الفهرس 
Introduction
Hearing lossOnly 14 pages are availabe for public view
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Abstract
Hearing is essential sense in life; performing an important role in society, because it is the basis for development of human communication. Hearing loss causes not only a handicap in the person’s capacity to perceive sounds, it brings about psychosocial compromises, keeping the individual from having a healthy social life and playing his/her role in society, which has a great impact on the person’s quality of life. Hearing loss has been considered a disabling disease for a long time. In recent years, much has been done to mitigate such stigmas and provide a better quality of life for hearing impaired individuals. The most common form of treatment for HL in adults is the provision of a HA.
Performance with the aid reported by the user can better guide the healthcare professionals as to the proper actions to take, enabling one to recognize the advantages provided by these devices in relation to hearing difficulties, preventing users to give up on them, increasing daily use and, consequently, user satisfaction.
Subjects:
The study subjects included 40 patients there age ranged from 18 to 60 years (23 male and 17 female), all patients were free of middle ear disease and had normal tympanograms and fitted with HA for at least 6 months. Informed consent was obtained from all participants of the study. The study was approved by the Ethics Committee of Assiut Medical University.
Equipment:
1- Two channel audiometer (Madsen model Orbiter 922) equipped with a free field loud speaker.
2- Immittancemetry interacoustics model AZ 26
3- Double wall sound treated booth (”IAC” model 1602).
4- Two-channel cassette tape recorder was connected to the audiometer and adjusted to deliver recorded speech stimuli.
- The Arabic versions of the following speech perception tests:
1. Speech perception in noise (SPIN) test (Tawfik et al., 1992).
2. Consonant recognition (CR) test (El-Kholi et al., 1997).
3. Vowel recognition (VR) test (El-Kholi et al., 1997).
- Arabic satisfaction with amplification in daily life (SADL) questionnaire for measurement of the patients’ satisfaction.
Methods:
1- Prefitting evaluatin:
a- History taking from all study groups.
b- Otoscopic examination.
c- Basic audiological evaluation including (pure tone audiometry, speech audiometry, immitancemetry).
d- Speech perception tests (SPIN, VRT and CRT).
2- Post fitting evalution:
a- Aided tonal sound field threshold.
b- Aided sound field speech testing.
c- Aided sound field Speech Perception Tests.
d- SADL questionnaire.
Results:
Basic audiolgical evaluation showed that HL degree varied from moderate to severe SNHL and there were no statistically significant differences between right and left ear.
There were improvements in all studied aided tests (ATSFTs, SRT, SDS and speech perception tests) that assess HA benefit when compared with unaided test results this indicates that all patients in this study got some benefit from their HAs but their degree of benefit and satisfaction were varied.
Factors affecting HA benefit and satisfaction were divided into intrinsic factors which related to patient as sex, age, level of education, duration of HL, HL with tinnitus or not, degree of HL, configuration of HL, H/D using HA and duration of HA use and extrinsic factors which related to HA as formula and style of HA. According to each factors subjects of the study were subdivided into subgroups and we studied effect of different factors separately.
Age of patient had effect on HA benefit as elderly patients had worse aided test results, degree and configuration of HL had effect on HA benefit and satisfaction as patients with severe hearing loss had worse aided test results and less mean score of subscales of SADL questionnaire. Type of HA had effect on HA benefit and satisfaction as patients with digital (non linear HA formula) had best aided test results and highest mean score of subscales of SADL questionnaire. Style of HA had effect on HA satisfaction as patients with ITE hearing aid had highest mean score in personal image subscale of SADL questionnaire.
Conclusions:
The Study evaluated HA satisfaction and showed that all users got varied degrees of HA benefit and are quite satisfied with their hearing aids. We evaluated HA benefit and factors such as age, degree of HL, configuration of HL, duration of HA use and type of HA are related to HA benefit. Factors such as degree of HL, configuration of HL, duration of HA use (experience), type and style of HA are related to hearing aid satisfaction.
It is hoped that this review will help us understand current satisfaction measures, how various factors affect satisfaction, and lead to a discussion of how we may improve the way we measure satisfaction to yield more reliable and valid data..
Recommendations:
1- Patients in our study with severe HL and sloping configuration HL had worse HA benefit and satisfaction should submitted to diagnosis of cochlear dead region for appropriate selection of HA technology as frequency transposition.
2- Elderly patients in our study with poor response HA benefit which speech perception tests should be managed with central remediation therapy beside their HA to maximize their HA benefit.
3- Different patterns of dissatisfaction suggest the efficacy of emphasizing a counseling approach to change patient attitudes and behaviors or of pursuing a more action-oriented approach to change the hearing instruments, their components, or accessories, depending on the pattern.