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 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 3  |  Issue : 1  |  Page : 26-30

Questionnaire on the “Knowledge and use of ear molds” by the hearing aid users


Department of Audiology, All India Institute of Speech and Hearing, Mysore, Karnataka, India

Date of Web Publication22-Aug-2019

Correspondence Address:
Dr. N Devi
Department of Audiology, All India Institute of Speech and Hearing, Mysore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aiao.aiao_27_18

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  Abstract 


Background Information: Ear molds are a part of hearing instrument made up of silicon which connects the hearing aid to the user's ear canal. These ear molds act as reservoir to collect the sound from the hearing aid. However, the knowledge about this is very less among the users. Professionals forget that the satisfactory usage of the hearing aid also depends on the ear mould which is always recommended for those individual who are fitted with the hearing aid. Aim and Objectives: The aim of the current study is to develop and standardize a questionnaire on the 'Knowledge and use of ear moulds' by the hearing aid users. Also, to compare the scores of the questionnaire between two groups who are divided with respect to different period of usage of ear molds. Materials and Methods: A total of sixty participants, were divided into two groups, as those individuals who used the ear moulds with hearing aid only for a period of 6 months and more than 6 months. The developed questionnaire consists of 20 questions with four choices for response. Along with the developed questionnaire a 'Hearing Aid Users Questionnaire' (HAUQ) was also administered for correlation regarding satisfaction. Results and Conclusions: Independent t-test results reveled that there was significant difference in the scores between the groups of participants. There was positive correlation between the administered questionnaires. Satisfaction is crucial to the whole hearing aid fitting process including ear mould fitting and its importance in audiology is evidenced by the fact that it is frequently included as a measure of outcome. This concludes that satisfaction is crucial to the whole hearing aid fitting process including ear mould fitting, knowledge on ear mould usage and care.

Keywords: Ear moulds, questionnaire, satisfaction


How to cite this article:
Devi N, Jayaram M T, Udhayakumar R. Questionnaire on the “Knowledge and use of ear molds” by the hearing aid users. Ann Indian Acad Otorhinolaryngol Head Neck Surg 2019;3:26-30

How to cite this URL:
Devi N, Jayaram M T, Udhayakumar R. Questionnaire on the “Knowledge and use of ear molds” by the hearing aid users. Ann Indian Acad Otorhinolaryngol Head Neck Surg [serial online] 2019 [cited 2019 Nov 16];3:26-30. Available from: http://www.aiaohns.in/text.asp?2019/3/1/26/265133




  Introduction Top


Ear molds are a part of hearing instrument made up of silicone which connects the hearing aid to the user's ear canal. The shape, size, style, and its configuration vary across individual based on the individual's type and degree of hearing loss, the anatomical configuration of the ear. Based on the studies, most commonly, the molds are classified into three types – they are the tiny (canal size), medium (half-shell size), and large (full-shell size); however, there are more than 10 different styles of mold available which vary in color, type, the material used to prepare, and the personal preferences and also based on the hearing instrument.[1] Even though these ear mold act as a reservoir to collect the sound from the hearing aid and giving to patient ear, the knowledge about this is very less among the users. Conventionally, satisfactions of the listening abilities are analyzed only based on the performance of the hearing aid or by self-satisfactory measures. However, professionals forget about that the satisfactory usage of the hearing also depends on the ear mold which is always recommended for those individual who are fitted with the hearing aid. Hence, just measuring or prediction of hearing aid users satisfaction should not be only based on the performance of the hearing aid listening. It is very important to rule out the knowledge and utility of the ear molds along with the hearing aid among the hearing aid users. This will provides ample information to the hearing care professionals to provide a better care and counseling to the hearing aid users regarding the care and maintenance of these ear molds for better satisfaction with the use of the hearing aids. There are some objective measures in the field of audiology which provides the hearing care professionals with some little information regarding the role of ear mold while hearing through the hearing aid by the individuals with hearing impairment. However, satisfaction with the usage of hearing aid also depends on the usage and knowledge on ear mold. Although there are many questionnaires and tools available to measure the hearing aid outcomes and satisfaction of the listening conditions, there is no tool or questions within the self-report questionnaire is available to measure the usage of the ear molds. Hence, there is a need to develop a tool should be developed to measure it effectively. The aim of the current study is to develop and standardize a questionnaire on the “Knowledge and use of ear molds” by the hearing aid users.


