Communication Profile For The Hearing Impaired Research Articles

A Comparison of the Perceived Hearing Difficulties of Community and Clinical Samples of Older Adults.

PurposeThis study aimed to compare the perceived hearing difficulties of a community sample of older adults to two clinical samples of older adults, one with no hearing aid experience and the other with hearing aid experience.MethodScale scores from the Communication Profile for the Hearing Impaired (CPHI) were analyzed for a community sample of older adults (N = 243) and compared to scores from two clinical samples, one without (N = 342) and one with prior hearing-aid experience (N = 179). General linear model (GLM) analyses were performed to examine the effects of data sample type and other factors on CPHI scale scores. Scores for the Hearing Handicap Inventory for the Elderly (HHIE) were also available for most participants and were analyzed.ResultsGLM analyses of each of the 20 CPHI scale scores showed significant effects of sample type with hearing-loss severity and age most frequently showing significant effects as well. GLM analyses controlling for hearing-loss severity and age across sample types found significant differences on most CPHI scales between the community sample and each of the two clinical samples. Significant differences between the two clinical samples were also found on several CPHI scales and on the HHIE.ConclusionsOlder adults from the community who did not seek help for hearing difficulties self-reported less difficulty and a greater denial or lack of awareness of communication problems than those who sought assistance at an audiology clinic. For those presumed to have sought a hearing evaluation, those acquiring hearing aids perceived greater communication difficulties in all environments, had greater awareness of communication difficulties, were more accepting of their hearing loss, but tended to allocate more responsibility for their difficulties to others, compared to those who sought clinical assistance but did not acquire hearing aids.

'Dual Sensory Loss Protocol' for Communication and Wellbeing of Older Adults With Vision and Hearing Impairment - A Randomized Controlled Trial.

ObjectivesMany older adults with visual impairment also have significant hearing loss. The aim was to investigate the effectiveness of a newly developed Dual Sensory Loss (DSL) protocol on communication and wellbeing of older persons with DSL and their communication partners (e.g., spouse or child) in the Netherlands and Belgium.MethodsParticipants (N = 131) and their communication partners (n = 113) were randomized in the “DSL-protocol” intervention group or a waiting-list control group. The intervention took 3 to 5 weeks. Occupational therapists focused on optimal use of hearing aids, home-environment modifications and effective communication strategies. The primary outcome was the Communication Strategies domain of the Communication Profile for the Hearing Impaired (CPHI). Secondary outcomes measured in participants were the Low Vision Quality Of Life Adjustment subscale, the Center for Epidemiological Studies - Depression Scale, De Jong Gierveld Loneliness Scale and the Fatigue Assessment Scale. The Hearing Handicap and Disability Inventory (HHDI) - Reaction of Others subscale and the Care-related Quality of Life - 7 Dimensions was measured in communication partners. Measurements were taken at baseline and 3-month follow-up. Linear mixed models (LMM) were used to analyze effects between groups over time for every outcome measure.ResultsIntention-to-treat analyses showed a significant effect of the DSL-protocol on the use of verbal strategies (effect size SMD = 0.60, 95% CI: 0.25 to 0.95) in favor of the control group, however, this effect was non-significant after adjustment for confounding. Effect sizes of other outcomes varied between −0.23 [−0.57, 0.12] and 0.30 [−0.05, 0.64]. The LMM showed a significant effect on the HHDI-Reaction of others scale in favor of communication partners in the treatment group, however, the effect did not remain significant at a 0.01 significance level and the effect size was very small and non-significant 0.12, 95% CI [−0.27 to 0.51]. Adjusted analyses did not reveal treatment effects.ConclusionThe DSL-protocol did not clearly contribute to the enhancement of communication and wellbeing in DSL-patients. Possible reasons for the lack of effects are OTs not being comfortable giving advice on communication and psychosocial issues or the short-term treatment and follow-up period. Further study is warranted to find out how the protocol may be adapted or whether it is necessary to involve mental healthcare professionals.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NTR2843.

Bone-anchored hearing implants in single-sided deafness patients: Long-term use and satisfaction by gender.

