA HRQOL measures was also undertaken. <p> Results: A series of analyses of variance and repeated-measures t-tests examined HRQOL outcomes for HIAs and their SOs between pre-treatment, post-treatment, and at 12-weeks follow-up. Results suggest a significant effect of time for all HRQOL assessments, with gender effects found for CPHI measures, but not for SOS-HEAR measures. Medium to large effect sizes were revealed for both HIAs and their SOs. <p> Conclusions: Group AR appears to be a beneficial treatment approach for reducing the consequences of hearing impairment for HIAs and for their normal hearing SOs.

Discontinued hearing-aid use is caused by a number of factors, most of which may lead to low hearing-aid self-efficacy (i.e. low confidence in one's ability to B a successful hearing-aid user). This paper describes the development of the Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids (MARS-HA), which was constructed in accordance with published recommendations for self-efficacy questionnaire development. The psychometric properties of the MARS-HA were evaluated with new and experienced hearing-aid users. The results revealed strong internal consistency and good test-retest reliability in both groups, with the following subscales identified both for the new users and the experienced users: (1) basic handling, (2) advanced handling, (3) adjustment to hearing aids, and (4) aided listening skills. Validity was established through the examination of expected differences based on group comparisons, training effects, and the impact of particular hearing aid features. The MARS-HA is a reliable and valid measure of hearing-aid self-efficacy and can be used to assist clinicians in identifying areas of low confidence that require additional audiologic training.

Hearing aid self-efficacy (i.e., beliefs individuals have in their ability to perform the skills needed to be successful hearing aid users) may be related to long-term hearing aid use. The purpose of the present investigation was to determine the audiologic correlates of hearing aid self-efficacy as assessed by the Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids (MARS-HA). New and experienced hearing aid users (n = 211) were given the MARS-HA. The results indicated that individuals with moderately severe hearing loss had lower self-efficacy for aided listening conditions than individuals with mild hearing loss. Individuals with poor word recognition abilities in quiet also had lower overall hearing aid self-efficacy than individuals with good to fair word recognition abilities. These results suggested that hearing aid users who have a moderate hearing loss (or worse) and hearing aid users with poor word recognition abilities may require additional counseling and audiologic rehabilitation to increase their hearing aid self-efficacy.

Purpose: The purpose of this tutorial is to provide a comprehensive overview of the self-efficacy framework and its application to audiologic rehabilitation. Method: A literature review was conducted on self-efficacy and its relevance to successful interventions in several health domains. Specific recommendations were presented for audiologic rehabilitation procedures that will enhance self-efficacy. Conclusions: As is the case in other health domains, clinical intervention by audiologists will be more effective when incorporating a self-efficacy framework in the audiologic rehabilitation process.

Objectives: The objective of this study was to develop and evaluate abbreviated versions of the Word Auditory Recognition and Recall Measure (WARRM) as part of an iterative process in the development of a feasible test for potential future clinical use. Design: The three original WARRM (O-WARRM) randomizations were modified by altering the presentation paradigm. Instead of presenting 5 trials per set size with set size increasing from 2 to 6 as in the O-WARRM (n = 100 words), the experimental WARRM (E-WARRM) paradigm consisted of one trial from each of set sizes 2 to 6 to create a "run" (n = 20 words) with each randomization consisting of 5 runs (n = 100 words). A total of 24 younger listeners with normal hearing and 48 older listeners with hearing loss (OHL) were administered 1 randomization of the O-WARRM and 1 different randomization of the E-WARRM. Results: The recognition and recall performances on the O-WARRM and all versions of the E-WARRM (five individual runs and overall) were similar within each listener group, with the younger listeners with normal hearing outperforming the OHL listeners on all measures. Correlation analyses revealed moderate to strong associations between the abbreviated WARRM runs and the O-WARRM for the OHL listener group. Hierarchical regression modeling suggested that run 1 of the E-WARRM was a good predictor of O-WARRM performance and that adding additional runs did not improve the prediction. Taken together, these findings suggest that administering one run from the E-WARRM warrants further examination for clinical use. Additional analyses revealed equivalent scores on all five runs from the three E-WARRM randomizations for both listener groups. Conclusions: Abbreviated versions of the O-WARRM were developed as part of this study. This was accomplished by modifying the original presentation paradigm and creating 15 unique "runs" among the original 3 randomizations. The resulting 15 runs could be considered 15 unique and abbreviated WARRM lists that have potential, in the future after further studies are conducted to establish important properties, for clinic use. The abbreviated WARRM lists may be useful for quantifying auditory working memory of listeners with hearing loss during the audiologic rehabilitation process.

