A recent study by a team at Aston University in England asked, “How do patients decide on interventions for single-sided deafness?” The researchers recognized that only having hearing in one ear presents communication challenges. With different hearing technology available, they wanted to know how people chose one over another. We explore their findings.
Eight participants were recruited from Portsmouth Hospitals University NHS Trust audiology service in England. The participants were using, planning to use, or had used one type of hearing technology available to people with unilateral hearing loss. These include conventional hearing aids, a bone-anchored hearing aid, and CROS. None had a cochlear implant.
Interviews were semi-structured with open questions used as prompts:
The study found that respondents were repeatedly adjusting their decisions about which device was best for their unilateral hearing loss. Their decision making was informed by previous experiences and a range of other factors. Priorities changed for the participants over time, for example, when working versus being retired.
Read more: Living with single-sided hearing loss
The researchers described their findings: “All participants described an ongoing evaluation of risks and benefits. This often involved evaluating the physical discomfort and practicalities of using a hearing aid against any benefit provided through using it.”
The risks and benefits involved in having surgery for a bone-conducting device (BCD) were also considered.
“Those participants who had previous experience of major surgery were less negative about the risks or perceived seriousness of the BCD as an intervention than those who did not have previous experience of surgery,” researchers said.
Surgery represented a last resort.
Three participants described using hearing aids as part of a journey back to ‘being normal.” Researchers said, “The desire to ‘be normal’ formed a core part of the drive to explore and use hearing aids for these participants.”
Access to information was key to decision making for participants. Participants highlighted that information was often “only available once already accessing hearing-related care.” All participants “used medical language” when describing their hearing loss and interventions. Participants sought information from clinicians, charities, peers, and online and face-to-face support groups. All participants wanted information on all the options available to them.
Participants expressed concerns about how visible a hearing device would be to others. The study provided detailed insight into the trade-offs participants considered: effectiveness of current technology, perceived benefit of a different technology, social judgement, appearance, and stigma.
“Participants explicitly expressed that effectiveness of hearing aids was a core goal of using them,” said the researchers.
The two participants who had received an implanted BAHATM said it provided significant benefit. But one of those participants had to have theirs removed due to an infection.
Participants described CROS aids as “Brilliant… It was a revelation,” and “Does help is all I’d say.”
The study provides new insights into the effect of personal experiences on decision making. It highlights the complex nature of how decisions are made. And it identifies the need for access to information for people with hearing in only one ear.