A Qualitative Study of the Effects of Hearing Loss and Hearing Aid Use on Music Perception in Performing Musicians.

Abstract

Hearing aids (HAs) are important for the rehabilitation of individuals with hearing loss. Although the rehabilitation of speech communication is well understood, less attention has been devoted to understanding hearing-impaired instrumentalists' needs to actively participate in music. Despite efforts to adjust HA settings for music acoustics, there lacks an understanding of instrumentalists' needs and if those HA adjustments satisfy their needs. The purpose of the current study was to explore the challenges that adult HA-wearing instrumentalists face, which prevent them from listening, responding to, and performing music. A qualitative methodology was employed with the use of semistructured interviews conducted with adult amateur instrumentalists. Twelve HA users who were amateur ensemble instrumentalists (playing instruments from the percussion, wind, reed, brass, and string families) and between the ages of 55 and 83 years (seven men and five women) provided data for analysis in this study. Amateur in this context was defined as one who engaged mindfully in pursuit of an activity. Semistructured interviews were conducted using an open-ended interview guide. Interviews were recorded and transcribed verbatim. Transcripts were analyzed using conventional qualitative content analysis. Three categories emerged from the data: (1) participatory needs, (2) effects of HA use, and (3) effects of hearing loss. Participants primarily used HAs to hear the conductor's instructions to meaningfully participate in music rehearsals. Effects of HA use fell within two subcategories: HA music sound quality and use of an HA music program. The effects of hearing loss fell within three subcategories: inability to identify missing information, affected music components, and nonauditory music perception strategies. Not surprisingly, hearing-impaired instrumentalists face challenges participating in their music activities. However, although participants articulated ways in which HAs and hearing loss affect music perception, which in turn revealed perspectives toward listening using the auditory system and other sensory systems, the primary motivation for their HA use was the need to hear the conductor's directions. These findings suggest that providing hearing-impaired instrumentalists access to musical experience via participation should be prioritized above restoring the perception of musical descriptors. Future research is needed with instrumentalists who no longer listen to or perform music because of hearing loss, so that the relationship between musical auditory deficiencies and participation can be better explored.