Objective: This study investigated the perspectives of adults with hearing impairment on hearing help-seeking and rehabilitation. Design: Individual semi-structured interviews were completed. Study sample: In total, 34 adults with hearing impairment in four countries (Australia, Denmark, UK, and USA) participated. Participants had a range of experience with hearing help-seeking and rehabilitation, from never having sought help to being satisfied hearing-aid users. Results: Qualitative content analysis identified four main categories (perceiving my hearing impairment, seeking hearing help, using my hearing aids, and perspectives and knowledge) and, at the next level, 25 categories. This article reports on the densest categories: they are described, exemplified with interview quotes, and discussed. Conclusions: People largely described hearing help-seeking and rehabilitation in the context of their daily lives. Adults with hearing impairment rarely described clinical encounters towards hearing help-seeking and rehabilitation as a connected process. They portrayed interactions with clinicians as isolated events rather than chronologically-ordered steps relating to a common goal. Clinical implications of the findings are discussed. / <p>Funding Agencies|University of Queensland Graduate School||</p>

The purpose of this project was to implement the newly revised International Classification of Functioning, Disability and Health (ICIDH-2) developed by the World Health Organization (WHO), to establish specific aural rehabilitation goals. Five graduate clinicians in speech language pathology and audiology interviewed ten participants with adult onset hearing loss. A modified version of the General Questions for Participation and Activities (i.e., a structured interview technique) from the ICIDH-2 Checklist, was developed. Prior to completing this checklist, the students attended a brief training session to become familiar with the major components of the ICIDH-2, specifically the ICIDH-2 Checklist. Completion of the ICIDH-2 Checklist, Version 2.1a, clinician form (prefinal draft, December 2000), allowed the students to classify and qualify disability and health according to the constructs of Activity and Participation, (i.e., what a person can and cannot do as a result of hearing loss and what a person does and does not do as a result of hearing loss, respectively). Following completion of Parts 2 (Activities and Participation) and 3 (Environmental Factors) of the Checklist for each of the ten clients interviewed, aural rehabilitation goals were developed. Four participants are highlighted to illustrate how the ICIDH-2 is used to objectify the impact of hearing loss and to establish specific treatment goals. The results support the use of the modified version of the General Questions for Participation and Activities in development of aural rehabilitation goals for clients with adult onset hearing loss. Graduate clinicians demonstrated the ability to complete the checklist with little assistance, suggesting that the use of the ICIDH-2 by experienced clinicians should be a relatively easy task. Goal development was also a relatively easy task using the checklist ratings, and the ratings related directly to the individual participant's quality of life in their current situation.

