2nd Global Congress for Qualitative Health Research - Milan, Italy, 29-30 June 2012
Hearing it from both sides:
Identifying and comparing
hearing aid users’ and audiologists’
perspectives on optimal hearing aid use
Lisbeth Dons Jensen*
Ariane Laplante-Lévesque*
Claus Nielsen*
Piers Dawes†
*Eriksholm Research Centre, Denmark
†
University of Manchester , United Kingdom
Background
HEARING AID USE IS AN IMPORTANT TREATMENT OUTCOME OF HEARING AID REHABILITATION.
Conventionally, audiologists measure hearing aid use quantitatively (number of hours per day), with
extended hearing aid use time representing a better treatment outcome. However, hearing aid users have
very different use patterns and the amount of hearing aid use time varies greatly1. It has been observed
that hearing aid use time does not always correspond to hearing aid satisfaction2. This indicates that a
quantitative measure (hearing aid use time) is not sufficient for assessing the outcome of treatment.
In a clinical situation, the hearing aid user and the audiologist must have a common definition of optimal
hearing aid use, in order to set common goals for the rehabilitation process. However, there is no consensus
as to the qualitative variables on which to assess hearing aid use as a rehabilitation outcome. What is
optimal hearing aid use?
With the aim of establishing common ground for hearing aid users and audiologists with regard to the
definition of optimal hearing aid use, this study explored hearing aid users’ and audiologists’ perspectives on
optimal hearing aid use and the determinants of optimal hearing aid use.
This study explored hearing aid users’ and audiologists’
perspectives on optimal hearing aid use and its
determinants. Focus group methodology captured the
viewpoints and experiences of the two groups. Maximum
variation sampling and qualitative content analysis helped
establish contrast within and between hearing aid users’
and audiologists’ perspectives.
Why qualitative content
analysis (QCA)?
Why maximum variation
sampling?
MAXIMUM VARIATION SAMPLING3 was applied in the selection
of focus group participants to obtain data with a great coverage with
regard to diversity. This fit with our intention to explore the range of
perceptions of the central topic and to identify the universal core across
different subgroups and populations.
Why focus groups?
EXPLORATIVE DATA COLLECTION METHODOLOGY effectively
captures the variety of viewpoints between hearing aid users
and between audiologists. This reveals the participants’ different
positioning in a normative discussion about hearing aid use patterns.
Hearing aid user
•
•
•
•
Age
Gender
Level of education
Years of experience using
hearing aids
• Client in public or private
hearing care system
• Self-perceived hearing
problems
• Satisfaction with hearing
aids
Audiologist
•
•
•
•
Age
Gender
Level of education
Years of experience fitting
hearing aids
• Affiliation with public or
private hearing care system
QCA TIES WELL TOGETHER WITH FOCUS GROUP METHODOLOGY:
• Concrete and interpretative
• Good tool for summarizing all voices in a group rather than focus on
individual meaning making
• Provides good overview of the direct links between concrete raw
data and abstract headlines
• Ideal for making comparison between samples/populations
THE QUOTES PROBE
Fictive quotes representing typical use patterns and motivations
related to hearing aid use.
Focus group participants discussed whether they perceived these use
patterns and motivations to be examples of optimal hearing aid use or
not.
The participants each selected one quote, which to them represented
optimal hearing aid use and argued why they thought so.
AT NIGHT.
THE TIME I GO TO BED
THE MORNING UNTIL
THE TIME I GET UP IN
OR IN MY EARS.”
“I WEAR MY HEARING AIDS FROM
R ON MY BEDSIDE TABLE
MY HEARING AIDS ARE EITHE
“I WEAR MY HEARING AIDS ALL THE TIME BECAUSE THAT’S
“I WEAR MY
HEARING
WHAT MY AUDIOLOGIST TOLD ME TO DO.”
AIDS ONLY
UNTIL I AM
WHEN I GO
AT THE VE
TO MEET
NUE BEFO
INGS OR WH
RE PUTTING
EN I GO OU
MY HEAR
T WITH FR
ING
TO
AID
O
NOISY IN
S ON BECA
“SOM
IENDS. I WA
THE CAR
USE I FIN
IT
OR THE TR
ETIM
D MY HEAR
AIN.”
ING AIDS
ES I
FOR
GET
I AM
WE
ARIN
“I WEAR MY HEARING AIDS ALL THE TIME BECAUSE I KNOW
GM
IT KEEPS MY WIFE AND KIDS HAPPY.”
YH
EAR
ING
MANIFEST VERSUS LATENT CONTENT
QCA distinguishes between manifest and latent content. Focusing
on this distinction in the analysis highlighted the difference between
principles and everyday practice regarding hearing aid use. This
distinction is also central for the results.
AID
S.”
THE “MARY & JOHN” PROBE
The audiologists’ focus group were introduced to images of two fictive
hearing aid users, about whom the only information provided were that
they both used their hearing aids for 8 hours per day.
Questions:
• What else do you need to know to assess
whether this is optimal hearing aid use?
• How would you counsel these persons if
they were your clients?
• How might they differ in ways that would
make one of them more optimal than the
other?
Manifest content
Latent content
Definition of
term (inspired by
literature4)
What the text
‘says’ (concrete
statement in focus
group)
What the text ‘talks
about’ (what can be
interpreted from
narrative)
Example in this
study
Participants’
ideals and general
principles for
optimal hearing aid
use
Participants’
individual practices
and experiences
regarding hearing
aid use
Results
Eriksholm Research Centre
Rørtangvej 20
DK - 3070 Snekkersten
Phone +45 4829 8900
Hearing aid users and
audiologists stated several
determinants of hearing aid use
adhering to i) the hearing aid
user, ii) the audiologist, or iii) the
hearing aid.
Hearing aid users and audiologists mentioned
the same topics but had different opinions.
&
Hearing aid
users’ and
audiologists’
perspectives
were
concordant with regard to the importance of
the audiologist providing information to the
hearing aid user.
Hearing
aid users
emphasized
the hearing
aid as a
central determinant, whilst audiologists
emphasized the importance of a good useraudiologist relationship for achieving optimal
hearing aid use. This is a crucial point where
improved concordance between hearing aid
user and audiologist must be sought.
>
>
The core
perception
of optimal
hearing aid
use is extended hearing aid use and
the user achieving a benefit from that.
However, optimal hearing aid use is above all
individual. Hearing aid users acknowledge
an ideal principle of optimal hearing aid use,
while in their daily lives they deviate from this
principle to meet their individual needs.
+ BENEFIT
Information
Lisbeth Dons Jensen
Eriksholm Research Centre
[email protected]
Scan to download this poster >
www.eriksholm.com
1 Staehelin, K, Bertoli, S, Probst, R, et al. (2011). Gender and hearing aids: Patterns of use and determinants of nonregular use. Ear & Hearing, 32, e26-e37. 2 Laplante-Lévesque, A, Knudsen, LV, Preminger, JE et al. (2012). Hearing help-seeking and rehabilitation: Perspectives of adults with hearing impairment. International Journal of Audiology, 51, 93-102. 3 Sandelowski, M. (2000). Focus on research methods: Whatever happened to qualitative description?
Research in Nursing & Health, 23, 334-340. 4 Graneheim, UH, Lundman, B. (2004). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 105-112.