To examine the long-term satisfaction and possible effects of gender in patients with single-sided deafness (SSD) who underwent bone-anchored hearing implant (BAHI) surgery. Retrospective case-control study. All (n = 145) consecutive SSD patients fitted with a BAHI between January 2001 and October 2011 were asked to complete a questionnaire consisting of the Abbreviated Profile of Hearing Aid Benefit (APHAB), the Communication Profile for the Hearing Impaired (CPHI), and the SSD questionnaire. Twenty-three of the 135 responding patients (17%) reported discontinuation of the device over an average follow-up time of 61.7 months. No significant differences were found in the degree of disability or coping between men and women, according to the APHAB and CPHI scores. Improvement in quality of life and appreciation of the BAHI were not affected by gender, age, directional hearing ability, and handling of the device. The appearance of the device positively affected their appreciation. At the mean follow-up time of 117 months, 69.2% was using their BAHI. In the domains background noise, reverberant surroundings, and aversion to sounds, the mean APHAB scores were significantly changed at 3 months, 1 year, and 10 years after implantation. Our study examined the results of BAHI use in SSD patients over a relatively long follow-up period, with an average of 5 years. The majority of users (83%) were satisfied with the device. No significant gender differences were in terms of reported appreciation, hearing disability, or coping with a BAHI. 3b.

Factor Structure and Reliability of the Dutch Version of Seven Scales of the Communication Profile for the Hearing Impaired (CPHI)

Seven scales of the Communication Profile for the Hearing Impaired (CPHI; M. E. Demorest & S. A. Erdman, 1987) were translated into Dutch: Maladaptive Behavior, Verbal Strategies, and Nonverbal Strategies (within the area of Communication Strategies) and Self-Acceptance, Acceptance of Loss, Stress, and Withdrawal (within the area of Personal Adjustment). This cross-sectional study evaluated the factor structure, internal consistency, test-retest reliability, and measurement error of the Dutch CPHI scales. In all, 399 adults with impaired hearing participated, and data on a subgroup of 40 patients were included in the test-retest analyses. The participants completed the questionnaire before routine clinical care or at home. Demographic data and data on pure-tone hearing thresholds were also collected. Based on item factor analyses, we omitted 5 items, moved 3 items to different scales, and combined the Stress and Withdrawal scales. The resulting 6 scales, containing 52 items, showed good internal consistency (alphas between 0.81 and 0.94), good test-retest reliability (intraclass correlation coefficients between 0.78 and 0.86), and small standard error of measurement (between 0.28 and 0.46). The suggested revisions of the Dutch CPHI scales will increase their interpretability. Further research is needed to evaluate their usefulness for monitoring patients and in longitudinal studies by determining their responsiveness and minimal important change values.

Psychosocial Correlates of Hearing Aid Adjustment

Despite considerable evidence regarding the detrimental effects of untreated hearing loss, there continues to be an underutilization of hearing aids by adults. The Long Term Follow-Up of Patients in the National Institute on Deafness and Other Communication Disorders/Veterans Affairs (NIDCD/VA) Hearing Aid Clinical Trial (Cooperative Studies Program [CSP] 418-A) provided the opportunity to compare a number of potential psychosocial influences and outcomes for hearing aid users and nonusers from the original CSP 418 study. The Communication Profile for the Hearing Impaired (CPHI) results provide compelling evidence of hearing aid benefit. Mean Communication Performance (CP) scores for hearing aid users on the Social, Work, and Home scales improved significantly from the original CSP 418 administration. For nonusers, there were no significant CPHI changes from the previous administration. Although hearing aid users and nonusers did not differ in optimism, this parameter was correlated with personal adjustment, measured via the CPHI. Hearing aid use was associated with the perception of major life events, such as illness, retirement, and so forth.

