Access to Hearing Health Care, Geographical Residency, and Quality of Life in Adults with and without Hearing Loss
Background There is an increased interest in the impact that hearing loss has on general well-being, including overall quality of life (QOL), to improve and expand care that is provided to individuals with hearing loss.
Purpose To evaluate QOL in adults with and without access to hearing health care (HHC).
Research Design A cross-sectional study examined QOL across groups of individuals with and without hearing loss.
Study Sample One hundred eight participants from West Central and South Alabama received pure-tone hearing evaluations. Thirty-two adults had hearing within normal limits and 76 had at least a mild hearing loss in one ear.
Data Collection and Analysis The Quality of Life Inventory (QOLI), the Charlson Comorbidity Index, and an Accessibility to Health Care questionnaire were administered to all participants. The QOLI outcomes were used as the dependent variable for the analysis of covariance (ANCOVA) statistical procedures.
Results For adults with hearing loss who did not have access to HHC, lower QOL scores were reported compared with those with access to HHC, but this finding was not significant. Although ANCOVA results did not suggest QOL differences across geographical regions, effect size calculations indicated that adults with hearing loss who lived in the most rural regions of Alabama had lower reported QOL scores than their counterparts who had hearing within normal limits. Finally, those with higher incomes, who were older, and who had fewer physical disorders reported higher QOL than those with lower incomes, who were younger, and who had more physical ailments.
Conclusions Adults with hearing loss who live in regions without access to HHC might be at risk for decreased QOL. A number of models for improving access to HHC will be necessary to decrease this potential risk.
Portions of this paper were presented at the 46th Annual Scientific and Technology Conference of the American Auditory Society in Scottsdale, AZ, February 28-March 2, 2019.
02 September 2020 (online)
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- 1 AHRQ. Access to Care (AC) Section. 2005 https://meps.ahrq.gov/survey_comp/hc_survey/2005/AC95.htm . Accessed October 2, 2018
- 2 Barnett M, Hixon B, Okwiri N, Irungu C, Ayugi J, Thompson R, Shinn JB, Bush ML. Factors involved in access and utilization of adult hearing healthcare: a systematic review. Laryngoscope 2017; 127 (05) 1187-1194
- 3 Carhart R, Jerger J. A preferred method for the clinical determination of pure tone thresholds. J Speech Hear Disord 1959; 24: 330-345
- 4 Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987; 40: 373-383
- 5 Chew H, Yeak S. Quality of life in patients with untreated age-related hearing loss. J Laryngol Otol 2010; 124 (08) 835-841
- 6 Chia E-M, Wang JJ, Rochtchina E, Cumming RR, Newall P, Mitchell P. Hearing impairment and health-related quality of life: the Blue Mountains hearing study. Ear Hear 2007; 28 (02) 187-195
- 7 Cleary KK, Howell DM. Using the SF-36 to determine perceived health-related quality of life in rural Idaho seniors. J Allied Health 2006; 35 (03) 156-161
- 8 Coco L, Titlow KS, Marrone N. Geographic distribution of the hearing aid dispensing workforce: a teleaudiology plan- ning assessment for Arizona. Am J Audiol 2018; 27 (3, Suppl): 462-473
- 9 Dalton DS, Cruickshanks KJ, Klein BE, Klein R, Wiley TL, Nondahl DM. The impact of hearing loss on quality of life in older adults. Gerontologist 2003; 43 (05) 661-668
- 10 DHHS. State Standards for Access to Care in Medicaid Managed Care. 2014 https://oig.hhs.gov/oei/reports/oei-02-11-00320.pdf . Accessed June 1, 2017
- 11 Farquhar M. Elderly people's definitions of quality of life. Soc Sci Med 1995; 41 (10) 1439-1446
- 12 Frisch MB. Quality of Life Inventory. Minneapolis, MN: National Computer Systems; 1994
- 13 Hart PD. Sex differences in the physical inactivity and health-related quality of life relationship among rural adults. Health Promot Perspect 2016; 6 (04) 185-189
- 14 Helvik A-S, Jacobsen G, Halberg LR. Psychological well-being of adults with acquired hearing impairment. Disabil Rehabil 2006; 28 (09) 535-545
- 15 Howell DM, Cleary KK. Rural seniors' perceptions of quality of life. Phys Occup Ther Geriatr 2007; 25 (04) 55-71
- 16 Hughson W, Westlake H. Manual for program outline for rehabilitation of aural casualties both military and civilian. Trans Am Acad Ophthalmol Otolaryngol 1944; 48: 1-15
- 17 Lamu AN, Olsen JA. The relative importance of health, income and social relations for subjective well-being: an integrative analysis. Soc Sci Med 2016; 152: 176-185
- 18 Lemos CF, Rodrigues MP, Veiga JR. Family income is associated with quality of life in patients with chronic kidney disease in the pre-dialysis phase: a cross sectional study. Health Qual Life Outcomes 2015; 13: 202
- 19 Lindner P, Andersson G, Ost LG, Carlbring P. Validation of the internet-administered Quality of Life Inventory (QOLI) in different psychiatric conditions. Cogn Behav Ther 2013; 42 (04) 315-327
- 20 Mondelli MFCG, de Souza PJS. Quality of life in elderly adults before and after hearing aid fitting. Braz J Otorhinolaryngol 2012; 78 (03) 49-56
- 21 National Academies of Sciences Engineering Medicine. Hearing Health Care for Adults: Priorities for Improving Access and Affordability. Washington, DC: The National Academies Press; 2016
- 22 Nieman CL, Lin FR. Increasing access to hearing rehabilitation for older adults. Curr Opin Otolaryngol Head Neck Surg 2017; 25 (05) 342-346
- 23 Nordvik O, Laugen Heggdal PO, Brannstrom J, Vassbotn F, Aarstad AK, Aarstad HJ. Generic quality of life in persons with hearing loss: a systematic literature review. BMC Ear Nose Throat Disord 2018; 18: 1
- 24 Penchansky R, Thomas JW. The concept of access: definition and relationship to consumer satisfaction. Med Care 1981; 19: 127-140
- 25 Pronk M, Deeg DJ, Kramer SE. Hearing status in older persons: a significant determinant of depression and loneliness? Results from the longitudinal aging study Amsterdam. Am J Audiol 2013; 22 (02) 316-320
- 26 Ratanjee-Vanmali H, Swanepoel W, Laplante-Levesque A. Characteristics, behaviours and readiness of persons seeking hearing healthcare online. Int J Audiol 2019; 58: 107-115
- 27 Robert SA, Cherepanov D, Palta M, Dunham NC, Feeny D, Fryback DG. Socioeconomic status and age variations in health-related quality of life: results from the national health measurement study. J Gerontol Ser B Psychol Sci Soc Sci 2009; 64B (03) 378-389
- 28 USDA. Rural-Urban Continuum Codes. 2017 https://www.ers.usda.gov/data-products/rural-urban-continuum-codes/documentation/ . Accessed September 25, 2018
- 29 van Zyl M, Swanepoel W, Myburgh HC. Modernising speech audiometry: using a smartphone application to test word recognition. Int J Audiol 2018; 57 (08) 561-569
- 30 Ward M, McGarrigle CA, Kenny RA. More than health: quality of life trajectories among older adults-findings from the Irish Longi- tudinal Study of Ageing (TILDA). Qual Life Res 2019; 28 (02) 429-439
- 31 World Health Organization. WHOQOL: Measuring Quality of Life. 2018 http://www.who.int/healthinfo/survey/whoqol-qualityoflife/en/ . Accessed November 16, 2018