Hearing aid satisfaction among Chinese users : a consumer research perspective

Abstract

Satisfaction is a frequently measured outcome of hearing aid fitting and can be defined as a pleasurable emotional experience that occurs as an outcome of performance evaluation. Factors that influence satisfaction remain unclear and methods for measuring satisfaction are not well defined. Hearing aids can be categorized as consumer products, but have not previously been evaluated as such. Consumer products are often evaluated using a disconfirmation-expectancy model hypothesizing that expectations, performance and/or disconfirmation (i.e., a comparison between actual performance and expectations) influence satisfaction. In addition, the effects of other factors such as payment equity (i.e., whether a product is worth the payment), aid usage, attribution of effort and repurchase intent on satisfaction have not been thoroughly evaluated. Therefore, this research was aimed at investigating 1) methodological issues in hearing aid satisfaction measurements 2), the elements of the disconfirmation-expectancy model in hearing aid satisfaction, and 3) how other factors related to aid satisfaction.Two studies were conducted, with Study 1 examining all three aims and Study II the second aim only. In Study I, important methodological issues in satisfaction measurement including whether satisfaction changes during the first year of use, how measurement using numeric and categorical scales compare, whether objective performance and benefit relate to satisfaction, and how subtractive and subjective measures of benefit/disconfirmation compare were examined. Participants were 58 older Chinese new hearing aid users living in Hong Kong. They were assessed pre-fitting and then at 3, 6, 13, 26 and 52 weeks post-fitting. Self-reports of hearing abilities, problems, cost and service and other outcomes were measured using structured interview and questionnaires including the Chinese version of the Profile of Hearing Aid Performance (C-PHAP; Wong, 1999), the Hearing Aid Outcome Measurement (HAOM) developed for this research, and the International Outcome Inventory (IOI-HA; Cox & Alexander, 2002). Performance and benefit were measured objectively as behavioural thresholds, real-ear insertion gain, and speech intelligibility using the Cantonese Hearing In Noise Test (CHINT; Wong & Soli, 2005).Study 1 results revealed that acclimatization did not occur during the first year post-fitting; numeric and categorical satisfaction scales yielded comparable results; and subjective measures of benefit/disconfirmation were preferable over subtractive ones because they better reflected self-perceived experiences. Objective performance and benefit with hearing aids did not relate to self-reported satisfaction. On the basis of these findings, results at a single point in time post-fitting (3 months), numeric ratings and subjective benefit/disconfirmation were adopted for further analysis.In terms of the second aim of the research to investigate the disconfirmation-expectancy model, it was found that satisfaction with specific aspects of hearing ability, problems, cost and service were related to each other. Self-reported aided hearing performance was related to satisfaction in the four areas. When discomfort from loud sounds was reduced or less than expected, satisfaction in all aspects increased; while other specific problems related to reduced satisfaction in the same problems or related conditions (e.g., noise annoyance was related to reduced satisfaction with hearing in noise). Expectations were not related to post-fitting satisfaction. Disconfirmation and satisfaction with cost were related.