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Internet Interventions for Hearing Loss: Examing rehabilitation, self-report measures and internet use for hearing-aid users
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In the future, audiological rehabilitation of adults with hearing loss will be more available, personalized and thorough due to the possibilities offered by the internet. By using the internet as a platform it is also possible to perform the process of rehabilitation in a cost-effective way. With tailored online rehabilitation programs containing topics such as communication strategies, hearing tactics and how to handle hearing aids it might be possible to foster behavioral changes that will positively affect hearing aid users.

Four studies were carried out in this thesis. The first study investigated internet usage among adults with hearing loss. In the second study the administration format, online vs. paper- and pencil, of four standardized questionnaires was evaluated. Finally two randomized controlled trials were performed evaluating the efficacy of online rehabilitation programs including professional guidance by an audiologist. The programs lasted over five weeks and were designed for experienced adult hearing-aid users. The effects of the online programs were compared with the effects of a control group.

It can be concluded that the use of computers and the internet overall is at least at the same level for people with hearing loss as for the general age-matched population in Sweden. Furthermore, for three of the four included questionnaires, the participants’ scores remained the same across formats. It is however recommended that the administration format remain consistent across assessment points. Finally, results from the two concluding intervention studies provide preliminary evidence that the internet can be used to deliver education and rehabilitation to experienced hearing aid users who report residual hearing problems and that their problems are reduced by the intervention; however the content and design of the online rehabilitation program requires further investigation.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2014. , 72 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1392Studies from the Swedish Institute for Disability Research, ISSN 1650-1128 ; 57
Keyword [en]
Counseling, hearing loss, hearing aids, rehabilitation of people with hearing loss, internet, outcome assessment, hearing aid satisfaction
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-103824DOI: 10.3384/diss.diva-103824ISBN: 978-91-7519-423-3 (print)OAI: oai:DiVA.org:liu-103824DiVA: diva2:691763
Public defence
2014-02-27, Berzeliussalen, Campus US, Linköpings universitet, Linköping, 13:00 (English)
Opponent
Supervisors
Available from: 2014-01-28 Created: 2014-01-28 Last updated: 2014-11-28Bibliographically approved
List of papers
1. Internet Access and Use in Adults With Hearing Loss
Open this publication in new window or tab >>Internet Access and Use in Adults With Hearing Loss
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2013 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 15, no 5, e91- p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

The future rehabilitation of adults with hearing loss is likely to involve online tools used by individuals at home. Online tools could also be useful for people who are not seeking professional help for their hearing problems. Hearing impairment is a disability that increases with age, and increased age is still associated with reduced use of the Internet. Therefore, to continue the research on online audiological rehabilitative tools for people with hearing loss, it is important to determine if and to what extent adults with hearing loss use the Internet.

OBJECTIVE:

To evaluate the use of the Internet and email in a group of adults with hearing loss and to investigate if their use of Internet and email differed between genders, among different age groups, and how it compared with the general population in Sweden.

METHODS:

Questionnaires containing multiple-choice questions about Internet access, email use, and educational level were mailed to individuals with hearing loss, who were registered as patients at a hearing aid clinic. Out of the 269 invited participants, 158 returned a completed questionnaire, which was a response rate of 58.7%.

RESULTS:

The results showed that 60% (94/158) of the participants with hearing loss used computers and the Internet. The degree of hearing loss in the group of participants did not explain the level of Internet usage, while factors of age, gender, and education did (P<.001). More men than women used the Internet (OR 2.54, 95% CI 1.32-4.91, P<.001). Use of the Internet was higher in the youngest age group (25-64 years) compared to the oldest age group (75-96 years, P=.001). A higher usage of the Internet was observed in the participants with hearing loss, especially the elderly, when compared with the general population of Sweden (OR 1.74, 95% CI 1.23-3.17, P=.04).

CONCLUSIONS:

We conclude that the use of computers and the Internet overall is at least at the same level for people with hearing loss as for the general age-matched population in Sweden, but that this use is even higher in specific age groups. These results are important for the future work in developing and evaluating rehabilitative educational online tools for adults with hearing loss.

Place, publisher, year, edition, pages
Journal of Medical Internet Research / JMIR Publications, Inc., 2013
Keyword
hearing loss, hearing rehabilitation, Internet, trends
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-96434 (URN)10.2196/jmir.2221 (DOI)000321960900019 ()23659867 (PubMedID)
Note

Funding Agencies|Oticon Foundation||Swedish Hard of Hearing Association (HRF)||

Available from: 2013-08-19 Created: 2013-08-19 Last updated: 2017-12-06Bibliographically approved
2. The use of research questionnaires with hearing impaired adults: online vs. paper-and-pencil administration
Open this publication in new window or tab >>The use of research questionnaires with hearing impaired adults: online vs. paper-and-pencil administration
2012 (English)In: BMC Ear, Nose and Throat Disorders, ISSN 1472-6815, E-ISSN 1472-6815, Vol. 12, no 12, 14- p.Article in journal (Refereed) Published
Abstract [en]

Background

When evaluating hearing rehabilitation, it is reasonable to use self-report questionnaires as outcome measure. Questionnaires used in audiological research are developed and validated for the paper-and-pencil format. As computer and Internet use is increasing, standardized questionnaires used in the audiological context should be evaluated to determine the viability of the online administration format.