  Methods Top


A total of 60 participants participated in the present study. These participants were divided into two groups. Group I consists of 30 participants (Mean age = 39.4, Standard Deviation [SD] = 6.8) who had used the ear molds with hearing aid only for 6 months. Group II had 30 participants (Mean age = 43.4 and SD = 4.6) who had used the ear molds with hearing aid for more than 6 months. A written consent was taken from the participants for their willingness toward their participation in the study. The study was carried out in two phases. The Phase I is the development and validation of the questionnaire, and phase II is the administration of the developed questionnaire. This study adhered to the ethical guidelines for biobehavioral research involving human subjects.[2]

Phase I

As there is very less literature regarding the utility and knowledge about the ear molds the questions in the questionnaire were employed basically from the complaints or difficulties faced by the hearing aid users were concealed together and a total of 30 questions were developed at first and these questions were given to 10 audiologist, 10 ear mold technicians, and 10 ENT doctors for content validation. The modified questionnaire consists of 20 questions which met 75% criteria of the suggestions provided at the time of content validation. Moreover, each question consists of four choices for the response. The questionnaire was administered to the clients or parents or the caregiver in case of children regarding their knowledge about the ear mold.

Phase II

In this phase, the developed question was administered on the hearing aid and ear mold users. The responses were scored as “1” for correct response and “0” for incorrect response. Along with the questionnaire on “Knowledge and use of ear molds” [Appendix A], a “Hearing Aid Users Questionnaire” (HAUQ)[3] was also administered. The HAUQ consists of 11-item questionnaire to assess hearing aid use, benefit, and satisfaction. Questions 1–2 deal with the usage of the hearing aid, with the categories in question 2 scaled from 1 to 6. Question 3 deals with benefits, with “not at all” scaled as a 1, “a little” scaled as a 2 and “a lot” scaled as a 3. Question 4 deals with problems, with “no” scaled as 2 and “yes” scaled as 1. Questions 5–7 deal with satisfaction each scaled from 1 to 4. In all cases, the largest numbers correspond to the most favorable outcome. Question 8 seeks the clients' assessment of whether they have problems that require an additional appointment. Questions 9–11 are open-ended questions aimed at finding out what the clients liked and disliked about the service or devices they received.



The data obtained were tabulated and entered into the Statistical Package for Social Sciences (SPSS) software version 20 (SPSS Inc., Chicago).


  Results Top


Analysis of the response between groups for the “Knowledge and use of ear molds”

Descriptive analysis was done for the scores obtained from the questionnaire “Knowledge and use of ear molds.” [Figure 1] depicts the mean and SD of the total scores obtained for both the groups of participants from the questionnaire “Knowledge and use of ear molds.”
Figure 1: Mean and standard deviation of the total raw scores for both the groups of participants from the questionnaire “Knowledge and use of ear molds”

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From [Figure 1], it is evident that the Group I participants scored lower that Group II which reveals that the knowledge of the ear mold is lesser as their duration of usage of the ear mold is also lesser. Further, the total score obtained for each of the participants was subjected to Independent t-test to find if there is any significant difference in the scores that were obtained from the questionnaire between the two groups of participants. The results revealed that there was significant difference t (58) = −4.7, P = 0.000 in the score of the questionnaire between the groups of participants. The scores of the questionnaire for Group I are Mean = 11.33 and SD = 2.5 and for Group II are Mean = 15.06 and SD = 1.75.

Analysis of the response between groups for the hearing aid users questionnaire

The responses obtained for the questionnaire HAUQ were subjected for analysis. Only the questions 1–5 (Q1 refers to question 1 and so on)/were analyzed, and the other questions were related to the servicing of the hearing aid, and satisfaction of the service provided and descriptive and hence were not analyzed as they directly do not correlate with the ear molds use and care. [Figure 2] depicts the percentage of the participants of the responses obtained for each of the questions from 1 to 5 for both the groups of participants.
Figure 2: Q1–Q5 Percentage of participants across groups for questions in hearing aid users questionnaire (a) number of hearing aids used by the participants, (b) number of hours of usage of hearing aid per day, (c) use of hearing aid in conversation, (d) difficulties faced with the hearing aid, (e) satisfaction with the hearing aids

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Analyzing the responses and the [Figure 2]a, [Figure 2]b, [Figure 2]c, [Figure 2]d, [Figure 2]e, Q1 reveals that in both the groups of participants almost all of them were binaural hearing aid users and Q2 reveals that the hearing aids are worn for more than 8–4 h; however, the percentage was more in Group II. The responses of Q3 reveal that Group I felt the hearing aids are useful more for small group conversation, whereas the percentage of responses is more for family conversations for Group II. Q4 reveals that the Group I reported more problems with the ear mold discomfort compared to the other difficulties with the use of hearing aids and the Group II had lesser problems with the ear molds. The next major problems what both the groups of hearing aid users reported is the positioning and removing of the hearing aid. This could also attribute to the ear molds. The Q5 responses revel that the dissatisfaction percentage was higher for Group I compared to Group II. However, the other questions in the questionnaire Q6–Q10 are related to the hearing aid servicing and their likeliness of the hearing aid. The Q11 which is related to least likeness around 64% of the participants in Group I and 32% of the participants in Group II had their negative opine about the ear molds. The other responses were related to the maintenance, noisiness, and distortions in hearing aid.

