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  • 201.
    Rönnberg, Niklas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
    Rudner, Mary
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
    Adverse listening conditions affect short-term memory storage and processing of speech for older adults with hearing impairmentManuscript (preprint) (Other academic)
    Abstract [en]

    Purpose: Previous work has shown an effect of noise type on memory for intelligible speech. The aim ofthis study was to investigate the effect of background noise on memory performance of intelligible speech for older adults with hearing impairment using the Auditory Inference Span Test (AIST).

    Method: Twenty participants with ages between 67 and 80 years with symmetrical hearing loss (29 to 47dB HL) performed the AIST, which requires processing of five-word sentences at three memoryload levels (MLLs) in three listening conditions: Quiet, steady-state noise (SSN), and backgroundvoices (ISTS). Individualized SNRs targeted 90% speech intelligibility. AIST performance reflects the amount of cognitive capacity occupied in listening, and consequently indicates the amount of listening effort. Working memory capacity (WMC) was assessed using the reading span test, and updating ability (UA) was assessed using the letter memory test.

    Results: AIST performance decreased in background noise and with increasing MLL. It was related to UA and age but not to WMC. Response times on questions designed to probe sentence recognition increased with the addition of background noise.

    Conclusions: The results demonstrate that the addition of background noise requires more cognitive resourcesto maintain speech recognition performance, leading to higher demands on the cognitive capacity,higher listening effort as measured by poorer memory performance, and longer AIST responsetimes. However, the type of background noise, SSN or ISTS, affected memory performance similarly.

  • 202.
    Rönnberg, Niklas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Linköping University, The Swedish Institute for Disability Research.
    Rudner, Mary
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Eriksholm Research Centre, Oticon A/S, Snekkersten.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Linköping University, The Swedish Institute for Disability Research.
    Assessing listening effort by measuring short-term memory storage and processing of speech in noise2014In: Speech, Language and Hearing, ISSN 2050-5728, Vol. 17, no 3, p. 123-132Article in journal (Refereed)
    Abstract [en]

    Objective

    The aim of this study was to investigate the effect of working memory capacity (WMC) and updating ability (UA) on listening effort measured using a new test, the Auditory Inference Span Test (AIST), as an objective measure of listening effort.

    Design

    The AIST is based on Swedish five-word sentences and taps into three memory load levels (MLLs). It was administered in stationary speech-shaped noise at −2, −4, and −6 dB signal-to-noise ratio (SNR). WMC was assessed using the reading span test, and UA was assessed using the letter memory test. We also collected data on speech-in-noise performance and subjectively rated listening effort at the three SNRs.

    Study sample

    Thirty-nine participants with normal hearing thresholds (≤20 dB HL for 250 to 4000 Hz) took part in the study.

    Results

    AIST performance decreased with increasing MLL and was related to WMC and UA. Participants with high WMC performed better than those with low WMC at more favorable SNRs. Participants with high UA performed better than participants with low UA at the intermediate MLL, which made particular demands on the UA. Neither speech recognition scores nor subjectively rated listening effort was associated with AIST performance or either of the cognitive variables.

    Conclusion

    AIST taps into cognitive functions necessary for understanding speech in noise. However, in its current form AIST may be too cognitively taxing to successfully measure graded listening effort in participants with lower cognitive capacity.

  • 203.
    Rönnberg, Niklas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Linköping University, The Swedish Institute for Disability Research.
    Rudner, Mary
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Oticon Research Centre Eriksholm, Denmark.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
    Memory performance on the Auditory Inference Span Test is independent of background noise type for young adults with normal hearing at high speech intelligibility2014In: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 5, no 1490Article in journal (Refereed)
    Abstract [en]

    Listening in noise is often perceived to be effortful. This is partly because cognitive resources are engaged in separating the target signal from background noise, leaving fewer resources for storage and processing of the content of the message in working memory. The Auditory Inference Span Test (AIST) is designed to assess listening effort by measuring the ability to maintain and process heard information. The aim of this study was to use AIST to investigate the effect of background noise types and signal-to-noise ratio (SNR) on listening effort, as a function of working memory capacity (WMC) and updating ability (UA). The AIST was administered in three types of background noise: steady-state speech-shaped noise, amplitude modulated speech-shaped noise, and unintelligible speech. Three SNRs targeting 90% speech intelligibility or better were used in each of the three noise types, giving nine different conditions. The reading span test assessed VVMC, while UA was assessed with the letter memory test. Twenty young adults with normal hearing participated in the study. Results showed that AIST performance was not influenced by noise type at the same intelligibility level, but became worse with worse SNR when background noise was speech-like. Performance on AIST also decreased with increasing memory load level. Correlations between AIST performance and the cognitive measurements suggested that WMC is of more importance for listening when SNRs are worse, while UA is of more importance for listening in easier SNRs. The results indicated that in young adults with normal hearing, the effort involved in listening in noise at high intelligibility levels is independent of the noise type. However, when noise is speech-like and intelligibility decreases, listening effort increases, probably due to extra demands on cognitive resources added by the informational masking created by the speech fragments and vocal sounds in the background noise.

