Discussion and outlook

First of all, the used method of focus group discussions worked well for our purpose, the guidelines used are adequate to fulfil the objectives of this study.

To recapitulate, the method of focus groups is an “open” form of interviewing: The participants can announce their arguments and views in their own words, not biased in any way. The biggest benefit is to get the information of the participants in their own context, with their own rank of importance and point of view. Furthermore important is the fact that it is easily possible to get new (but for the participants relevant) facts into the discussions. This would be impossible with questionnaires or “closed” interviews, where the participants only can put their answers in the structure given by the questionnaire/ interviewer.

The proposed  Initial Opinion is well suited for hearing aid fitting, all important elements are included. Nevertheless the importance of the various elements is ranked differently by the three participating groups – in the following some important points are summarised:

The vision of the hearing aid dispensers in Germany for an “ideal medical care with hearing aids” is close to the Initial Opinion . Most complaints were about speech-audiometry. The hearing aid dispensers want the Freiburger Speech-Test to be replaced by a more contemporary, state of the art and standardised test.

The hearing aid dispensers classify as especially relevant those procedures that give the best information to guide the fitting procedure itself: Besides the objective measurements, the ratings done by the hearing impaired are most important.

During the presentation of the elements of the Initial Opinion it became obvious that some measurements are at present usually not performed at all or are performed only rarely. These include: questionnaires, horizontal localization and loudness-scaling for the unaided measurements; in-situ-measurement (real ear measurements) for hearing aid fitting; in-situ-measurement (real ear measurements), horizontal localization, loudness-scaling and questionnaires for the aided (evaluation) measurements; and questionnaires during the follow-up.

During the discussions it became clear, that the hearing impaired participants generally would readily invest “all time of the world” if it finally led to an improved result.

The hearing impaired people who were not using hearing aids, attributed their non-use to their experience of relatively low psychological strain: “So far I come to grips with it“; “if it gets necessary, I will obtain one”. Other participants had had bad experiences in a test phase or know persons who are dissatisfied with their hearing aids. During the fitting-procedure they think that the physical / technical measurements are more important than counselling.

Hearing aid users attribute a high importance to pure-tone audiometry. Presumably they consider this procedure as a basic entrance into hearing aid fitting.

Very important is the fact that the hearing impaired users assess the methods for checking the intelligibility of speech in noise or in quiet much higher than the HAD do. This is because the ability to communicate is very important for the hearing impaired, for most of them it is by far the most important issue.

Experienced hearing aid users estimate the test of the hearing aids in everyday life as very important.

The hearing impaired participants who had not used hearing aids put the focus onto the search for the best hearing aid. All hearing impaired estimate the possibility to test at least 3 hearing aids especially high. “Finding” the right hearing aid seems to be very important, more important than verifying if the fitted aid is effective and more important that making an optimal fit for a “first-guess” hearing aid.

 

References for this Chapter