The maintenance and utilisation of government fitted hearing aids

Abstract

The dispensation of hearing aids in the public sector of South Africa is burdened with problems such as lack of provision of batteries for hearing aids, poor repair services and inadequate follow-up. This affects the maximum benefit derived from the hearing aid. Hearing loss which affects communication also negatively impacts on speech and language development, cognitive development, pragmatic skills, and employment opportunities i.e. all aspects of daily living. A hearing aid is an example of an assistive listening device that attempts to minimise the consequences of hearing loss. It is a restorative mechanism that amplifies sound to compensate for hearing loss. For the greater part of the population with hearing loss it is the most cost-effective solution. Therefore, the hearing aid must be correctly fitted and used. It is vital that the client knows how the instrument operates, how to handle it, how to care for it, and, most importantly, how to use it. This involves a great deal of information giving, practice, and counselling by the speech-language pathologist and audiologist. An effective orientation and rehabilitation programme should constitute of the following: a discussion of the types of hearing loss, the facilitation of understanding of the audiogram; information on troubleshooting and using hearing aids effectively; as well as information on the expectations of the hearing aid/s. Speech-reading techniques, coping and communication repair strategies are also important. It is hypothesized that many individuals who are fitted with government hearing aids cannot adequately utilise and maintain their devices. Furthermore, this problem could be related to the initial hearing aid orientation and lack of follow-up rehabilitation as this when information regarding utilisation and maintenance is usually disseminated to clients. This study therefore aimed to examine the maintenance and utilisation of hearing aids given to clients attending provincial hospitals in Tshwane and to probe factors that impacted on the aural rehabilitation and the hearing aid fitting process, in order to contribute to the formation of service delivery guidelines. Both a qualitative and quantitative research approach was utilised. The type of research was cross-sectional and analytical. The nature of the investigation was a descriptive survey utilising face-to-face interviews. A method of non-probability purposive sampling was employed. Fifty seven adult hearing aid users were interviewed with a structured interview schedule. Quantitative results were analysed using statistics and qualitative data was categorised into main themes and ideas. Results showed that there was a general consensus about the self-image and wearing of hearing aids, as most participants were embarrassed to wear their devices. This could be due to inadequate and lack of counselling and public awareness. Furthermore, it was found that most government fitted hearing aids and accessories were poorly cared for and maintained. There were several factors which negatively influenced the utilisation and maintenance of hearing aids. One of these factors was finance i.e. the cost of travelling to and from hospitals, the cost of batteries as well as the cost of repairs to hearing aids played a significant role in how the hearing aid was utilised and cared for. Distance from hospitals also impacted on the maintenance as all hearing aid services were only available at tertiary institutions and not at community level. Furthermore, the issue of multilingualism presented an obstacle in terms of utilising hearing aids correctly and to their full benefit, as most participants were not instructed on hearing aid care and use in their first language. The results from this study were utilised in the development of service delivery guidelines for the dispensation of government hearing aids.