  • 204.
    Rönnberg, Niklas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Rudner, Mary
    Linköping University, Department of Behavioural Sciences and Learning, Cognition, Development and Disability. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research.
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences. Linköping University, Department of Behavioural Sciences and Learning, Cognition, Development and Disability. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research.
    An objective measure of listening effort: The Auditory Inference Span Test2011Conference paper (Refereed)
    Abstract [en]

    One aim of hearing aid fitting is to ease the patient’s effort in understanding speech, i.e. the listening effort needed to perceive speech in different sound environments. To obtain a good hearing aid fitting, knowledge about the patient’s auditory as well as cognitive abilities seems to be important. However, listening effort is usually not included as a fitting criterion, partly as it is not clear how to measure listening effort objectively.

    The Auditory Inference Span Test (AIST) is a dual-task hearing-in-noise test, that combines auditory and memory processing. The basis for the test is that when more cognitive resources are required for understanding speech, less cognitive resources are available for storage and processing of the speech information. In AIST, Hagerman sentences are presented in noise and the subject is required to recall and process the sentence information. Recall ability is tested with different cognitive loads. Button-press responses are recorded and used as an estimate of listening effort. In a pilot study, listeners showed decreasing accuracy with increasing cognitive load and longer reaction time at maximum cognitive load, suggesting that the test may be suited as a clinical test for listening effort.

    In an ongoing study, the AIST is being evaluated in relation to other auditory and cognitive measures: baseline audiometry (audiogram) and speech in noise test (Hagerman sentences) as well as text based dual processing and storage test (reading span) and updating (letter memory test), as well as subjective rating of listening effort. Data from this study will be presented.

  • 205.
    Rönnberg, Niklas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Rudner, Mary
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Frequency discrimination and human communication2013Conference paper (Other academic)
    Abstract [en]

    The voice is the most common means of communication and tends to change, sliding up and down the pitch scale when forming phonemes and words, as different emotions and thoughts are expressed. Therefore the ability to discriminate frequencies is of importance for speech intelligibility in a communication situation. Furthermore, this ability is also of importance in speech recognition in noise, by separating the target and noise by spectral and temporal differences of the sources. The choice of rehabilitation is crucial for the frequency discrimination ability. Cochlear implants, for example, lack the ability to pass the temporal fine structure of acoustic waves to the auditory nerve, which in turn lead to reduced precision of phase locking, inferior frequency discrimination ability, and a relatively poor ability to understand speech when background sounds are present.The aim of the study is to investigate how frequency discrimination and temporal resolution abilities interact with performance in speech recognition in noise using a psychoacoustic, speech, and cognitive test battery. These tests will give insight to interactions between performance and hearing status, type of rehabilitation(hearing aid, cochlear implant, and electro-acoustic stimulation), cognitive capacity, and language ability. It is hypothesized that normal hearing participants have a better frequency discrimination ability than hearing impaired participants and by that, better understanding of speech. It is also hypothesized that type of rehabilitation effects performance on frequency discrimination, and that this performance correlates with speech recognition in noise. Finally, it is hypothesized that cognitive capacity and language ability can, to some extent, compensate for loss of frequency resolution in the peripheral auditory system. Preliminary results from the study will be presented and discussed.

  • 206.
    Rönnberg, Niklas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Rudner, Mary
    Linköping University, Department of Behavioural Sciences and Learning, Cognition, Development and Disability. Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Department of Behavioural Sciences and Learning, Cognition, Development and Disability. Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Health Sciences.
    Testing listening effort for speech comprehension2011Conference paper (Other academic)
    Abstract [en]

    One aim of hearing aid fitting is to reduce the effort of understanding speech, especially in noisy environments. For a good hearing aid fitting, knowledge about the patient’s auditory abilities is necessary, but knowledge about cognitive abilities may also be important.