Objectives: The purpose of this study was to develop the Word Auditory Recognition and Recall Measure (WARRM) and to conduct the inaugural evaluation of the performance of younger adults with normal hearing, older adults with normal to near-normal hearing, and older adults with pure-tone hearing loss on the WARRM. Design: The WARRM is a new test designed for concurrently assessing word recognition and auditory working memory performance in adults who may have pure-tone hearing loss. The test consists of 100 monosyllabic words based on widely used speech-recognition test materials. The 100 words are presented in recall set sizes of 2, 3, 4, 5, and 6 items, with 5 trials in each set size. The WARRM yields a word-recognition score and a recall score. The WARRM was administered to all participants in three listener groups under two processing conditions in a mixed model (between-subjects, repeated measures) design. The between-subjects factor was group, with 48 younger listeners with normal audiometric thresholds (younger listeners with normal hearing [YNH]), 48 older listeners with normal thresholds through 3000 Hz (older listeners with normal hearing [ONH]), and 48 older listeners with sensorineural hearing loss (older listeners with hearing loss [OHL]). The within-subjects factor was WARRM processing condition (no additional task or with an alphabet judgment task). The associations between results on the WARRM test and results on a battery of other auditory and memory measures were examined. Results: Word-recognition performance on the WARRM was not affected by processing condition or set size and was near ceiling for the YNH and ONH listeners (99 and 98%, respectively) with both groups performing significantly better than the OHL listeners (83%). The recall results were significantly better for the YNH, ONH, and OHL groups with no processing (93, 84, and 75%, respectively) than with the alphabet processing (86, 77, and 70%). In both processing conditions, recall was best for YNH, followed by ONH, and worst for OHL listeners. WARRM recall scores were significantly correlated with other memory measures. In addition, WARRM recall scores were correlated with results on the Words-In-Noise (WIN) test for the OHL listeners in the no processing condition and for ONH listeners in the alphabet processing condition. Differences in the WIN and recall scores of these groups are consistent with the interpretation that the OHL listeners found listening to be sufficiently demanding to affect recall even in the no processing condition, whereas the ONH group listeners did not find it so demanding until the additional alphabet processing task was added. Conclusions: These findings demonstrate the feasibility of incorporating an auditory memory test into a word-recognition test to obtain measures of both word recognition and working memory simultaneously. The correlation of WARRM recall with scores from other memory measures is evidence of construct validity. The observation of correlations between the WIN thresholds with each of the older groups and recall scores in certain processing conditions suggests that recall depends on listeners' word-recognition abilities in noise in combination with the processing demands of the task. The recall score provides additional information beyond the pure-tone audiogram and word-recognition scores that may help rehabilitative audiologists assess the listening abilities of patients with hearing loss.

Includes vita. / Professional research project (Au.D.)--University of South Florida, 2001. / Title from PDF of title page. / Document formatted into pages; contains 47 pages. / Includes bibliographical references. / Text (Electronic thesis) in PDF format. / ABSTRACT: The purpose of this project was to implement the newly revised International Classification of Functioning, Disability and Health (ICIDH-2) developed by the World Health Organization (WHO), to establish specific aural rehabilitation goals. Five graduate clinicians in speech language pathology and audiology interviewed ten participants with adult onset hearing loss. A modified version of the General Questions for Participation and Activities (i.e., a structured interview technique) from the ICIDH-2 Checklist, was developed. Prior to completing this checklist, the students attended a brief training session to become familiar with the major components of the ICIDH-2, specifically theICIDH-2 Checklist. / Completion of the ICIDH-2 Checklist, Version 2.1a, clinician form (prefinal draft, December 2000), allowed the students to classify and qualify disability and health according to the constructs of Activity and Participation, (i.e., what a person can and cannot do as a result of hearing loss and what a person does and does not do as a result of hearing loss, respectively). Following completion of Parts 2 (Activities and Participation) and 3 (Environmental Factors) of the Checklist for each of the ten clients interviewed, aural rehabilitation goals were developed. Four participants are highlighted to illustrate how the ICIDH-2 is used to objectify the impact of hearing loss and to establish specific treatment goals. / The results support the use of the modified version of the General Questions for Participation and Activities in development of aural rehabilitation goals for clients with adult onset hearing loss. Graduate clinicians demonstrated the ability to complete the checklist with little assistance, suggesting that the use of the ICIDH-2 by experienced clinicians should be a relatively easy task. Goal development was also a relatively easy task using the checklist ratings, and the ratings related directly to the individual participant's quality of life in their current situation. / System requirements: World Wide Web browser and PDF reader. / Mode of access: World Wide Web.

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.