Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Doctor of Philosophy

Program

Health and Rehabilitation Sciences

Supervisor

Scollie, Susan

Abstract

Modern hearing aids can vary in both digital signal processing (DSP) and non-signal processing (non-DSP) features. The complexity and availability of these features can differ at opposite ends of the technology spectrum, potentially influencing aided benefit and preference. Furthermore, the amount of feature choices in modern hearing aids has led to increasing complexity in the selection process.

The first aim of this dissertation was to investigate the aided benefit and preference differences between premium and entry-level hearing aids, and to investigate the drivers of any preference differences. No significant differences were found between the entry-level and premium hearing aids in aided loudness ratings, speech quality, speech recognition, and consonant recognition. However, most participants preferred the premium hearing aids.

Investigation of this preference using group concept mapping revealed nine clusters, representing both DSP and non-DSP features. Three clusters were rated as significantly more important by participants that preferred the premium hearing aids. These three clusters represented technologies predominantly found in premium hearing aids (such as remote fitting compatibility).

The second aim was to design the Hearing Aid Feature Importance Evaluation (HAFIE) questionnaire. This provides clinicians with a methodology to gather patient feature importance ratings to facilitate hearing aid recommendations.

Questionnaire items were designed using concept mapping results as a theoretical framework. Hearing care professional focus groups provided feedback for modification. Validation of the 34-item questionnaire was conducted via Qualtrics. Exploratory factor analysis was used to assess factor structure, resulting in three subscales: “Advanced connectivity & streaming”, “Physical features & usability”, and “Sound quality & intelligibility”. Seven items were removed due to poor factor loading, resulting in a 28-item questionnaire with three subscales. Reliability of each of these subscales was assessed via Cronbach’s alpha and item-total correlation and was found to be appropriate.

This thesis has resulted in a conceptual framework of the different aspects of the hearing aid user experience, identifying features which may influence user preference. Furthermore, it has resulted in the development of an evidence-based hearing aid selection tool, providing a structured methodology which may potentially be useful in a clinical setting.

Summary for Lay Audience

Modern hearing aids can differ in terms of the quality of the sound produced as well as other features (such as Bluetooth connectivity). The complexity and availability of these features can differ between premium and entry-level hearing aids, potentially influencing how much benefit the hearing aids give, and hearing aid user preference. Furthermore, the number of features in modern hearing aids has made choosing a hearing aid a more complex task.

The first aim of this dissertation was to investigate whether premium and entry-level hearing aids provide different sound benefits to hearing aid users, and whether they prefer one over the other (and why). The entry-level and premium hearing aids were found to benefit hearing aid users equally. However, most participants still preferred the premium hearing aids.

Investigation of this preference revealed nine distinct feature areas influencing preference, including features related to sound as well as features without a sound focus (such as physical comfort). Three feature areas were rated as significantly more important by individuals who preferred the premium hearing aids. These represented technologies predominantly found in premium hearing aids.

The second aim was to design the Hearing Aid Feature Importance Evaluation (HAFIE) questionnaire. This provides clinicians with an efficient way to recommend appropriate hearing aids to their patients by knowing how highly they rate different hearing aid features.

Questionnaire items were designed using the features identified in the previous preference investigation. Hearing care professionals were asked for their opinion on the items. Validation of the 34-item questionnaire was conducted via online survey. The internal structure of the data was statistically analyzed, resulting in three subscales: “Advanced connectivity & streaming”, “Physical features & usability”, and “Sound quality & intelligibility”. Seven items were removed due to poorly fitting onto the subscales, resulting in a 28-item questionnaire. The internal consistency and reliability of the questionnaire were found to be appropriate.

This thesis has added to the existing knowledge of the different aspects of the hearing aid user experience and how they affect preference. Furthermore, it has resulted in a hearing aid selection questionnaire which has shown potential for clinical use.

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