The biopsychosocial impact of hearing loss on people with hearing loss and their communication partners

Hearing loss is a prevalent condition that can have negative implications on the day-to-day lives of those with hearing loss, and their communication partners. Several reviews have identified numerous questionnaires that explore the impact of hearing loss, with little consensus among researchers as to their preference. One reason for this is a lack of an agreed framework concerning exactly what is the impact of hearing loss, and what is important to those who live with the condition. To address this gap in understanding, the experiences of those living with hearing loss or with someone that has hearing loss was investigated using various systematic research methods and tools. A comprehensive review of published studies exploring the impact of hearing loss on those with hearing loss and/or their communication partner was conducted. An inductive (data-driven) synthesis of the research evidence led to the development of two frameworks; one for each perspective. Each framework comprised of three higher-level ‘supra-domains’ (i.e. Auditory, Social and Self) which capture the broader implications of hearing loss, and numerous lower-level ‘domains’ and ‘subdomains’ that tap into distinct aspects of life. The frameworks were evaluated for face-validity in focus groups with hearing aid users, communication partners and audiologists. Hearing aid users and communication partners were then asked to rank the domains in order of importance based on their experience of living with hearing loss. The domain ‘communicating’ was ranked most important from both perspectives. A subdomain mutual to both frameworks, ‘raising the volume of the television/radio’ was explored further in a case-control study. The preferred TV volume across 42 couples where one partner was a hearing aid user and the other was a non-hearing aid user was measured. A mean difference in volume preference of 6.3dB was observed between groups across the TV programmes viewed by all participants. The hearing aid prescription of hearing aid users was not verified. Future research should explore how domains in the frameworks are currently being measured and addressed in clinic. Also, data-driven methods should be applied to identify coping mechanisms adopted by people with hearing loss and their partner to accommodate for the diverse range of hearing-related difficulties depicted in the frameworks