     

    The Auditory Inference Span Test (AIST) is a dual-task hearing-in-noise test, that combines auditory and memory processing. In AIST, Hagerman sentences are presented in steady state speech-shaped noise at -2dB, -4dB or -6dB SNR and the subject is required to recall and process the information from the sentences by giving button-press responses to multiple-choice questions thereby assessing what the subject could infer from what was heard.

     

    AIST will be administered to 40 normal hearing subjects (29 to date) and performance related to speech reception threshold, working memory capacity and updating ability, as well as subjective rating of listening effort. Preliminary results show a greater SNR-related improvement in AIST scores at low SNRs than can be explained by improved audibility alone, consistent with release of memory resources due to reduced listening effort. There is also a trend towards a positive relationship between AIST scores and individual working memory capacity and updating ability.

  • 207.
    Rönnberg, Niklas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Rudner, Mary
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Testing listening effort for speech comprehension2012In: Speech Perception and Auditory Disorders, Danavox Jubilee Foundation , 2012, p. 73-80Chapter in book (Other academic)
  • 208.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon A/S, Helsingor, Denmark.
    Ng, Elaine
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Lidestam, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Zekveld, Adriana
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. VU University Medical Center, Amsterdam, Netherlands.
    Sörqvist, Patrik
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. University of Gävle, Gävle, Sweden.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Träff, Ulf
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Yumba, Wycliffe
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Classon, Elisabet
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, The Swedish Institute for Disability Research.
    Hällgren, Mathias
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Larsby, Birgitta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, The Swedish Institute for Disability Research.
    Signoret, Carine
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Pichora-Fuller, Kathleen
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. University of Toronto, Toronto, Canada.
    Rudner, Mary
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Danielsson, Henrik
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Rönnberg, Jerker
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Auditory, signal processing, and cognitive factors  influencing  speech  perception  in  persons with hearing loss fitted with hearing aids – the N200 study2016Conference paper (Other academic)
    Abstract [en]

    Objective: The aim of the current study was to assess aided speech-in-noise outcomes and relate those measures to auditory sensitivity and processing, different types of cognitive processing abilities, and signal processing in hearing aids.

    Material and method: Participants were 200 hearing-aid wearers, with a mean age of 60.8 years, 43% females, with average hearing thresholds in the better ear of 37.4 dB HL. Tests of auditory functions were hearing thresholds, DPOAEs, tests of fine structure processing, IHC dead regions, spectro-temporal modulation, and speech recognition in quiet (PB words). Tests of cognitive processing function were tests of phonological skills, working memory, executive functions and inference making abilities, and general cognitive tests (e.g., tests of cognitive decline and IQ). The outcome test variables were the Hagerman sentences with 50 and 80% speech recognition levels, using two different noises (stationary speech weighted noise and 4-talker babble), and three types of signal processing (linear gain, fast acting compression, and linear gain plus a non-ideal binary mask). Another sentence test included typical and atypical sentences with contextual cues that were tested both audio-visually and in an auditory mode only. Moreover, HINT and SSQ were administrated.

    Analysis: Factor analyses were performed separate for the auditory, cognitive, and outcome tests.

    Results: The auditory tests resulted in two factors labeled SENSITIVITY and TEMPORAL FINE STRUCTURE, the cognitive tests in one factor (COGNITION), and the outcome tests in the two factors termed NO CONTEXT and CONTEXT that relates to the level of context in the different outcome tests. When age was partialled out, COGNITION was moderately correlated with the TEMPORAL FINE STRUCTURE and NO CONTEXT factors but only weakly correlated with the CONTEXT factor. SENSITIVITY correlated weakly with TEMPORAL FINE STRUCTURE and CONTEXT, and moderately with NO CONTEXT, while TEMPORAL FINE STRUCTURE showed weak correlation with CONTEXT and moderate correlation with NO CONTEXT. CONTEXT and NO CONTEXT had a  moderate correlation. Moreover, the overall results of the Hagerman sentences showed 0.9 dB worse SNR with fast acting compression compared with linear gain and 5.5 dB better SNR with linear  gain and noise reduction compared with only linear gain.

    Conclusions: For hearing aid wearers, the ability to recognize speech in noise is associated with both sensory and cognitive processing abilities when the speech materials have low internal context. These associations are less prominent when the speech material has contextual cues.

