Factors influencing making a choice and accessing a hearing aid among elders with hearing disability: mixed methods

Purpose Hearing aid (HA) using is an option for enhancing the sound transmission. It effectively improves hearing ability during communication. In Thailand, two-third of hearing impaired persons were elders, while the utilization of an HA was low. This study aims to explore how the decision was made on the use of HA among the hearing impaired elderly. Design/methodology/approach Mixed-methods sequential explanatory design was used by starting with a retrospective study to identify the prevalence of HA use and influencing factors including demographic and clinical data. Total, 199 elders with moderate to severe hearing impairment were enrolled. Qualitative data collection for thematic analysis was conducted by interviewing 28 participants to reveal elders’ subjective reasoning. Findings It was found that 25.63% of elders used an HA, whereas age, types of health insurance and disability registration were significant influencing factors. Six themes of subjective reasoning emerged including social activities, disability perspective, social support, medical and personnel, rights and accessibility and benefit of HA, which determined the elders’ decisions on HA use. Originality/value This study broadened insights of the elders’ decision process on HA use, which was mutually made by both health-care professional and care recipients. The elders themselves would make the final decision. Not only objective indications but also subjective reasoning of users played significant roles on HA acquisition. To enhance HA use among hearing impaired elders, patient engagement in decision-making was crucial while hearing counselling and elimination of reimbursement barriers became essential.