Clinical Interpretation of the CPHI

Clinical Interpretation of the CPHI

The Effect of Hearing Aids and Frequency Modulation Technology on Results from the Communication Profile for the Hearing Impaired

Hearing impairment has been associated with decline in psychosocial function. Previous investigations have reported that the utilization of hearing aids can ameliorate these reductions in psychosocial function. To date, few investigations have examined the effects of frequency modulation technology on hearing handicap, adjustment to hearing loss, and communicative strategies. The purpose of this investigation was to examine these effects and to compare them to the benefits obtained when using hearing aids alone. Subjects ranged in age from 34 to 81 years and had mean pure-tone thresholds consistent with a bilateral moderate to severe sloping sensorineural hearing loss. All subjects wore hearing aids only and hearing aids plus FM system in a randomized fashion. The Communication Profile for the Hearing Impaired (CPHI) was administered prior to fitting the study devices and once a month for three months in each of the two conditions. A statistically significant difference between device conditions was obtained for the Importance of Communication in Work Situations subscale. Additionally, statistically significant differences over time were noted in several CPHI subscales. Despite statistical significance, none of these results were clinically significant. The implications of these results will be discussed.

Examination of differences between successful and unsuccessful elderly hearing aid candidates matched for age, hearing loss and gender: Evaluación de las diferencias entre los candidatos exitosos y no exitosos de edad mayor, al uso de auxiliar auditivo por edad, grado de hipoacusia y sexo

This study examined group differences on a variety of measures for three groups of elderly hearing aid candidates matched for gender, age and hearing loss. These three groups were: (1) 26 candidates who declined amplification (non-adherents): (2) 24 individuals who purchased hearing aids, but subsequently returned them (rejected HA); and (3) 26 who purchased hearing aids and continued to use their hearing aids for at least the first 6 months following delivery (accepted HA). Following demonstration of adequate reliability for these measures, using the non-adherents as the test-retest study sample, group differences were examined for each pre-fit measure. The group of non-adherents who declined amplification differed from the two groups who purchased hearing aids on their scores for the Hearing Handicap Inventory for the Elderly (HHIE) and for several scales of the Communication Profile for the Hearing Impaired (CPHI) that assessed the individual's personal adjustment to hearing impairment. These findings were generally confirmed for the individual data, with the use of discriminant analysis. For the two groups who tried hearing aids, there were no group differences between those who retained them and those who did not. Discriminant analysis, however, indicated that those in the group who retained their (linear) hearing aids tended to have better finger dexterity and higher loudness discomfort levels than those who did not.

Objective and subjective measures of self-reported hearing deterioration in older hearing-impaired adults

A small proportion of hearing-impaired older adults reports hearing deterioration during their annual otologic examination without exhibiting any concomitant changes in audiometric or otologic results. This study examined the ability of a self-report questionnaire and a battery of speech perception tests to distinguish these subjects from a set of matched subjects who had no reported hearing deterioration. The Communication Profile for the Hearing Impaired (CPHI) and three performance-based speech perception measures [objective and subjective speech reception threshold tests (SRT) and a suprathreshold nonsense word task] were included in the test battery. Responses to some specific items of the CPHI and the difference between the subjective and objective SRTs in noise differed between listeners with reported hearing deterioration and those without. Those who reported deterioration underestimated their hearing ability to hear in noise more than the control group. They were also more aware of their communication difficulties in some communication settings. [Work supported by the Natural Sciences and Engineering Research Council of Canada, Health Canada, and Unitron Industries Ltd.]

Psychometric evaluation of a Swedish version of the communication strategies scale of the communication profile for the hearing impaired.

The Communication Strategies scale of the Communication Profile for the Hearing Impaired (CPHI) was translated into Swedish and used in several studies of people with hearing impairment (Hallberg & Carlsson, in press; Hallberg, Erlandsson, & Carlsson, 1991). In this study the scale was evaluated in terms of descriptive statistics, corrected item-total correlations, principal component analysis, and internal consistency reliability. Agreement with results from American studies is surprisingly good. Normative data based on three samples are presented: a general Swedish hearing-impaired sample with predominantly sensorineural hearing loss (N = 199), a subgroup of 105 younger subjects with noise-induced hearing loss, and a subgroup of 39 older subjects with sensorineural hearing loss due to heredity and/or old age. A significantly more frequent use of maladaptive behaviors (p less than .001) and verbal communication strategies (p less than .01) was reported by older subjects with age-related and/or hereditary hearing loss than by younger subjects with noise-induced hearing loss. The Communication Strategies scale seems to be an adequately reliable and clinically useful instrument for assessing adaptive and maladaptive strategies in hearing-impaired subjects.