  • 209.
    Sundewall Thoren, Elisabet
    et al.
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Öberg, Marie
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Internet Interventions for Hearing Loss2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, p. 316-319Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of the two studies presented in this research forum article was to develop audiological rehabilitation programs for experienced hearing aid users and evaluate them in online versions. In this research forum article, the differences between the two studies are discussed. Method: Two randomized controlled trials (RCTs) were performed evaluating the efficacy of online rehabilitation, including professional guidance by an audiologist. In each RCT, the effects of the online programs were compared with the effects measured in a control group. Results: The results from the first RCT showed a significant increase in activity and participation for both groups with participants in the intervention group improving more than those in the control group. At the 6-month follow-up, after the study, the significant increase was maintained; however, amounts of increase in the two groups were no longer significantly different. The results from the second RCT showed significant increase in activity and participation for the intervention group, although the control group did not improve. Conclusions: The results from the RCTs provide evidence that the Internet can be used to deliver rehabilitation to hearing-aid users and that their problems are reduced by the intervention; however, the content of the online rehabilitation program requires further investigation.

  • 210.
    Sundewall Thorén, Elisabet
    et al.
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark .
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark .
    The use of research questionnaires with hearing impaired adults: online vs. paper-and-pencil administration2012In: BMC Ear, Nose and Throat Disorders, ISSN 1472-6815, E-ISSN 1472-6815, Vol. 12, no 12, p. 14-Article in journal (Refereed)
    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.

  • 211.
    Sundewall Thorén, Elisabet
    et al.
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Lunner, Thomas
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Professional online rehabilitation of hearing-impaired adults2012Conference paper (Other academic)
  • 212.
    Sundewall Thorén, Elisabet
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Svensson, Monica
    Lund University.
    Tornqvist, Anna
    Lund University.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Carlbring, Per
    Umeå University.
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Online self-help via a controlled discussion forum2009In: Binaural Processing and Spatial Hearing, Ballerup: The Danavox Jubilee Foundation , 2009Conference paper (Other academic)
    Abstract [en]

    Recent studies on hearing rehabilitation with group discussions show similar long-term benefits as conventional professional counselling (Abrams et al., 2002; Hickson et al., 2007). The use of professional support for self-help via Internet may reduce anxiety and depression (Andersson et al., 2005). Inspired by those results, we created an online discussion forum for self-help where 29 experienced hearing-aid users communicated, on their own for five weeks. Each week they started the discussions from a given topic, without any professional assistance. We measured their reported subjective hearing problems online using standardized questionnaires (HHIE, IOI-HA and SADL) pre and post the online intervention. The findings show that the participants reduced their reported subjective hearing problems significantly by taking part in the discussions. Six months after the online intervention was finished the significant reduction was persistent.

    By using manifest qualitative content analysis of the participants’ online communication we will present results including typical categories and themes in the discussions, as well as peer-to-peer helping behavior.

    The findings indicates that interacting with peers have a positive significant effect on the long-term outcome of their hearing rehabilitation. Further development of this tool could be a very useful instrument in the rehabilitation of hearing impaired adults.

     

    References: Abrams, H., Chisholm., T. H., McArdle, R. (2002). A cost-utility analysis of adults group audiologic rehabilitation: Are the benefits worth the cost? Journal of Rehabilitation Research and Development, 5, 549-558.

    Andersson, G., Bergström, J., Carlbring, P., Lindefors, N. (2005). The use of internet in the treatment of anxiety disorders. Current opinion in Psychiatry, 18, 73-77.

    Hickson, L., Worrall, L., Scarinci, N. (2007). A randomized controlled trial evaluating the Active Communication Education program for older people with hearing impairment. Ear and Hearing, 28, 212-230.

  • 213.
    Sundewall Thorén, Elisabet
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology.
    Svensson, Monica
    Lund University.
    Tornqvist, Anna
    Lund University.
    Andersson, Gerhard
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Psychology.
    Carlbring, Per
    Umeå University.
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Rehabilitative Online Education versus Internet Discussion Group for Hearing Aid Users: A Randomized Controlled Trial2011In: JOURNAL OF THE AMERICAN ACADEMY OF AUDIOLOGY, ISSN 1050-0545, Vol. 22, no 5, p. 274-285Article in journal (Refereed)
    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.

  • 214.
    Thorén, Elisabet
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Wänström, Gunilla
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    A randomized controlled trial evaluating the effects of online rehabilitative intervention for adult hearing-aid users2014In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 53, no 7, p. 452-461Article in journal (Refereed)
    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.

  • 215.
    Thorén, Elisabet
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Wänström, Gunilla
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Internet Access and Use in Adults With Hearing Loss2013In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 15, no 5, p. e91-Article in journal (Refereed)
    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.

