Abstract:
The prevalence of hearing loss in adults is well documented. Hearing loss leads to poor
communication, which is essential for daily living. Cogitating that we have an ageing population
who are living longer with more co-morbidities, the consequences of a hearing loss can have a
devastating impact on psychosocial aspects of an individual’s life. This in turn can negatively
affect the quality of life of individuals with hearing loss. Although hearing aids are said to improve
quality of life, studies have proven that many patients who are issued with hearing aids do not
comply with aural rehabilitation services (either do not use the hearing aids at all or do not use
them consistently). Research documents how this is costly (both financially and psychosocially) to
patients, their caregivers as well as audiologists providing the service. Motivation and self-reported
hearing disability and handicap have been highlighted in the literature as reasons why patients do
not comply with aural rehabilitation. With current NHS reforms imposing cost-effective care with
more patient choice and patient collaboration, aural rehabilitation services should evolve to include
aspects of patient motivation and self-reported hearing disability and handicap by renouncing old
medical models of rehabilitation and utilising models such as the Operational Model of behaviour
change (OM). This model is said to be cost effective and patient-centred. The main aim of this
study was to determine the value of using the OM of behaviour change on adult aural
rehabilitation outcomes. The sub-aims outlined were designed to compare aural rehabilitation
outcomes between two groups of subjects: one group that did not receive the OM of behaviour
change and one that received the OM of behaviour change. This study was a quantitative,
experimental study that utilised a pre-test post-test design. A total of 141 adult subjects with
sensorineural hearing loss, who have never worn hearing aids, were recruited to this study and 68
of these were deemed suitable to participate as per the inclusion and exclusion criteria. Only 43
subjects completed the study and attended their final follow up appointment. Data from 24 subjects
in the control group and 19 subjects in the experimental group were analysed and reported. The
HHIE-S, HHIA-S, GHABP, IOI-HA and hearing aid data logging statistics were utilised as
outcome measures for this study. Pre-test results displayed no significant difference between
groups prior to implementation of the OM. Post-test results showed no significant difference for
hearing aid use, reported benefit, hearing aid satisfaction and self-reported hearing difficulties.
Conversely, the subjects in the experimental group scored significantly less residual disability for
the GHABP than those in the control group. It could be inferred that subjects in the experimental
group who received the OM, were more engaged and more supported during their rehabilitation
process and as such had less difficulty with hearing aids. With regard to hearing aid benefit, results
did have some positive effect, but this was not statistically significant. Secondary analysis of the
results revealed corroborations with other studies with regard to the value of hearing aids and
improvement in quality of life and reduction of self-reported hearing disability and handicap. On
the basis of this study’s results, further research is required to determine the value of the OM in
similar audiology settings. Adaptation of service delivery models such as the OM corresponds with
the drive for improving the quality of services by giving patients more control of their healthcare.