Influences on hearing aid use in people with dementia

Hooper, Emma ORCID: https://orcid.org/0000-0002-4059-6035 (2024) Influences on hearing aid use in people with dementia. Doctoral thesis, University of Manchester.

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Abstract

Hearing loss is highly prevalent in people with dementia. Treating hearing loss with hearing aids represents an important opportunity to address hearing disabilities and improve quality of life. However, little is known about influences on hearing aid use in people with dementia. This is problematic because, until these influencing factors are sufficiently understood, they cannot be addressed in interventions aimed at supporting hearing aid use. Through identifying enablers, barriers, and correlates of hearing aid use in community-residing people with dementia, this thesis aimed to develop this understanding. The work presented within this thesis was informed by behaviour change theory and includes three studies. First, a systematic review evaluated evidence within the extant literature of factors that are associated with hearing aid use in people with dementia. Data synthesis was underpinned by the Theoretical Domains Framework and key findings for which the evidence was strongest were formulated. Second, a qualitative exploration of enablers and barriers to hearing aid use was undertaken with eleven people living with dementia and their care partners through semi-structured interviews. The interview schedule was informed by the Theoretical Domains Framework. Third, correlates of hearing aid use in 239 people with dementia and hearing loss were evaluated. In this study, the Capabilities-Opportunities-Motivations model of Behaviour (COM-B) was used to organise potential predictor variables. The correlations of these variables with hearing aid use were evaluated through bivariate and multivariate logistic regression models. Taken together, the findings of these studies suggest that influences on hearing aid use in people with dementia are multifaceted, incorporating a range of factors related to intrinsic capabilities and motivations of the person and extrinsic social and environmental opportunities. Capability factors include hearing aid handling skills, the extent of cognitive impairment, and the establishment of hearing aid routines. Motivation factors include recognition of hearing difficulty, perceived need for hearing aids, and consequences of using hearing aids. Social opportunity factors include social and professional support, and cultural influences on hearing aid use. Environmental opportunity factors include features of hearing aids and their resources, and establishment of set places to store and maintain hearing aids. This thesis has developed theory-informed understanding of key influences on hearing aid use in people with dementia. The findings suggest that tailoring interventions to the capabilities and motivations of the individual, whilst accounting for their environment and support systems, may optimise hearing aid use. From this evidence, interventions to support hearing aid use and improve quality of life for people living with dementia and comorbid hearing loss can be developed.

Item Type:	Thesis/Dissertation (Doctoral)
Departments:	Institute of Health > Rehabilitation and Sport Science
Additional Information:	Emma K. Hooper, Programme Lead for BSc (Hons) Occupational Therapy Programme, Department of Rehabilitation and Sports Science, Institute of Health, University of Cumbria, UK (completed PhD at Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK). A thesis submitted to the University of Manchester for the degree of Doctor of Philosophy in the Faculty of Biology, Medicine and Health, 2024, word count: 38,014.
Depositing User:	Anna Lupton
Date Deposited:	11 Nov 2024 10:13
Last Modified:	11 Nov 2024 10:15
URI:	https://insight.cumbria.ac.uk/id/eprint/8488

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