The value of using the operational model of behaviour change in hearing aid rehabilitation

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.