The aim of this study was to compare administration of questionnaires online versus paper- and pencil of four standardised questionnaires used in hearing research and clinic. We included the Hearing Handicap Inventory for the Elderly (HHIE), the International Outcome Inventory for Hearing Aids (IOI-HA), Satisfaction with Amplification in Daily Life (SADL), and the Hospital Anxiety and Depression Scale (HADS).

Methods

A cross-over design was used by randomly letting the participants complete the questionnaires either online or on paper. After 3 weeks the participants filled out the same questionnaires again but in the other format. A total of 65 hearing-aid users were recruited from a hearing clinic to participate on a voluntary basis and of these 53 completed both versions of the questionnaires.

Results

A significant main effect of format was found on the HHIE (p < 0.001), with participants reporting higher scores on the online format than in the paper format. There was no interaction effect. For the other questionnaires were no significant main or interaction effects of format. Significant correlations between the two ways of presenting the measures was found for all questionnaires (p<0.05). The results from reliability tests showed Cronbachs α’s above .70 for all four questionnaires and differences in Cronbachs α between administration formats were negligible.

Conclusions

For three of the four included questionnaires the participants’ scores remained consistent across administrations and formats. For the fourth included questionnaire (HHIE) a significant difference of format with a small effect size was found. The relevance of the difference in scores between the formats depends on which context the questionnaire is used in. On balance, it is recommended that the administration format remain stable across assessment points.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-88084 (URN)10.1186/1472-6815-12-12 (DOI)
Available from: 2013-01-29 Created: 2013-01-29 Last updated: 2017-12-06
3. Rehabilitative Online Education versus Internet Discussion Group for Hearing Aid Users: A Randomized Controlled Trial
Open this publication in new window or tab >>Rehabilitative Online Education versus Internet Discussion Group for Hearing Aid Users: A Randomized Controlled Trial
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2011 (English)In: JOURNAL OF THE AMERICAN ACADEMY OF AUDIOLOGY, ISSN 1050-0545, Vol. 22, no 5, 274-285 p.Article in journal (Refereed) Published
Abstract [en]

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 handle 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 randomized controlled study with two groups of participants. Repeated measures at prestudy, 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 questionnaires administered online were used as outcome measures: (1) Hearing Handicap 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 Handicap 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 discussions could be a promising rehabilitation tool.

Place, publisher, year, edition, pages
American Academy of Audiology, 2011
Keyword
Counseling; duty to recontact; hearing loss; Internet; outcome assessment; rehabilitation of hearing impaired
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-69912 (URN)10.3766/jaaa.22.5.4 (DOI)000292679800004 ()
Available from: 2011-08-09 Created: 2011-08-08 Last updated: 2014-11-28
4. A randomized controlled trial evaluating the effects of online rehabilitative intervention for adult hearing-aid users
Open this publication in new window or tab >>A randomized controlled trial evaluating the effects of online rehabilitative intervention for adult hearing-aid users
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2014 (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 53, no 7, 452-461 p.Article in journal (Refereed) Published
Abstract [en]

Objective: Previous research shows that the internet can be used in the rehabilitation of hearing aid users. By further developing the online program, it might be possible to foster behavioral changes that will positively affect hearing aid users.

Design: A randomized controlled study with two groups of participants. The intervention group underwent a five-week online intervention while the control group was referred to a waiting-list. Questionnaires were used as outcome measures.

Study Sample: Seventy-six experienced hearing aid users participated in the study, ranging in age from 26 to 81 years (mean 69.3 years).

Results: The findings showed significant improvements in the intervention group after the intervention, measured by the Hearing Handicap Inventory for the Elderly. The effects were maintained and improved at the follow-up. Furthermore, the results indicated that the participants in the intervention group improved at two items of the International Outcome Inventory for Hearing Aids, and the effects were partly maintained at the followup. Finally, significant improvements in the domain of psychosocial wellbeing were found at the follow-up.

Conclusions: This study provides further evidence that the internet can be used to deliver intervention of rehabilitation to hearing aid users.

Place, publisher, year, edition, pages
Informa Healthcare, 2014
Keyword
Counseling, Hearing loss, Internet, Outcome assessment, Rehabilitation of hearing impaired
National Category
Health Sciences Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-103823 (URN)10.3109/14992027.2014.892643 (DOI)000337029000006 ()
Available from: 2014-01-28 Created: 2014-01-28 Last updated: 2017-12-06Bibliographically approved

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Sundewall Thorén, Elisabet

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