Using Patient Perceptions of Relative Benefit and Enjoyment to Assess Auditory Training

Abstract

Patients seeking treatment for hearing-related communication difficulties are often disappointed with the eventual outcomes, even after they receive a hearing aid or a cochlear implant. One approach that audiologists have used to improve communication outcomes is to provide auditory training (AT), but compliance rates for completing AT programs are notoriously low. The primary purpose of the investigation was to conduct a patient-based evaluation of the benefits of an AT program, I Hear What You Mean, in order to determine how the AT experience might be improved. A secondary purpose was to examine whether patient perceptions of the AT experience varied depending on whether they were trained with a single talker's voice or heard training materials from multiple talkers. Participants completed a 6 wk auditory training program and were asked to respond to a posttraining questionnaire. Half of the participants heard the training materials spoken by six different talkers, and half heard the materials produced by only one of the six talkers. Participants included 78 adult hearing-aid users and 15 cochlear-implant users for a total of 93 participants who completed the study, ages 18 to 89 yr (M = 66 yr, SD = 16.67 yr). Forty-three females and 50 males participated. The mean better ear pure-tone average for the participants was 56 dB HL (SD = 25 dB). Participants completed the single- or multiple-talker version of the 6 wk computerized AT program, I Hear What You Mean, followed by completion of a posttraining questionnaire in order to rate the benefits of overall training and the training activities and to describe what they liked best and what they liked least. After completing a 6 wk computerized AT program, participants completed a posttraining questionnaire. Seven-point Likert scaled responses to whether understanding spoken language had improved were converted to individualized z scores and analyzed for changes due to AT. Written responses were coded and categorized to consider both positive and negative subjective opinions of the AT program. Regression analyses were conducted to examine the relationship between perceived effort and perceived benefit and to identify factors that predict overall program enjoyment. Participants reported improvements in their abilities to recognize spoken language and in their self-confidence as a result of participating in AT. Few differences were observed between reports from those trained with one versus six different talkers. Correlations between perceived benefit and enjoyment were not significant, and only participant age added unique variance to predicting program enjoyment. Participants perceived AT to be beneficial. Perceived benefit did not correlate with perceived enjoyment. Compliance with computerized AT programs might be enhanced if patients have regular contact with a hearing professional and train with meaning-based materials. An unheralded benefit of AT may be an increased sense of control over the hearing loss. In future efforts, we might aim to make training more engaging and entertaining, and less tedious.