The Relationship between Communication Problems and Psychological Difficulties in Persons with Profound Acquired Hearing Loss

Communication strategies, accommodations to deafness, and perceptions of the communication environment by profoundly deaf subjects were correlated with indices of psychosocial adjustment to determine whether accommodations to deafness could play a role in the presence of psychological difficulties among deaf persons. Persons with postlingually acquired profound deafness were administered the Communication Profile for the Hearing Impaired (CPHI) and several standardized tests of psychological functioning and adjustment. Inadequate communication strategies and poor accommodations to deafness reported on the CPHI were associated with depression, social introversion, loneliness, and social anxiety. Limited communication performance at home and with friends was related to both social introversion and the experience of loneliness; perceived attitudes and behaviors of others correlated with depression as well as loneliness. In general, the pattern of correlations obtained suggests that specific communication strategies and accommodations to deafness, rather than deafness per se, may contribute to the presence of some psychological difficulties in individuals.

Factor structure of the communication profile for the hearing impaired.

Factor structure of 23 scales of the Communication Profile for the Hearing Impaired (CPHI) (Demorest & Erdman, 1986, 1987) was examined in a sample of 1,226 patients who participated in the Aural Rehabilitation Program at Walter Reed Army Medical Center from 1985 through 1987. Five factors were identified: Adjustment, Reaction, Interaction, Communication Performance, and Communication Importance. To enhance clinical interpretation of the CPHI, it is recommended that factor scores be added to the communication profile.

Retest stability of the communication profile for the hearing impaired.

Retest stability of the Communication Profile for the Hearing Impaired (CPHI) was assessed in a sample of 101 active-duty military personnel who attended the Aural Rehabilitation Program at Walter Reed Army Medical Center. Pretests were administered by referring audiologists; retests were administered from 6 to 40 weeks later, at the beginning of the rehabilitation program. Mean scores on 5 of the 25 scales of the CPHI decreased significantly (p less than 0.01) over time, but the changes were small in magnitude (approximately -0.20). Distributions of retest-test differences were used to establish criteria for inferring significant improvement in scores over time. Retest correlations for scales in the communication environment, communication strategies, and personal adjustment areas ranged from 0.58 to 0.78. Communication performance and communication importance were less stable (r = 0.28 to 0.54). Retest correlations were comparable for short versus long retest intervals, but varied as a function of military rank. Implications of the results for clinical use of the CPHI are discussed.

Development of the Communication Profile for the Hearing Impaired

The rehabilitative needs of hearing-impaired adults depend on the degree of communication handicap experienced and on many other factors (environmental, behavioral, emotional, and attitudinal) that contribute to communication problems. The Communication Profile for the Hearing Impaired (CPHI) is a 145-item self-assessment inventory for adults. Its 25 scales encompass four areas: Communication Performance, Communication Environment, Communication Strategies, and Personal Adjustment. The inventory was developed at Walter Reed Army Medical Center and pilot tested over a 3-year period on 827 patients who attended the Aural Rehabilitation Program at the Army Audiology and Speech Center. The rationale and methods used to develop the CPHI are discussed, and normative data for the Walter Reed population are presented.

Scale composition and item analysis of the Communication Profile for the Hearing Impaired.

The Communication Profile for the Hearing Impaired (CPHI) is a self-assessment inventory that provides 25 scores describing the Communication Performance, Communication Environment, Communication Strategies, and Personal Adjustment of hearing-impaired adults (Demorest & Erdman, 1986). Description of the content and measurement objective for each scale is given and an analysis of the psychometric properties of the 145 items in the CPHI is presented. Results are based on a sample of 433 active-duty military personnel tested at Walter Reed Army Medical Center during the final phase of CPHI development. Included are frequency distributions, descriptive statistics, item-total correlations, and factor structure of the items within each scale and across scales within each of the areas assessed by the CPHI. Applications of these data in clinical interpretation, construct validation, and further development of the CPHI scales are discussed.