Gabrielle (Gaby) Saunders

Research Area Manager

The aim of this PhD project was to develop and evaluate online tools that would be useful in the rehabilitation of hearing-impaired adults. Two intervention studies were carried out, with positive results for the participating experienced hearing-aid users.


professional online rehabilitation of hearing impaired adults 1 - results from the second intervention

Intervention studies of online rehabilitative education

Two intervention studies were carried out to evaluate the effects of online rehabilitation. In the first study, experienced hearing-aid users tested an online rehabilitative course with weekly, professional contact. The book Fading Sounds was used as course material. In the second intervention study the programme was expanded. Material from the Active Communication Program was included together with the ability to interact with hearing-impaired peers via a controlled, online discussion forum.

The results from the first intervention study were published in the Journal of American Academy of Audiology in 2011. The overall results revealed that online tools can be used in the rehabilitation process for older hearing-aid users. The practical setup of using the Internet for interactions with the population in question was successful, since almost all participants completed the computerised exercises. The results from the second intervention study were in terms of that the participants showed significant improvements in the domains of activity limitation and participation restriction. The effects were maintained and improved at the three-month follow-up, see Figure 1. Additionally, significant improvements in the domain of psychosocial well-being were found at the three-month follow-up.

Feasibility studies of using the Internet in an audiological context

A crossover study was carried out, with the aim of comparing the administration of online questionnaires to the administration of pencil-and-paper questionnaires using four standardised healthcare questionnaires related to hearing was also included in the PhD project. The included questionnaires were the Hearing Handicap Inventory for the Elderly, the International Outcome Inventory for Hearing Aids, Satisfaction with Amplification in Daily Life, and the Hospital Anxiety and Depression Scale. The results from the study revealed sufficient evidence that participants’ scores remained consistent across administrations and formats for the included questionnaires. The main outcome from the study is the recommendation of an administration format that remains stable across surveys.

The fourth included study in the PhD project was a descriptive study with the aim of evaluating the use of Internet and e-mail in a group of hearing-impaired adults was also carried out. The results showed that overall, the usage of computer and the Internet are on the same level in the group of hearing impaired as for the general population of Sweden. In some specific age groups it is even higher. This information is relevant for the development and evaluation of rehabilitative educational online tools for hearing-impaired adults.

Link to thesis: pid=diva2:691763&dswid=-7507

The PhD project is designed as an Industrial PhD project with collaboration between Linköping University (Sweden) where Professor Gerhard Andersson and Med. Dr. Marie Öberg are supervisors and Eriksholm Research Centre where Professor Thomas Lunner is supervisor. Some parts of the project were included in a Master thesis by Monica Svensson and Anna Törnqvist, Lund University (Sweden)  

Further reading

Elberling C, Worsøe K (2005). Fading Sounds. Herlev: Videncenter for Døvblevne, Døve og Hørehæmmede. ISBN 87-991307-0-8. Boarding A/S, Denmark.

Hickson L, Worrall L, Scarinci N (2007). A randomized controlled trial evaluating the Active Communication Education program for older people with hearing impairment. Ear and Hearing 28, p. 212–230.

Thorén ES, Svensson M, Törnqvist A, Andersson G, Carlbring P, Lunner T (2009). Online self-help via discussion forum. In: Buchholz J, Dalsgaard JC, Dau T, Poulsen T (Eds.) Binaural Processing and Spatial Hearing. Proceedings of the Second International Symposium on Audiological and Auditory Research, ISAAR, p. 481-485.

Thorén E, Svensson M, Törnqvist A, Andersson G, Carlbring P, Lunner T (2011). Rehabilitative Online Education versus Internet Discussion Group for Hearing Aid Users: A Randomized Controlled Trial. Journal of the American Academy of Audiology, 22(5), p. 274-285.

Thorén ES, Andersson G, Lunner T (2012). The use of research questionnaires with hearing impaired adults: online vs. paper-and-pencil administration. BMC Ear, Nose and Throat Disorders, 12(12), 14 p.

Thorén ES, Öberg M, Wänström G, Andersson G, Lunner T (2013). Internet access and use in adults with hearing loss. Journal of Medical Internet Research. 15(4):e91.

Thorén ES, Öberg M, Wänström G, Andersson G, Lunner T. (2014). A randomized controlled trial evaluating the effects of online rehabilitative intervention for adult hearing-aid users. International Journal of Audiology, 53, 452-61.

Learn more

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    Fading sounds

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    Online rehabilitation of heairng-impaired

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    Online self-help via discussion forum

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    A randomized controlled trial of professional online rehabilitation for adult hearing-aid users

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    Professional online rehabilitation of hearing impaired adults