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(MRC DTP) Improving the lives of older adults with hearing loss: developing a self-report measure of effortful listening to guide clinical practice


Project Description

Hearing loss increases with age and is the most prevalent sensory deficit. Hearing loss results in communication difficulties, which in turn can lead to social isolation, depression and reduced quality of life. Hearing loss is most commonly managed via the fitting of hearing aids. While hearing aids often improve the intelligibility of speech sounds, it remains unclear whether hearing aids reduce the cognitive effort required to achieve listening success i.e. listening effort. Listening effort is high in challenging and cognitively demanding situations such as when background sounds are too loud, or when the speaker has an unfamiliar accent or produces unclear speech. For adults affected by hearing impairment, effortful listening is a frequent complaint but it is not assessed or managed as part of standard audiological care.

The aim of this project is to develop and validate a patient-reported outcome measure (questionnaire) on listening effort in hearing aid users that comprehensively assesses listening effort due to hearing difficulty and quantifies benefit of treatment. By doing this we will provide a more effective management of hearing loss and fewer complaints about hearing aids. By better dealing with difficulties due to listening effort, which has such high impact on functioning and is a huge problem for the majority of hearing aid users, we also aim to improve the effectiveness of management of conditions related to communication difficulties. The project will have three stages: (i) creation of the questionnaire, (ii) item refinement and internal validation, (iii) external validation and sensitivity to change. At the conclusion of the project we aim to incorporate the new questionnaire into education and training of hearing healthcare practitioners and scientists.

The project is highly interdisciplinary and offers unique training experiences in a number of areas within the same project: (i) during the initial development stage you will use qualitative methods of instrument development including focus groups, structured interviews and qualitative analysis methods; (ii) during the construct validation and reliability assessment stage you will use quantitative methods of biostatistics, and become acquainted with tools of both classical test theory and item response theory; (iii) due to the clinical purpose of the questionnaire, and our close clinical links with Manchester Foundation Trust, you will have a chance to build professional relationships within the NHS through direct interactions with clinicians and patients. All this is possible due to a team of internationally-recognised experts with expertise in these disparate disciplines.

https://www.research.manchester.ac.uk/portal/rebecca.millman.html

https://www.research.manchester.ac.uk/portal/kevin.j.munro.html

https://www.research.manchester.ac.uk/portal/antje.heinrich.html

https://www.research.manchester.ac.uk/portal/helen.chilton.html

Entry Requirements:
Applications are invited from UK/EU nationals only. Applicants must have obtained, or be about to obtain, at least an upper second class honours degree (or equivalent) in a relevant subject.

Funding Notes

This project is to be funded under the MRC Doctoral Training Partnership. If you are interested in this project, please make direct contact with the Principal Supervisor to arrange to discuss the project further as soon as possible. You MUST also submit an online application form - full details on how to apply can be found on the MRC DTP website View Website

As an equal opportunities institution we welcome applicants from all sections of the community regardless of gender, ethnicity, disability, sexual orientation and transgender status. All appointments are made on merit.

References

[1] Pichora-Fuller, M. K., Kramer, S. E., Eckert, M. A., Edwards, B., Hornsby, B. W., Humes, L. E., . . . Wingfield, A. (2016). Hearing Impairment and Cognitive Energy: The Framework for Understanding Effortful Listening (FUEL). Ear and Hearing, 37 Suppl 1, 5S-27S.
[2] Alhanbali, S., Dawes, P., Millman, R.E., Munro, K.J. (2019). Measures of listening effort are multidimensional. Ear and Hearing 40, 1084-1097.
[3] Alhanbali, S., Dawes, P., Lloyd, S., Munro, K.J. (2017). Self-reported listening-related effort and fatigue in hearing-impaired adults. Ear and Hearing 38, 39-48.
[4] Heinrich, A., Mikkola, T.M., Polku, H., Rantanen, T., & Viljanen, A. (2018). Hearing in Real-Life Environments (HERE): Structure and reliability of a questionnaire on perceived hearing for older adults. Ear and Hearing
[5] Henshaw, H., Sharkey, L., Crowe, D. Ferguson, M. (2015). Research priorities for mild-to-moderate hearing loss in adults. The Lancet, 386 (10009), 2140-2141.

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