  • 216.
    Vlaescu, George
    et al.
    Linköping University, Sweden.
    Carlbring, Per
    University of Stockholm, Sweden.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Denmark; Karolinska Institute, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    An E-Platform for Rehabilitation of Persons With Hearing Problems2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, p. 271-275Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this research forum article was to describe a feasible web-based solution for improving the quality of life of persons with hearing problems, such as hearing loss or tinnitus. The online platform was developed at the Department of Behavioural Sciences and Learning at Linkoping University, Sweden, and has been running for a number of years and used in numerous studies and treatments. Method: The security aspects of the platform as well as the process flow for running a study or treatment are described, focusing primarily on the technical and practical considerations. Also presented are the design characteristics and the main features and functions available in the platform. Results: We point out the many advantages of running Internet-assisted intervention treatments, the challenges that we have faced, and some intended developments. Many of our research colleagues, both from Sweden and other countries, have already implemented or intend to implement their own studies on this platform. Conclusions: Audiological rehabilitation can be delivered via the Internet using a stable online platform. Security and usability are important factors to have in mind for the design as well as adaptability to the patients. A next development step is to implement and test blended treatments using video conferencing inside the platform.

  • 217.
    Wang, DeLiang
    et al.
    Ohio State University, Columbus, USA .
    Kjems, Ulrik
    Oticon A/S, Smørum, Denmark .
    Pedersen, Michael S
    Oticon A/S, Smørum, Denmark .
    Boldt, Jesper B
    Oticon A/S, Smørum, Denmark .
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences. Oticon Research Centre Eriksholm, Snekkersten, Denmark.
    Speech intelligibility improvements in noise with ideal binary time-frequency masking2008Conference paper (Other academic)
  • 218.
    Wang, DeLiang
    et al.
    Ohio State University, USA.
    Kjems, Ulrik
    Oticon A/S, Smørum, Denmark .
    Pedersen, Michael S
    Oticon A/S, Smørum, Denmark .
    Boldt, Jesper B
    Oticon A/S, Smørum, Denmark .
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences. Oticon Research Centre Eriksholm, Snekkersten, Denmark .
    Speech intelligibility in background noise with ideal binary time-frequency masking2009In: Journal of the Acoustical Society of America, ISSN 0001-4966, E-ISSN 1520-8524, Vol. 125, no 4, p. 2336-2347Article in journal (Refereed)
    Abstract [en]

    Ideal binary time-frequency masking is a signal separation technique that retains mixture energy in time-frequency units where local signal-to-noise ratio exceeds a certain threshold and rejects mixture energy in other time-frequency units. Two experiments were designed to assess the effects of ideal binary masking on speech intelligibility of both normal-hearing (NH) and hearing-impaired (HI) listeners in different kinds of background interference. The results from Experiment 1 demonstrate that ideal binary masking leads to substantial reductions in speech-reception threshold for both NH and HI listeners, and the reduction is greater in a cafeteria background than in a speech-shaped noise. Furthermore, listeners with hearing loss benefit more than listeners with normal hearing, particularly for cafeteria noise, and ideal masking nearly equalizes the speech intelligibility performances of NH and HI listeners in noisy backgrounds. The results from Experiment 2 suggest that ideal binary masking in the low-frequency range yields larger intelligibility improvements than in the high-frequency range, especially for listeners with hearing loss. The findings from the two experiments have major implications for understanding speech perception in noise, computational auditory scene analysis, speech enhancement, and hearing aid design.

  • 219.
    Wang, DeLiang
    et al.
    Department of Computer Science & Engineering, and Center for Cognitive Science, The Ohio State University, Columbus, USA.
    Kjems, Ulrik
    Oticon A/S, Smørum, Denmark .
    Pedersen, Michael S
    Oticon A/S, Smørum, Denmark.
    Boldt, Jesper B
    Oticon A/S, Smørum, Denmark.
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences. Oticon Research Centre Eriksholm, Snekkersten, Denmark and Department of Clinical and Experimental Medicine, and Technical Audiology, Linköping University, S-58183 Linköping, Sweden .
    Speech perception of noise with binary gains2008In: Journal of the Acoustical Society of America, ISSN 0001-4966, E-ISSN 1520-8524, Vol. 124, no 4, p. 2303-2307Article in journal (Refereed)
    Abstract [en]

    For a given mixture of speech and noise, an ideal binary time-frequency mask is constructed by comparing speech energy and noise energy within local time-frequency units. It is observed that listeners achieve nearly perfect speech recognition from gated noise with binary gains prescribed by the ideal binary mask. Only 16 filter channels and a frame rate of 100Hz are sufficient for high intelligibility. The results show that, despite a dramatic reduction of speech information, a pattern of binary gains provides an adequate basis for speech perception

