Consumer perspective on improving hearing aids : a qualitative study

Abstract

Optimal hearing aid fittings are central to the management of hearing loss. While research studies using quantitative scales typically report high hearing aid user satisfaction rates, other studies show poor uptake and sustained usage of hearing aids. While quantitative research is valuable, nuanced factors influencing hearing aid user experiences can be minimised. This underscores a need for the qualitative exploration of holistic hearing aid experiences, to promote successful outcomes. In light of this, the present study aimed to describe user perspectives on desired changes to hearing aids, in order to make them more useful. An open- ended question from a cross-sectional online survey was retrospectively analysed using inductive, qualitative content analysis. Participants were adult hearing aid users in the United States (U.S.), who had obtained their hearing aids either through the traditional hearing healthcare professional (HHP) mediated prescription route, or through the OTC service delivery model. The survey was disseminated over email through the Hearing Tracker forum database and through Lexie Hearing, an OTC hearing aid company. Results showcased a rich variety of information and highlighted diverse viewpoints. 628 participant responses were manually coded and categorised to form domains. The mean age of the surveyed population was 66 years old (13. 4 SD). The majority were bilateral, behind-the-ear hearing aid users. Three domains illustrating desired hearing aid changes emerged from the data. The (i) hearing aid features domain (n= 635 responses) illustrated challenges surrounding hearing aid usability (appearance and comfort), durability (Ingress Protection (IP) ratings) and digital functionality (Bluetooth connectivity). The (ii) sound quality domain (n=282 responses) described challenges surrounding sound recognition and clarity (as an independent concept from volume) as well as the performance of noise reduction technology. The (iii) service- delivery domain (n=378 responses) described user concerns about affordability, audiologist

credibility and overall hearing aid industry market transparency. Participants expressed satisfaction with hearing aid technological developments, similar to previous studies indicating high satisfaction rates, but expressed a strong desire for further improvements, to better align hearing aids and services with their needs. Key areas for improvement include cost accessibility, physical device aesthetics and comfort, technical functioning, user autonomy, sound clarity and collaboration and trust between patients and HHPs. While some participant suggestions such as those surrounding aesthetics are known, novel information regarding features enhancing user autonomy and promoting industry transparency, were highlighted. Against the backdrop of an evolving hearing aid industry, the findings of this study can assist HHPs in being informed facilitators for both, health consumers and their patients. Consideration should be given to intervention solutions which promote principles of Person- Centred Care (PCC), enhance patient self-efficacy and maintain transparency.