Correlation between the responses of the questionnaires “Knowledge and use of ear molds” and hearing aid users questionnaire

A Pearson correlation coefficient was done between the two questionnaires to check if there is any correlation between the knowledge of the ear molds and their dissatisfaction with the use of hearing aids for two groups of individuals separately. [Table 1] depicts the significant Pearson correlation coefficient for two groups between the two administered questionnaires.
Table 1: Pearson correlation coefficient for two groups between the two administered questionnaires

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The results of [Table 1] reveal that there was a significant positive correlation for the questionnaire “Knowledge and use of ear molds” and Q4 and Q5 of the questions in HAUQ for Group I participants and significant positive correlation for the questionnaire “Knowledge and use of ear molds” and only Q5 of the questions in HAUQ for Group II participants. This depicts that for Group I participants who have lesser experience with the use of ear molds, also have lesser satisfaction with the hearing aid, for which ear mold discomfort or the use and positioning of the ear mold and hearing aid in the ear could be a reason. For Group II participants, the satisfaction level with the hearing aid is better as the acclimatization level of the use of ear mold increases. Although they report the other problems in the hearing aid, their acceptance and satisfaction of the hearing aid is better than the Group I.


  Discussion Top


The self-report satisfaction questionnaire on the use of hearing aid usually evaluates the problems only related to the hearing aid like unnatural sound quality; hollow sound, muffled sound.[4] The hearing aid users have also identified several variables which are very important to the adaptation process of the hearing aid use, such as comfort, the mold or fit, hearing ability in quiet environments as well as in noisy environments, sound quality, and ease of cleaning, operation, and insertion of the hearing aid.[5] Although mold fit and comfort play a major role most of the time, the importance of the ear mold are highly neglected. However, most of the hearing aid users use ear molds. Hence, the present study was aimed to develop and administer a questionnaire on “knowledge and use of ear mold” and correlate with the participant's dissatisfaction of the hearing aid if any because of the poor use of the ear mold. The results reveal the usage of ear mold over a period can add up their knowledge with care and maintenance of ear mold which is very important information while measuring the satisfactory component of usage of hearing aid. The satisfaction of the hearing aid had a good positive correlation on discomfort and knowledge of the ear mold. The satisfaction is crucial to the whole hearing aid fitting process, including ear mold fitting and its importance in audiology is evidenced by the fact that it is frequently included as a measure of outcome.[4],[6] Hence, considering the proper and satisfactory ear mold fitment will improve the satisfaction of the use of hearing aid which leads to better communication in daily life. An audiologist should cautiously counsel the hearing aid user regarding the role, importance, care, and use of ear molds along with the hearing aid holistically for better benefits and satisfaction.


  Conclusions Top


The current study concluded that though the measurement of satisfaction of hearing aid usage is mainly dependent on the hearing aid, knowledge on ear mold usage and care also plays a major role in an individual's acceptance of the hearing aid.

Acknowledgments

The authors would like to thank the Director, All India Institute of Speech and Hearing, Mysuru, for granting permission to carry out the study and the participants for their cooperation.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Starkey CH. Ear Mold for Hearing Aids. United States; 1956.  Back to cited text no. 1
    
2.
Venkatesan S. Ethical Guidelines for Bio-Behavioral Research Involving Human Subjects. Dr. Vijayalakshmi Basavaraj, Director, Manasagangothri, Mysore: All India Institute of Speech and Hearing; 2009. Available from: http://www.aiishmysore.in/en/pdf/ethical_guidelines.pdf. [Last retrieved on 2015 Mar 11].  Back to cited text no. 2
    
3.
Dillon H, Birtles G, Lovegrove R. Measuring the outcomes of a national rehabilitation program: Normative data for the client oriented scale of improvement (COSI) and the hearing aid user's questionnaire (HAUQ). J Am Acad Audiol 1999;10:67-79.  Back to cited text no. 3
    
4.
Prakash SG, Aparna R, Kumar SR, Madhav T, Ashritha K, Navyatha K. Sensori-neural hearing Loss client's performance with receiver-in-canal (RIC) hearing aids. Int J Otolaryngol Head Neck Surg 2013;2:68.  Back to cited text no. 4
    
5.
Cox RM, Alexander GC. Expectations about hearing aids and their relationship to fitting outcome. J Am Acad Audiol 2000;11:368-82.  Back to cited text no. 5
    
6.
Cox RM, Alexander GC. Measuring satisfaction with amplification in daily life: The SADL scale. Ear Hear 1999;20:306-20.  Back to cited text no. 6
    


    Figures

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    Tables

  [Table 1]



 

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