  • 220.
    Wang, Yang
    et al.
    VU University Medical Center, ENT/audiology.
    Zekveld, Adriana
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, The Swedish Institute for Disability Research. VU University Medical Center, ENT/audiology.
    Naylor, Graham
    Snekkersten, Oticon A/S, Eriksholm Research Centre.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Snekkersten, Oticon A/S, Eriksholm Research Centre.
    Ohlenforst, Barbara
    The Netherlands, VU University Medical Center, ENT/audiology.
    Koelewijn, Thomas
    VU University Medical Center, ENT/audiology.
    Kramer, Sophia E.
    VU University Medical Center, ENT/audiology.
    The Pupil Light Reflex and its possible connection to Hearing Impairment2015Conference paper (Other academic)
  • 221.
    Wang, Yang
    et al.
    Vrije University of Amsterdam Medical Centre, Netherlands; Vrije University of Amsterdam Medical Centre, Netherlands; Oticon AS, Denmark.
    Zekveld, Adriana
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences. Vrije University of Amsterdam Medical Centre, Netherlands.
    Naylor, Graham
    MRC CSO Institute Hearing Research, Scotland.
    Ohlenforst, Barbara
    Vrije University of Amsterdam Medical Centre, Netherlands;Oticon AS, Denmark.
    Jansma, Elise P.
    Vrije University of Amsterdam, Netherlands.
    Lorens, Artur
    Institute Physiol and Pathol Hearing, Poland.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Oticon AS, Denmark.
    Kramer, Sophia E.
    Vrije University of Amsterdam Medical Centre, Netherlands.
    Parasympathetic Nervous System Dysfunction, as Identified by Pupil Light Reflex, and Its Possible Connection to Hearing Impairment2016In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 4, p. e0153566-Article in journal (Refereed)
    Abstract [en]

    Context Although the pupil light reflex has been widely used as a clinical diagnostic tool for autonomic nervous system dysfunction, there is no systematic review available to summarize the evidence that the pupil light reflex is a sensitive method to detect parasympathetic dysfunction. Meanwhile, the relationship between parasympathetic functioning and hearing impairment is relatively unknown. Objectives To 1) review the evidence for the pupil light reflex being a sensitive method to evaluate parasympathetic dysfunction, 2) review the evidence relating hearing impairment and parasympathetic activity and 3) seek evidence of possible connections between hearing impairment and the pupil light reflex. Methods Literature searches were performed in five electronic databases. All selected articles were categorized into three sections: pupil light reflex and parasympathetic dysfunction, hearing impairment and parasympathetic activity, pupil light reflex and hearing impairment. Results Thirty-eight articles were included in this review. Among them, 36 articles addressed the pupil light reflex and parasympathetic dysfunction. We summarized the information in these data according to different types of parasympathetic-related diseases. Most of the studies showed a difference on at least one pupil light reflex parameter between patients and healthy controls. Two articles discussed the relationship between hearing impairment and parasympathetic activity. Both studies reported a reduced parasympathetic activity in the hearing impaired groups. The searches identified no results for pupil light reflex and hearing impairment. Discussion and Conclusions As the first systematic review of the evidence, our findings suggest that the pupil light reflex is a sensitive tool to assess the presence of parasympathetic dysfunction. Maximum constriction velocity and relative constriction amplitude appear to be the most sensitive parameters. There are only two studies investigating the relationship between parasympathetic activity and hearing impairment, hence further research is needed. The pupil light reflex could be a candidate measurement tool to achieve this goal.

  • 222.
    Weineland, Sandra
    et al.
    Linköping University.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Oticon AS, Denmark.
    Carlbring, Per
    Stockholm University, Sweden.
    Hesser, Hugo
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Ingo, Elisabeth
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Molander, Peter
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Nordqvist, Peter
    Horselskadades Riksforbund, Sweden.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Bridging the Gap Between Hearing Screening and Successful Rehabilitation: Research Protocol of a Randomized Controlled Trial of Motivational Interviewing via Internet2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, p. 302-306Article in journal (Refereed)
    Abstract [en]

