Sadl hearing aid questionnaire,can allergies worsen tinnitus 2014,woke up with ear clogged,ear plugs 6g caracteristicas - New On 2016

Author: admin, 10.04.2016. Category: Buzzing In Ears

INTRODUCTIONIn 2000, Ministerio da Saude (MS-Brazil) approved the regulation SAS #432(1), which focused on the social importance of hearing impairment consequences and on the need to enlarge the hearing aid concessions to patients who are assisted in public hospitals (SUS).
This fact has forced the Department of Health (Ministerio da Saude) to create policies about the problem, which includes the concession of hearing aids. In 2004, with the purpose of strength hearing impairment care, it was established the Politica Nacional de Atencao a Saude Auditiva (National Policy on Auditory Health) through regulations GM # 2073(2) and SAS # 587(3). Among adults, the wearers over 60 were in larger numbers.In the elderly population, presbyacusis is a type of acquired hearing loss. Neves and Feitosa(4) report over American studies which say that around 30% and 50% of people over 65 and 75 years old respectively, assured having some loss. It damages consonant sound perception and consequently the speech understanding as a whole.
Besides, there is decay on central auditory process as age approaches, as innate redundancy which depends on central and peripheral hearing integrity tends to diminish due to aging. In elderly people with hearing impairment that is more evident by the alteration on filtering and codifying peripheral hearing system, what it justifies an unequal degree on communication difficulty from those individuals.
All this goes together with the fact that people hide their language external redundancy which depends on context clues(5). Due to hearing impairment impact on psychosocial life of the elderly, the chance of wearing hearing aids, which helps communication by reducing loss degree, can motivate them improve their quality of life. They are designed to amplify and modulate sounds, but do not influence brain activity or wearer's behavior(6).Many authors report several variables that are meant to be important for hearing aids' wearers regarding their adaptation process. Hearing aid outcome surpasses its profit(7) and satisfaction is the most reliable measure for it, as it consists of a number of factors, it holds dynamic feature, it depends on wearer's perception and attitude and moreover it is not connected only to hearing aid performance(7,9,10). For that, the Satisfaction with Amplification in Daily Life Scale (SADL) by Cox e Alexander, 1999 was used, by being translated into Portuguese to reach individual's reality. Other complemental tools favored better understanding of the associated factors towards hearing aid satisfaction and the search of new routes for better advantages from it.MATERIAL AND METHODThis research was first authorized by SESAU-TO manager. The project was registered on CONEP in February 22nd, 2006 and analyzed and approved by Research Ethics Committee of the Universidade Catolica - Goias (Catholic University) under # 0279 - April 20th, 2006. From the 55 found individuals, 3 of them were not in physical condition to take part in the research. From the 52 ones who answered the questionnaire, 6 of them were not selected because they had difficulty in oral and written understanding and did not answer the questions reliably; 5 did not wear hearing aid properly, then did not have parameters to notice the positive and negative aspects of it, and 1 had congenital hearing loss. Regarding type of hearing disorder, 95% of them had sensorineural loss, and 5% of the remaining subjects presented mixed hearing loss. When developing SADL, authors noticed that such aspect when by itself, it is the one that interfere most on satisfaction range. When developing SADL, such factors represented low importance and high satisfaction degrees, what can justify its exclusion from the final questionnaire. However, it was sustained by Cox and Alexander when realizing that, for some people, the appearance of devices and the impact they cause on others are expressive. This study displays a new version of the questionnaire (Annex), which is adjusted grammatically to Portuguese language and to the aspects of the evaluated subjects' lives.Scoring answers was also changed. To guarantee hearing aid sensitiveness towards wearer's dissatisfaction, it was also used a satisfaction scale with a single item as according to Cox and Alexander (2001), in the validation study of SADL(14).The satisfaction scale of single item corresponds to a multiple-choice answer from question on general satisfaction degree with hearing aids. Scoring ranges from 1 to 5 proportionally to satisfaction level.Besides satisfaction scale, a complemental form was used to help on interpreting results and determining associated factors to satisfaction or dissatisfaction feeling of the wearers towards the aids.
Comparison between these results according to Cox and Alexander(7) showed that 20% of the subjects were very satisfied, 75% was satisfied and 5% was dissatisfied regarding prosthesis problems, noise environment performance, microphonia and telephoning(Chart 3).Chart 3. Comparing such results according to Cox and Alexander(7), it is noticed that Personal Image topic presented more dissatisfied feeling people (37.5%). Satisfaction level of the studied subjects on Personal Image subscale of SADL (translated version), according to regulations by Cox and Alexander (1999). Comparison between Global SADL results (translated version) and Satisfaction Scale of a Single Item for the studied individuals.85% of the individuals were satisfied or very satisfied when evaluated by the two tools.
