Factors Affecting Hearing Aid Adoption and Use: A Qualitative Study

BACKGROUND: Despite a high prevalence of age-related hearing loss in older people, there is an unexplained low level of hearing aid adoption and use. Further research is required to determine the reason because hearing aids can vastly improve the quality of life for those with hearing loss. PURPOSE: The aim of this study was to explore factors associated with hearing aid adoption and use, and to determine whether these differed between groups with different hearing aid use behaviors. RESEARCH DESIGN: Individual face-to-face semistructured interviews. STUDY SAMPLE: Three groups of older people with hearing loss in Northern Ireland were recruited: (1) regular hearing aid users (n = 12), (2) irregular hearing aid users (n = 10), and (3) hearing aid nonowners (n = 10). DATA COLLECTION AND ANALYSIS: Qualitative thematic analysis, using principles of grounded theory, was used to code the data and extract emerging themes for each of the three groups to distinguish similarities and differences between the groups. One-way analysis of variance and χ² tests were used to determine the difference in continuous and categorical variables, respectively, between the three groups. RESULTS: Similar themes emerged across the three groups: the complexity of low hearing aid use and attitudes to hearing loss/hearing aid use. A third theme, inadequacy of audiology services, was identified in both groups using hearing aids. Older age people having more severe hearing loss and longer duration of hearing aid ownership were associated with greater hearing aid adoption and use. CONCLUSIONS: Similar themes emerged from qualitative analysis across groups of people with hearing loss. More information for those with hearing loss and those with hearing aids and scheduled follow-up appointments for those with hearing aids are essential to improve hearing aid adoption and use in older people. Further research should focus on the most suitable methods of distributing this information and how often follow-up appointments should take place to achieve optimal hearing aid adoption and use.