    Purpose: Studies point to low help-seeking after a failed hearing screening. This research forum article presents the research protocol for a randomized controlled trial of motivational interviewing via the Internet to promote help-seeking in people who have failed an online hearing screening. Method: Adults who fail a Swedish online hearing screening, including a speech-in-noise recognition test, will be randomized to either an intervention group (participating in motivational interviewing) or an active control group (reading a book on history of hearing aids). Both of the conditions will be delivered via the Internet. The primary outcome is experience with seeking health care and using hearing aids 9 months after the intervention. Secondary outcomes are changes in before and after measures of self-reported hearing difficulties, anxiety, depression, and quality of life. Stages of change and self-efficacy in hearing help-seeking are measured immediately after intervention and at a 9-month follow-up for the purpose of mediation analysis. Results: The results of this randomized controlled trial may help bridge the gap between hearing screening and successful hearing rehabilitation. Conclusion: Although no large instantaneous benefits are expected, a slow change toward healthy behaviors-seeking health care and using hearing aids-would shed light on how to use the Internet to assist people with hearing impairment.

  • 223.
    Wendt, Dorothea
    et al.
    Snekkersten, Oticon A/S, Eriksholm Research Centre.
    Koelewijn, Thomas
    VU University Medical Center, ENT/audiology.
    Zekveld, Adriana
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, The Swedish Institute for Disability Research. VU University Medical Center, ENT/audiology.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Snekkersten, Oticon A/S, Eriksholm Research Centre.
    Investigating the effect of competing talkers on speech processing load as shown by task invoked pupil-dilation2015Conference paper (Other academic)
  • 224.
    Wänström, Gunilla
    et al.
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Rydberg, Emelie
    Swedish Institute for Disability Research, School of Health and Medical Science, Linnaeus Centre HEAD, Örebro University.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    The psychological process from avoidance to acceptance in adults with acquired hearing impairment2014In: Hearing, Balance and Communication, ISSN 2169-5717, Vol. 12, no 1, p. 27-35Article in journal (Refereed)
    Abstract [en]

    Objective: This study explored the psychological process from avoidance to acceptance in adults with acquired hearing impairment. Study design: A descriptive qualitative interview study was conducted in Sweden in 2010. Participants were 18 adults with an acquired sensorineural hearing impairment aged 50-70 years, who had recently obtained hearing aids at the Audiology Clinic of the Örebro University Hospital. The sample included both first-time hearing aid users (n = 10) and experienced hearing aid users (n = 8). Each participant took part in one semi-structured interview. Qualitative content analysis was performed on the manifest content of the interview transcripts. Results: Participants described the process from avoidance to acceptance as a slow and gradual process rooted in the awareness of the frequency and severity of hearing disability and of its psychological consequences. Facilitators included adaptive coping mechanisms, other peoples comments and positive experiences, accessibility of help-seeking and routine health assessments. In contrast, barriers included maladaptive coping mechanisms and stigma. Conclusions: Participants described the process of acceptance as a personal process that involved, to some extent, their social network of family, friends and colleagues. It was also a trade-off between the consequences of untreated hearing impairment and the threat to normal identity that, through stigma, hearing impairment carries. Further studies are needed to fully investigate the role of access to information on hearing impairment acceptance. How professionals and society can facilitate the process of acceptance should also be a focus of future research efforts. 

  • 225.
    Öberg, Marie
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology . Linköping University, Faculty of Health Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Wänström, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology . Linköping University, Faculty of Health Sciences.
    The effects of a pre-fitting intervention on hearing aid benefit:a randomized controlled trial2009In: Audiological Medicine, ISSN 1651-386X, E-ISSN 1651-3835, Vol. 7, no 4, p. 211-215Article in journal (Other (popular science, discussion, etc.))
    Abstract [en]

    Thirty-nine first time hearing aid users with mild to moderate hearing losses were randomly assigned to a pre-fitting intervention group (N=19) or a control group (N=20). The pre-fitting intervention consisted of three weekly visits, where the user adjusted the amplification of an experimental hearing aid to preferred settings, and wore the aid between the visits. After the pre-fitting intervention phase, both groups received conventional hearing aid fitting. Standardized questionnaires (IOI-HA, HHIE, ECHO, SADL, HADS) were administered before and after pre-fitting intervention, after conventional hearing aid fitting, and at one-year follow-up. Hearing aid success was evaluated by an independent audiologist at the one- year follow-up appointment. The pre-fitting intervention phase showed positive effects for the intervention group but not for the control group on activity limitation and participation restriction, and expectations. However, the intervention in its current version had no lasting effects beyond the control group after conventional hearing aid fitting or after a year. Furthermore, both groups showed mostly successful hearing aid fittings, improved psychosocial well-being, quality of life, and reduced participation restriction.