In practice, this did not always happen, but the application of questionnaire in person, what differs from the original proposes, reduced troubles with tools. Besides having reduced reading difficulty due to low education level, the selection of answers with the help of the researchers helped scoring them according to the scale and prevented void answers. This is also important to the wearers, who will be able to analyze their condition regarding both a standard and how to chose the type of device, as the evolution of conditions helps on how develop new assistance strategies. Yet, in the current one, Personal Image was the second lowest and the only one below with average by Cox and Alexander(7).Personal Image subscale refers to wearer's self-image and hearing aid stigma. Hearing aids might give an impression of incapacity, which is a serious obstacle for a successful result on amplification and that is reinforced by the fact that new wearers has lower expectancy than the experienced ones(8).The prejudice against hearing loss and hearing aids is highly mentioned in the literature. Authors report that the ones who do not wear aids support the stigma as a reason, the elderly denies them for being 'visible', then making hearing loss clear(19).All subjects from this study wear retroauricular-like hearing aids, which are more visible. It was also noticed that dissatisfied individuals with Personal Image are highly socialized according to data from Complemental Form, what suggests that appearance concern belongs to these ones.The high rate of dissatisfaction with Personal Image suggests another type of hearing aids from the concession program and also an addition of programs on hearing training and orientation starting before wearing aids and spreading up to total adaptation of them.
Those actions might be useful to clear up the use and prejudice against hearing aid, besides they help on how to handle the devices and how to communicate.Regarding Global Satisfaction, the average obtained was higher than the one by Cox and Alexander(7). Comparing Global score with Scale of Single Item was useful to clarify cases of neighboring scoring, by helping to better understand the influence of each subscale in the questionnaire, besides the single item is easy to be applied, and that is why it is used together with SADL. According to SADL's authors, scores from Global, Positive Effect and Service and Cost subscales are more reliable than the ones from the Negative Features and Personal Image subscales.
However, in the current study, Personal Image subscale was more important for some subjects.
This datum is in accordance with findings in the literature that indicate influence of psychological and subjective factors such as hearing aid expectancy and hearing loss acceptance(18,19). Comparing results from Global Score of SADL and Scale of a Single Item, it was noticed that the satisfaction rate in this study was high (85%). The original study(7) showed 70% of Global Satisfaction on SADL and other researchers reported 76% among hearing aid wearers(18).Some reasons can be listed when considering the high rate of satisfaction of the studied groups from their personal features, from hearing loss and from hearing aids. The ones belonging to this age-group is more likely to face adaptation problems of the hearing aids. This shows action-taking by most of subjects in order to solve health problems, contributing for a positive outcome. Just some of the individuals who are aware of their hearing loss and of the psychological impact when wearing hearing aids search for help(8). Another fact for the high level of satisfaction, in this study, is that 90% of samples show that the individuals are socialized. Social life raises more chances of communication and exposes individuals to different hearing situations. Many authors report positive relation of satisfaction with hearing aids and social support(18,19).The current study also shows that 65% of the individuals reported wearing hearing aids for 4 hours a day, what means a good result when wearing hearing aids(18).
Regarding hearing loss features, 90% of the subjects presented normal, mild and moderate tone average. That might have provided good satisfaction results as hearing aid performance is worse when hearing loss is more severe.
Although the hearing aids were conceded by the National Government, the State Government takes advantage of such program to persuade people of the provision idea. These aspects together with political context (in Tocantins) suggest that the high level of the individuals' satisfaction expresses their gratitude to concession program and their fear for not being benefited anymore if gratitude is not expressed. During questionnaire application, professionals tried to control such issues by explaining the targets of the study to subjects. However, the fact that the researchers were federal government employees, individuals might have felt embarrassed, even if they did not neglect information intentionally. SADL scale, for being short, clinical use-aimed and provides objective measures and not dependent from satisfaction topics, represented a suitable tool to measure satisfaction with hearing aids.There was a high rate of satisfaction with hearing aids in all topics of SADL.
Personal Image subscale presented the highest number of dissatisfied people, and this might be related to the type of retroauricular device.The Scale of a Single Item and Complemental Form provided a proper interpretation of SADL scores as well as a better understanding of aspects associated to satisfaction.
Clinical application of the satisfaction with amplification in daily life scale in private practice I: statistical, content, and factorial validity.
Satisfacao com a protese auditiva na vida diaria em usuarios do Sistema de Saude do Exercito. A comparison of two measures of hearing aid satisfaction in a group of elderly hearing aid wearers.
An investigation of the applicability of the inventory, satisfaction with amplification in daily life, at 2 weeks post hearing aid fitting.
Technology, expectations, and adjustment to hearing loss: predictors of hearing aid outcome.
Hearing loss, control, and demographic factors influencing hearing aid use among older adults.

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