Attitudes to noise in young adults and associated factors: adaptation of the youth attitude to noise scale into Spanish using item response theory analysis.

OBJECTIVE: This study aimed to identify the attitudes to noise in young adults and the possible effects of gender, age, and a positive history of auditory symptoms related to recreational noise exposure on the attitudes to noise in this population. DESIGN: The Youth Attitude to Noise (YANS) and the hearing symptom description (HSD) scales were adapted into Spanish to be used with young adults. The validity was determined using factor analyses and Item Response Theory (IRT) models. Linear regression models were used to determine whether the YANS scores were associated with gender, age, and auditory symptoms. STUDY SAMPLE: Both instruments were given to a sample of 728 Chilean young adults. Data obtained from this sample was used to determine the YANS and HSD scales' validity and to assess the effects of gender, age, and auditory symptoms on attitudes. RESULTS: Our results showed that the YANS and HSD scales had adequate validity and reliability. Differences in the items' capacity to discriminate attitudes to noise were noted using the IRT model. Auditory symptoms were significantly associated with the YANS scores. CONCLUSIONS: The attitudes to noise in Chilean young adults are influenced by self-perception of auditory symptoms, age, and gender.

Social determinants of health associated with attitudes towards hearing loss and hearing aids in older adults fitted in a Latin American country: validation of the ALHQ questionnaire into Spanish.

OBJECTIVE: This study aimed to evaluate the association between certain social determinants of health (i.e. educational level, income, and social support) and attitudes towards hearing loss and hearing aids among older adults with hearing loss fitted in a Latin American country. DESIGN: Older adults were asked about their attitudes towards hearing loss and hearing aids, years of formal education, income, social support, perception of having a hearing disability, and social pressure when using the hearing aid. To do so, we adapted the Attitudes towards Loss of Hearing Questionnaire (S-ALHQ) into Spanish. All the questionnaires were conducted as structured interview. STUDY SAMPLE: Two hundred fifty-two older hearing aids users were recruited from a public hospital in Chile. RESULTS: The S-ALHQ showed adequate validity, along with good reliability. The multivariate models showed that educational level and social support were the social determinants of health negatively associated with the attitudes. Aided hearing disability and social pressure to use hearing aids were the co-variables associated with S-ALHQ scores. CONCLUSIONS: The study showed a significant relationship between specific social determinants of health and attitudes towards hearing loss and hearing aids. These attitudes should be considered when implementing rehabilitation programs for older adults with hearing loss.

Does educational level predict hearing aid self-efficacy in experienced older adult hearing aid users from Latin America? Validation process of the Spanish version of the MARS-HA questionnaire.

Hearing aids are the most common rehabilitation strategy for age-related hearing loss. However, 25% to 50% of older adults fitted with hearing aids do not wear them post-fitting. Hearing aid self-efficacy has been suggested as one of the key factors that may explain adherence to hearing aids in older adults. The primary aim of this study was to determine a possible association between educational level and hearing aid self-efficacy in older adult hearing aid users from a Latin American country (i.e., Chile). The secondary aim was to determine if in this sample of older adults, hearing aid self-efficacy predicted hearing aid adherence as previously suggested by other studies. The MARS-HA (Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids) questionnaire was used to measure hearing aid self-efficacy. This questionnaire was initially adapted into Spanish (S-MARS-HA) using forward and backward translations by bilingual English-Spanish speakers. A sample of 252 older adults fitted with hearing aids at a public hospital in Santiago, Chile, was investigated. Educational level was measured as the number of years of formal education. Participants responded to the S-MARS-HA along with questions exploring social support, attitudes in using hearing aids, participation in social events, and vision and joint problems. Hearing aid adherence was investigated with the use of a question from the International Outcome Inventory for Hearing Aids. All these procedures were conducted at the participants' homes. Pure-tone average (PTA; 500-4000 Hz) in the fitted ear was obtained from the participants' medical records. Univariate and multivariate regression models were constructed to investigate the association between educational level and hearing aid self-efficacy controlling for the covariates of interest (e.g., social support, attitudes in using hearing aids, PTA). The S-MARS-HA showed an adequate construct validity along with a good reliability. Results of the multivariate regression analyses showed that educational level significantly predicted hearing aid self-efficacy. Covariates significantly associated with this outcome included attitudes in using hearing aids and PTA in the fitted ear. Finally, a significant association between hearing aid self-efficacy and adherence to hearing aid use was observed. In conclusion, this study showed a significant association between educational level and hearing aid self-efficacy in older adults from a developing Latin American country. Thus, this variable should be considered when designing and delivering aural rehabilitation programs such as hearing aids to older adults, especially those from developing countries.

Effects of auditory and socio-demographic variables on discontinuation of hearing aid use among older adults with hearing loss fitted in the Chilean public health sector.

BACKGROUND: The percentage of older adults with hearing loss who stop using their hearing aids and the variables associated with this phenomenon have not been systematically investigated in South America. This problem is relevant to the region since countries such as Colombia, Brazil and Chile have public programmes that provide hearing aids to older adults. The aims of this study were to determine the percentage of older adults fitted with a hearing aid at a public hospital in Chile who subsequently stop using it and the auditory and socio-demographic variables associated with the hazard of discontinuing hearing aid use. METHODS: A group that included 355 older adults who had been fitted with a hearing aid was studied retrospectively. In a structured interview, participants were asked about socio-demographic variables and answered part of the Chilean National Survey on Health, evaluating self-perceived hearing loss and responding to questions about discontinuation of hearing aid use and their satisfaction with the device. Survival models were applied to determine the hazard of stopping hearing aid use in relation to the variables of interest. RESULTS: The rate of discontinuation of hearing aid use reached 21.7%. Older adults stopped using their hearing aids mainly during the first 5-6 months post-fitting, and then this number steadily increased. The income fifth quintile was 2.56 times less likely to stop using the hearing aid compared to the first. Those who self-reported that they could not hear correctly without the hearing aid were 2.62 times less likely to stop using it compared to those who reported normal hearing. The group that was very dissatisfied with the hearing aid was 20.86 times more likely to discontinue use than those who reported satisfaction with the device. CONCLUSIONS: Socio-demographic variables such as economic income and auditory factors such as self-perceived hearing loss and satisfaction with the device were significantly associated with the hazard of stopping hearing aid use. Self-perceived hearing loss should be considered part of the candidacy criteria for hearing aids in older adults in Chile and other (developing) countries.