Examining the Relation Between Hearing Loss and Successful Aging

186 p.Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 2009.A decline in social engagement has a negative impact on numerous elements considered critical for successful aging. Because many social and productive activities require effective communication skills for individuals to remain fully engaged, it was hypothesized that self-perceived hearing problems limit the frequency of engagement in social and productive activities that require, to a large degree, the ability to hear and understand the speech of others. It was also hypothesized that social disengagement due to hearing difficulties alone directly affects perceptions of overall well-being. A third hypothesis proposed was that the level of confidence an individual has toward overcoming everyday obstacles to hearing and understanding speech (i.e., self-efficacy beliefs) directly affects his/her perceptions of hearing problems. Self-efficacy has been demonstrated to not only be a reliable predictor of health-promoting behaviors, but a personal resource that can be developed and enhanced as well. However, little is currently known about the impact that hearing-related self-efficacy beliefs have on the perceptions of hearing difficulties and the practice of maladaptive coping behaviors, such as activity disengagement. The present study was designed to explore this relation for the first time. This cross-sectional survey study examined relations among hearing loss, self-efficacy strength and social engagement from a sample of 156 older volunteers (M age = 69.8 years) with documented hearing loss, recruited from a clinical population. Data were analyzed using covariance modeling to develop and test four theoretical models as a means to advance understanding about the complex associations among variables. Data supported each of the proposed hypotheses, suggesting a direct effect of hearing-related activity limitations on participation restrictions; a direct effect of participation restrictions due to hearing difficulties on satisfaction with life and a direct effect of self-efficacy strength on perceptions of hearing difficulties. Data also suggested that degree of hearing loss was directly related to strength of self-efficacy. Interestingly, model estimates suggested that the degree of hearing loss was directly related to the self-report of hearing difficulties, but mediated by the strength of self-efficacy beliefs. Findings from the present study provide support for the theory that hearing loss affects more than just communication, but the overall process of successful aging. To treat the whole person and not just the hearing loss, these findings emphasize the need to identify the extent in which social engagement is being restricted directly by the hearing problem. Data also suggested that strong self-efficacy beliefs are associated with fewer negative consequences of hearing loss. Because self-efficacy is a personal resource that can be enhanced, intervention efforts made to strengthen hearing-related efficacy beliefs may lead to an increase of positive health-promoting behaviors, made evident by more frequent participation in activities that would otherwise be avoided due to hearing/communication problems. Two of the four models tested in the present study, the Self-efficacy Mediating AL-PR model and the Self-efficacy Mediating HHI model, provide a framework on which to examine this relation further. Efforts to expand these two models are expected to lead to better understanding of the effect of hearing loss on functional performance, participation in life and overall well-being.U of I OnlyRestricted to the U of I community idenfinitely during batch ingest of legacy ETD