Details

Autor(en) / Beteiligte

• Shields, Callum A

Titel

What Is the Optimum Way to Measure the Concept of Listening Effort in Children with Hearing Impairment

Ort / Verlag

ProQuest Dissertations & Theses

Erscheinungsjahr

2023

Link zum Volltext

• ProQuest

Quelle

ProQuest Dissertations & Theses A&I

Beschreibungen/Notizen

• BackgroundListening effort (LE) can be described as the effort required to understand and interpret an auditory stimulus. It is a phenomenon experienced by everyone but is most acutely felt by those with a hearing impairment. Currently, measuring LE is not part of the routine clinical assessment of children and young people with a hearing impairment. This is despite growing evidence to suggest that it may have a detrimental effect on quality-of-life factors and educational attainment. The importance of considering LE as an outcome measure is further emphasized when discussing those individuals with a mild or asymmetrical hearing impairment. In this group, traditional outcome measures such as pure tone audiometry may not adequately capture the burden associated with their hearing difficulties. One of the main barriers to incorporating LE into clinical practice is the lack of consensus on how to measure the concept. Many proposed tools exist, but there is a lack of evidence over which is the optimum instrument. This thesis aims to explore this issue by outlining the current challenges associated with measuring listening effort, exploring this further by conducting a systematic review of the correlations between different LE tools and combining this with normative research to look at potential alternative options for measuring LE.MethodsInitially, an editorial letter was composed to outline the key challenges preventing LE from being used routinely. Subsequently, a systematic review was undertaken to explore the different tools that measure LE. Papers that compared two or more specific tools via correlational analysis were included. The outline of the search process is presented in a PRISMA diagram. The results of the data extraction were presented as a narrative synthesis due to the heterogeneity of included studies. Risk of bias was assessed using the GRADE and ROBINs I tools. Additionally, a protocol for exploratory research was developed to determine the relationship between LE and other related factors such as fatigue, Page | 8 confidence, and stress. A cohort of 100 participants with a range of hearing abilities will be recruited. Each participant will be sent a series of online questionnaires which measured the aforementioned quality of life factors.ResultsThe editorial letter highlighted the overarching barrier associated with LE as an outcome measure relates to the lack of consensus on the best way to measure the concept. This finding is enshrined in the multidimensional model of LE explaining that each measuring instrument taps into a different component of LE and therefore making it difficult to select one all-encompassing tool. This formed the basis of the systematic review of this thesis which looked to see whether this lack of correlation applied across the literature. The systematic review results show that current LE measures are weakly and insignificantly correlated with one another. Even when significant correlations did occur, they were often dependent on the experimental conditions of each study and, therefore, may not translate into real-world clinical practice. Together this supports the idea the no single tool encompasses the complex concept of LE and thus supports the multidimensional mode. Therefore, an alternative approach to capturing LE would be beneficial. An exploratory study investigating the use of downstream consequences as a proxy measure of LE is proposed in chapter 4.ConclusionCurrent measures of LE do not correlate well with one another and therefore appear to capture different elements of the concept. The work within this thesis has suggested the potential of a relationship between LE and fatigue, stress, and self-confidence. The protocol contained within this thesis details a study whereby the validity of using these downstream effects as a proxy measure for LE can be assessed. Further work is needed to undertake this study and subsequently investigate other potential sequelae of prol