Short- and long-term outcomes of adult audiological rehabilitation

Abstract

Objective: To examine short- and long-term subjective benefits of providing a counseling-oriented audiological rehabilitation (AR) program as an adjunct to hearing aid intervention for individuals with adult-onset hearing loss.

Design: One hundred six veterans (68 men and 38 women), fit binaurally with digitally programmable analog hearing aids, participated. The Communication Profile for the Hearing Impaired (CPHI; ) was administered to all participants before hearing aid fitting. Half the patients were randomly assigned to receive hearing aids alone (i.e., control); the other patients were assigned to participate in a 4-wk group AR program in conjunction with receiving hearing aids (i.e., HA + AR). At the end of the AR program, the CPHI was again administered to all participants to assess short-term benefit and at 6 mo and 1 yr after hearing aid fitting to assess long-term benefit.

Results: A separate repeated-measures version of the general linear model was used to examine short- and long-term benefits for the CPHI factor scores (communication importance, communication performance, adjustment, interaction, and reaction) and for individual importance ratings and scale scores. Hearing aid use improved both short- and long-term self-perception of communication performance, with no additional benefits from participation in the AR program. Consistent with the goals of a counseling-oriented AR program, differential short-term treatment effects were found for communication strategy usage, which led to differential short-term benefits for the interaction and reaction factors. Although failing to reach strict criteria for statistical significance, there was an observable difference in short-term outcomes between the two groups for the adjustment factor, with greater improvements occurring for the HA + AR group. Over the course of the year, benefits measured for the HA + AR group remained stable, whereas scores for the control group continued to increase, resulting in no differences in factor scores between groups at 1 yr after intervention.

Conclusions: The finding of a short-term differential treatment benefit for AR in terms of interaction and reaction, and possibly for adjustment, was important, as better outcomes in these areas may be important in the decision to keep hearing aids. If this is the case, then the data support the inclusion of a counseling-oriented AR program. Differential treatment effects in interaction and reaction appeared to result from communication strategy use, indicating that the AR program is meeting many of its goals in this area. The lack of long-term differential effects appeared as the result of continued changes in adjustment, interaction, and reaction with continued hearing aid experience.