Attitudes toward Hearing Aids and Cochlear Implants for Older Adults

1. Attitudes toward Hearing Aids and Cochlear Implants for Older Adults among Ear, Nose and Throat (ENT) Physicians Patthida Maroongroge, D.D.S.*, Rose L. Allen, Ph.D.*, and Todd Daniel, Ph.D.† *Department of Communication Sciences & Disorders, †RStats Institute, Missouri State University RESULTS INTRODUCTION RESULTS Hearing aids and cochlear implants are an effective intervention for older people with hearing impairment.1 However, adoption of these devices among the older population has remained low.2 Ear, Nose and Throat (ENT) physicians play an important role in referring older patients with hearing loss for hearing aid and cochlear implant services. The Health Belief Model (HBM)3has been demonstrated to be a useful framework for assessing the attitudes of primary care physicians (PCPs) toward hearing rehabilitation for older patients.4 This study aimed to use the HBM to examine attitudinal factors that might influence ENT physicians’ recommendations and decisions to refer older patients for hearing aids and cochlear implants. Furthermore, the attitudes of ENT physicians in this study were compared to the attitudes of PCPs in the Gilliver and Hickson study.4 Figures 2-6 show responses to sample statements that reflect attitudes in each HBM construct (CIs = cochlear implants). • Comparison between ENT physicians and PCPs • ENT physicians had more positive attitudes in the areas of perceived benefits, t(38) = 7.43, p < .001; and self-efficacy, t(38) = 5.92, p < .001. • There were no significant differences in their attitudes in perceived susceptibility, severity, and barriers. • Susceptibility • ENT physicians expressed neutral attitudes about their older patients’ susceptibility to hearing loss (M = 3.06). • Severity • ENT physicians believed that hearing loss has serious consequences on their older patients’ lives (M = 3.95). • Benefits • ENT physicians reported positive attitudes towards the benefits of hearing aids and cochlear implants for older patients (M = 4.15). • Comparison between groups revealed that ENT physicians whose offices provide cochlear implant services had more positive attitudes toward the benefits of cochlear implants than those whose do not (p=.022). • Barriers • ENT physicians had negative perceptions about the ability of older patients to use hearing aids and cochlear implants (M = 2.49). • They believed that patients would have difficulties with cost, stigma, and adaptation to the use of devices. • Self-Efficacy • ENT physicians reported high confidence in their ability to counsel and refer patients for hearing aids and cochlear implants (M = 3.97). METHODS • Survey • The survey was adapted from a previously published questionnaire, which was developed based on the HBM constructs.4 • 22 statements measured attitudes toward hearing aids and cochlear implants for older adults via five HBM constructs (see Figure 1). • Each HBM item required participants to respond on a 5-point scale, ranging from strongly disagree (1) to strongly agree (5). • Mean scores for each HBM construct were calculated from items in that construct. • Participants • 147 ENT physicians were recruited from one local hospital and four physician conferences held in Missouri, Illinois, and Georgia. • A total of 46 surveys were returned; 39 were usable (31.3% response rate). • Procedure • The survey was distributed by two methods: (a) paper survey distributed at the conferences and at the local hospital, (b) online survey distributed to ENT physicians’ email addresses after attending the conference. • Independent samples t-test was used for comparison between groups. CONCLUSIONS • Generally, ENT physicians were aware of the high susceptibility and the severity of hearing loss in older patients, and had positive attitudes toward the benefits of hearing aids and cochlear implants for this population. • However, ENT physicians expressed a high level of concern about their older patients’ ability to afford and adjust to these devices. • When compared with PCPs, ENT physicians had more positive attitudes toward the benefits of hearing aids and cochlear implants, and had higher levels of self-efficacy for referral (p < .001). • ENT physicians and audiologists should collaborate to develop outreach educational programs for PCPs on current intervention options, especially cochlear implants, and their potential benefits to the hearing impaired elderly. • Both ENT physicians and PCPs believed that older patients have difficulty in affording and adjusting to hearing aids and cochlear implants. These beliefs may affect their decisions to refer patients for audiological services. REFERENCES Sprinzl, G., & Riechelmann, H. (2010). Current trends in treating hearing loss in elderly people: a review of the technology and treatment options - a mini-review. Gerontology, 56(3), 351-358. Chia, E., Wang, J., Rochtchina, E., Cumming, R., Newall, P., & Mitchell, P. (2007). Hearing impairment and health-related quality of life: the Blue Mountains Hearing Study. Ear & Hearing, 28(2), 187-195. Rosenstock, I. (1966). Why people use health services. The Milbank Memorial Fund Quarterly, 44(3), 94-127. Gilliver, M., & Hickson, L. (2011). Medical practitioners' attitudes to hearing rehabilitation for older adults. International Journal of Audiology, 50(12), 850-856. Figure 1. Components of the HBM proposed by Gilliver and Hickson (2011)