  • 226.
    Öberg, Marie
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Wänström, Gunilla
    Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    The effects of a sound awareness pre-fitting intervention: A randomized controlled trial2008In: Audiological Medicine, ISSN 1651-386X, E-ISSN 1651-3835, Vol. 6, no 6, p. 129-140Article in journal (Refereed)
    Abstract [en]

    The objective of the study was to evaluate the effects of an individual pre-fitting intervention for first-time hearing aid users. Thirty-eight hearing impaired adults were randomly assigned to a sound awareness pre-fitting intervention (n=19) or to a control group (n=19). The purpose of the sound awareness training was to facilitate the users' acclimatization to amplified sound. The pre-fitting intervention consisted of three visits and was followed by conventional hearing aid fitting that was identical for both groups. Standardized questionnaires were administered before and after the pre-fitting intervention, after the conventional hearing aid fitting, and at a one-year follow-up. The follow-up also included a clinical assessment by means of a telephone interview performed by an independent audiologist. The pre-intervention did not result in any major improvement over and above the control group. However, improvements were found for both groups following hearing aid fitting. In addition, most participants were considered as successful users in the interview. Future research should target individuals in need of extended hearing aid rehabilitation.

  • 227.
    Öberg, Marie
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Wänström, Gunilla
    Östergötlands Läns Landsting.
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Utökad rådgivning före hörapparatanpassning- gör det någon nytta?2008Conference paper (Refereed)
  • 228.
    Öberg, Marie
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology . Linköping University, Faculty of Health Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Psychometric evaluation of hearing specific self-report measures and their associations with psychosocial and demographic variables2007In: Audiological Medicine, ISSN 1651-386X, E-ISSN 1651-3835, Vol. 5, no 3, p. 188-199Article in journal (Refereed)
    Abstract [en]

    The main aim of this study was to collect descriptive data and to evaluate the psychometric properties of a range of self-report questionnaires in a Swedish population. Other aims were to investigate the correlations between these measures and the higher order factorial structure of the included questionnaires. One hundred and sixty-two first-time hearing aid users completed four standardized hearing specific questionnaires: the Hearing Handicap Inventory for the Elderly (HHIE); the Satisfaction with Amplification in Daily Life (SADL); the Communication Strategies Scale (CSS); and the International Outcome Inventory for Hearing Aids (IOI-HA). In addition, two psychosocial questionnaires were completed: the Sense of Coherence scale (SOC); and the Hospital Anxiety and Depression Scale (HADS). All measures were administered at one year post hearing aid fitting. Mean scores for the questionnaires were in agreement with previous studies. The questionnaires were found to be reliable and acceptable for further clinical use. Correlations were seen across different hearing specific questionnaires, and between hearing aid use and satisfaction. Psychosocial variables were more strongly associated with participation restriction and satisfaction than with the demographic variables, confirming the importance of subjective measures. The factor analysis extracted four factors: psychosocial well-being, hearing aid satisfaction, adaptive communications strategies, and residual participation restriction, and indicated that the number of questionnaires could be reduced. It is concluded that psychosocial factors are important to consider in hearing aid rehabilitation and their possible role should be further investigated in future studies.

  • 229.
    Öberg, Marie
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Wänström, Gunilla
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Eriksholm Research Centre, Denmark.
    Behandlingsprocessens betydelse vid hörapparatanpassning2015Conference paper (Other academic)
  • 230.
    Öberg, Marie
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Wärnström, Gunnilla
    Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Hjertman, Heléne
    Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology . Linköping University, Faculty of Health Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Development and initial validation of the “Clinical Global Impression” to measure outcomes for audiological rehabilitation2009In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 31, no 17, p. 1409-1417Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to develop and validate an interview instrument for assessing outcome following hearing aid fitting based on clinical global impressions.

    Method: The Audiological Rehabilitation Clinical Global Impression (AR-CGI) was developed and used in a telephone interview in two separate samples. The first sample (N=69) consisted of hearing aid owners who had participated in two intervention studies and the second sample consisted of hearing aid owners receiving regular services from a hearing clinic (N=21). Following the structured telephone interview, participants were categorized into three categories: Successful, Successful with some limitations, or Unsuccessful.

    Results: A vast majority were categorized as Successful (80% of the intervention sample and 71% of the clinical sample). Those categorized as successful were found to differ from those categorized as less successful in terms of age and self-reported hearing aid use, depressed mood, and residual participation restriction, but they did not differ in terms of degree of hearing loss.

    Conclusion: It is suggested that the brevity and usefulness of the AR-CGI makes it a potential tool for further use in audiological settings.

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