College of Behavioral & Social Sciences
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The collections in this community comprise faculty research works, as well as graduate theses and dissertations..
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Item Values in American Hearing Healthcare(2024) Menon, Katherine Noel; Hoover, Eric C; Hearing and Speech Sciences; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The long-term objective of this research is to create a more inclusive, patient-centered hearing healthcare system that aligns with all stakeholders’ diverse values and needs. This dissertation explores the values shaping hearing healthcare through three complementary studies. Chapter 2 analyzes the introduction of over-the-counter (OTC) hearing aids, revealing a values shift from traditional audiology’s focus on accuracy, safety, and subjective benefit to prioritizing access and affordability. Implementing an OTC service delivery model for hearing healthcare promoted values different from those of traditional audiology. Still, the creation of OTC offers affordances that enable us to create more patient-centered hearing healthcare systems to reflect stakeholders’ values. Chapter 3 validates a comprehensive list of values in audiology through a national survey of audiologists, confirming alignment with best-practice guidelines. Previous work developed a codebook of values based on textual documents representing best practices in traditional audiology, and it was essential to validate these findings by directly engaging with audiologists. Chapter 4 develops a codebook based on the values of individuals with hearing difficulties, categorizing their concerns into Material, Social, and Healthcare domains. Results from this study highlight the importance of considering the values of individuals with hearing loss, which encompasses not only the use of hearing aids and affordable hearing healthcare but also concerns regarding the effectiveness, usefulness, and social implications of hearing aids. Together, these studies underscore the balance between efforts to improve accessibility and the need to maintain patient-centered outcomes, suggesting that future research should focus on understanding how values intersect with the daily lives and decision-making processes of all people with difficulty hearing.Item Predicting the loudness discomfort level from the acoustic reflex threshold and growth function(2008-08-18) Cannavo, Justine Marie; Gordon-Salant, Sandra; Hearing and Speech Sciences; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The purpose of the present study was to evaluate the relationship between several measures of the acoustic reflex [acoustic reflex threshold (ART), dynamic range of the acoustic reflex growth function, the 50% point along the acoustic reflex growth function, and the maximum intensity value of the acoustic reflex growth function] and behavioral measurements of loudness [loudness discomfort level (LDL) and the loudness contour (LC)]. The underlying objective was to determine if any of these measures can be used to predict the LDL. A finding of a strong relationship between these measures could potentially assist in the creation of an objective method to measure LDLs, which may have implications for hearing aid fittings. Prior research in this area has yielded conflicting results. However, very few studies examined measures of loudness growth and the dynamic range of the acoustic reflex. Twenty young adults ranging from 22-35 years of age (Mean age = 25.85, s.d. 3.07) with normal hearing participated in this study. Participants were required to provide a subjective loudness rating to warbled-tone stimuli in accordance with a categorical loudness scaling procedure adapted from Cox et al. (1997), as well as an LDL rating. Additionally, an ART was obtained from each participant, as defined by a 0.02 mmho change in admittance. Following identification of the ART, the acoustic reflex growth function was obtained by increasing the stimulus until the termination point. Experimental measures were obtained over two test sessions. Results revealed no significant relationship between measures of the acoustic reflex and loudness. Analysis of test-retest measures revealed moderate to very high positive (0.70 - 0.92) correlations for the acoustic reflex and LDL measures over a period of 1 day to 2 weeks. Test-retest performance on the majority of loudness categories on the LC did not reveal stable results. Implications for these findings are that the ART cannot be used to reliably predict the LDL. Additionally, the LC may not be a reliable clinical measurement to assess loudness.Item Personality Type and Self-perception of Hearing Aid Benefit(2006-06-02) Segar, Allyson Adrianne; Gordon-Salant, Sandra; Hearing and Speech Sciences; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Hearing aid benefit is frequently assessed using subjective measures in which the patient is asked to respond to a series of questions regarding how much benefit they feel they are receiving from their hearing aids. Previous research has shown that audiological factors are related to the amount of self-reported benefit from hearing aids, but these factors do not explain all of the variance in hearing aid benefit scores. The purpose of this investigation was to assess the relationship between several non-audiological factors, including personality, mood, and gender, to self-reports of hearing aid benefit. Measures of hearing aid benefit, personality, and mood were obtained from 20 older adult listeners with sensorineural hearing loss who were experienced hearing aid users. The two measures of hearing aid benefit were the Hearing Aid Performance Inventory (HAPI) (Walden, Demorest, & Hepler, 1984) and the Abbreviated Profile of Hearing Aid Benefit (APHAB) (Cox & Alexander, 1995); the two measures of personality were the Myers-Briggs Type Indicator (Myers & McCaulley, 1985) and the Keirsey Four Types Sorter (Keirsey, 1998); and the mood assessment was the Positive and Negative Affect Schedule (Watson, Clark & Tellegen, 1988). The results demonstrated significant relationships between extraversion/introversion and self-reported hearing aid benefit, and between mood and self-reported hearing aid benefit. Overall, the measures of mood, Keirsey personality type, and gender were predictors of difficulty communicating in a reverberant environment while wearing hearing aids, and accounted for 71 percent of the variance on this subscale. The results of this study have provided evidence that self-reported hearing aid benefit is associated with certain non-audiological factors including extraversion/introversion preference, certain Keirsey personality types, mood, and gender. Although these factors explained a relatively small amount of the variance in HAPI and APHAB scores, they still provide support for the notion that the amount of benefit an older adult individual reportedly receives from his or her hearing aids is not entirely dependent on hearing sensitivity, but on other attributes that characterize an individual. The findings suggest that certain dimensions of personality should be considered when developing an individualized treatment plan for a patient prior to hearing aid delivery.