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The aim of this secondary analysis was to examine the relationships between the ways in which caregivers coped with caregiving stressors and their experience of distress over time. Three coping subscales were derived from the Carers' Assessment of Management Index (CAMI) coping scale: "maintaining balance", "focusing on caregiving" and "avoidance". A proportional (relative) scoring technique was applied. The analysis was based on the responses of 115 pairs of caregivers and care recipients. Care recipients were aged 66-92 years, with no symptoms of dementia, and the majority had mild to moderate hearing impairment. Data were collected at baseline and 6 months later. Caregivers who increased the proportion of strategies endorsed in the "maintaining balance" subscale experienced a decrease in distress, irrespective of change in the proportion of strategies endorsed in the "avoidance" subscale. "Focusing on caregiving" was not significantly related to distress. The results highlight the potential benefits to these caregivers of maintaining a balance in their lives by taking breaks from caregiving.

The aim of the present study is to examine the extent to which caregiving stressors could explain change in family relationships over time – a construct termed stress proliferation – in a secondary analysis of an existing database. The sample of caregivers and care recipients (N = 132) was drawn mainly from records held by general practitioners in Glasgow. Care recipients were aged 65 years and over, and the majority had impaired hearing. Caregivers were younger non-spouse relatives of care recipients. Using hierarchical multiple regression analysis, two stressors were found to be significantly related to deterioration in family relationships over a period of six months, irrespective of change in caregiver distress: the care recipient's hearing disability (β = −0.21), and change in the caregiver's negative reactions to caregiving (β = −0.23). It was concluded that the care recipient's hearing disability and more negative reactions to caregiving were related to a deterioration in family relationships over ...

Hearing difficulties in older people may have a negative impact on younger relatives, a construct termed "hearing hassles". Although the provision of a hearing aid to older people with hearing difficulties can reduce the hearing hassles experienced by younger relatives, there is considerable variation in response. In this paper, we examine the factors associated with change in hearing hassles over a period of 6 months. Participants included 56 pairs of older people (65 - 93 years) and younger relatives (24 - 66 years) drawn from the community. None of the older participants had severe cognitive impairment. A hearing aid was supplied to the older participants. Increase in hearing hassles over the 6-month period was associated with greater initial caregiving time demands, deterioration in the quality of the relationship with the older person, a decrease in the use of coping strategies aimed at maintaining a balance in life, and the following characteristics of the older person: greater age, more impaired co...

A newly developed self-report instrument, designed to assess variation in the social and psychological impact of a relative's hearing difficulties (‘hearing hassles’), was administered to younger relatives of people with hearing impairment. The first aim was to examine the properties (reliability, validity and sensitivity to change) of this instrument, and the second aim was to examine the contributions of a range of characteristics of the older person to the younger relative's appraisal. The analysis was informed by caregiving stress theory (Pearlin et al., 1990). This was a secondary analysis of an existing data set. The original study, which assessed the impact of hearing aid provision on stress-related measures, used a randomized controlled design. In the current analysis (N = 113), group (intervention or control) was controlled in all analyses. The measure of hearing hassles was found to be reliable, valid and sensitive to change. Those with higher hearing hassle scores had relatives with more hearin...

When selecting the frequency response of a hearing aid, a target is usually selected using a predictive formula from the international literature. Nowadays real ear measurements can readily be carried out to ensure that the real ear gain closely matches the prescribed target. Such measurements are usually only carried out on a subset of patients fitted in the UK, though it has been suggested that they should be carried out on all hearing aid prescriptions. Real ear insertion gains were measured on 319 first-time National Health Service (NHS) hearing aid issues. A total of 181 (57%) failed to come within 10 dB of the target gain at one or more frequencies between 0.25 and 3 kHz. Though there were audiometric differences between those who achieved satisfactory gain and those who did not, there was too much overlap between groups to make any audiometric index or combination of indices of value in predicting the likelihood of failure to achieve target gain. Sixty-eight patients with inadequate real ear gain were invited to attend for alterations to their hearing aid prescription. Twelve (18%) were fitted with a high frequency aid, while the rest were managed by alterations to their NHS aid or to the earmould and tubing. After appropriate changes, 58 (85%) achieved a satisfactory gain. The routine use of real ear insertion gains in all hearing aid fittings would result in many patients having a more accurately fitted hearing aid. As the majority of prescriptions could be adequately improved using NHS hearing aids, the effects on the hearing aid budget would be relatively small.

The aim of this study was to compare individuals referred to an Audiology Clinic (consulters) with hearing-impaired individuals in the population who have never sought advice (non-consulters) in order to identify factors which lead some individuals with hearing problems to seek management while others with apparently similar impairments do not seek advice. Two hundred and sixty nine consulters referred to the Audiology Clinic at Glasgow Royal Infirmary were compared with 289 individuals identified in the MRC National Study of Hearing who had never sought advice as an adult about hearing problems. Age, sex, socio-economic group and better-ear hearing threshold were controlled for in all analyses. Consulters were found to have more asymmetrical hearing than non-consulters. They had greater measured disability and reported more disability when their measured disability and impairment were controlled for. They were also more handicapped when impairment and disability were controlled for.

The criteria generally used to decide in which ear to fit a monaural hearing aid are based on theory or anecdote and have not been verified by experimental observation. In this study to determine optimum side of fitting, 58 new hearing aid users were fitted with a hearing aid in one ear for 10 weeks, and then fitted in the other ear for a further 10 weeks. Subsequently, the subjects were asked their preference for side of hearing aid use and their reasons for this preference. 30 (52%) subjects reported better hearing with their aid in one ear than in the other; 24 (80%) of these preferred the ear with the poorer half-peak level elevation on a speech audiogram. The remaining 28 (48%) reported no difference in their aided hearing ability between ears, though 20 preferred one ear for practical reasons, unrelated to audiometric parameters. A patient's preference for side of fitting can be predicted from audiometric data but with only modest reliability. It is, therefore, recommended that bilateral ear moulds should be routinely provided for bilateral mild to moderate hearing impairment (speech frequency average less than 75 dB HL). If it is decided that only one ear mould should be provided, this should be made for the poorer hearing ear. The poorer hearing ear is best identified from the half-peak level elevation on a speech audiogram.