|Ng, Ho Yee
|Determinants of hearing aid adoption and use among Chinese elderly in Hong Kong
|Loke Yuen, Alice (SN)
|Hong Kong Polytechnic University -- Dissertations
Older people -- China -- Hong Kong
|Faculty of Health and Social Sciences
|xiv, 187 pages : color illustrations
|Background: Presbycusis is a common sensory disorder among elderly and is becoming an important public health issue globally alongside the ageing population. The focus of audiology practice is primarily on the diagnosis and intervention of hearing loss as a physical disability. The introduction of the International Classification of Functioning, Disability, and Health (ICF) by the World Health Organization casts light on the fact that hearing loss in the elderly is not only defined by the audiogram, but also the contextual factors in the social environment of an individual. Despite the known benefits associated with hearing aid usage, hearing aid adoption and use among individuals with presbycusis remained low. Study aim: Hearing aid usage is a trajectory consisting of a series of health behaviors including acknowledging the need to seek help, deciding to adopt hearing aid, and continual regular use. By adopting the Trans-theoretical Model (TTM) as a conceptual framework, the present study aims at identifying the determinants of hearing aid adoption and use in a local elderly sample in Hong Kong. Methods: A cross-sectional survey. A questionnaire was developed to solicit information including: the severity of hearing loss, self-perceived hearing problem, expectation relevant to stigma, social support, self-perceived benefit, satisfaction, demographics as well as environmental and personal factors. The study recruited ethnic Chinese, aged 60 years or above, with disabling symmetrical sensorineural hearing loss, from a large private audiology practice group in Hong Kong.
Results: The study sample comprised 109 elderly, with 86 of them (78.9%) wore hearing aid. Among the study participants with hearing aids, 75.6% were using behind-the-ear style; and 37.2% adopted binaural hearing aid. Two binary logistic regression analyses were conducted to identify significant predictors for hearing aid adoption and regular hearing aid use respectively. The significant predictors of hearing aid adoption were: perceived support from significant others on hearing aid use, shopping as daily activities, perceived hearing difficulties in restaurant, main source of current income other than children support, and severity of hearing loss. The significant predictors of regular hearing aid use were: impact on others, positive effects of amplification, severity of hearing loss, coupling with the suppression effect of morning walk as daily activities. Conclusion: The findings of this study highlighted the importance to address non-audiological factors in the clinical management of presbycusis. Specifically, perceived support from significant others on hearing aid use was identified as a strong predictor for hearing aid adoption among the elderly in Hong Kong. In addition, impact on others has been found to be a strong predictor for longer daily hours of hearing aid use after adoption. The study results underline the potentials for significant others to play an important role in different stages of the trajectory of hearing aid adoption and use, as shown in the temporal schema developed in accordance with the TTM. To optimize hearing aid usage among individuals with presbycusis, audiology practitioners could involve significant others in information provision and reassurance prior to hearing aid adoption and consider various aspects of third-party disability in the management of presbycusis.
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