The Effects of Hearing Aid Use on Listening Effort and Mental Fatigue Associated With Sustained Speech Processing Demands
The Effects of Hearing Aid Use on Listening Effort and Mental Fatigue Associated With Sustained Speech Processing Demands
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DOI：
10.1097/aud.0b013e31828003d8
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发表时间：
2013-09-01
期刊：
影响因子：
3.7
通讯作者：
Hornsby, Benjamin W. Y.
中科院分区：
文献类型：
--
作者：
Hornsby, Benjamin W. Y.
目的：为了保持最佳的理解能力，感音神经性听力损失（SNHL）患者通常报告说，与没有听力损失的人相比，他们需要更多的注意力、注意力和“倾听努力”。一般认为，这种增加的努力与听力损失的人主观报告的精神疲劳有关。虽然助听器在提高可理解性方面的好处是有据可查的，但它们对听力努力和精神疲劳的影响却不太清楚。本研究采用主观和客观的方法来研究助听器使用和高级助听器功能对SNHL成人听力努力和精神疲劳的影响。设计：16名患有轻度至重度倾斜性SNHL的成年人（47-69岁）参与研究。双任务范式评估了单词识别、单词回忆和视觉反应时间（RTs），以客观地量化听力努力和疲劳。精神疲劳在操作上被定义为在实验期间（大约1小时）表现下降。参与者配备了助听器，并在无辅助和两种辅助条件下（全向和定向处理和数字降噪活动）进行测试。研究人员还获得了白天听力努力的主观评分，以及在双重任务之前和之后的疲劳和注意力评分。结果：在辅助条件下，单词回忆能力更好，双任务RTs的记忆速度明显快于无辅助条件下，这表明听力辅助下听力努力减少。在独立和辅助条件下的单词识别和记忆在双重任务期间保持相对稳定，这表明这些过程抵抗精神疲劳。相比之下，双任务RTs在语音任务期间系统地增加，这与精神疲劳的发展相一致。然而，在两种辅助条件下，双任务RTs随着时间的推移保持稳定，这表明助听器的使用减少了对精神疲劳的易感性。完成双任务后，主观疲劳评分和注意力评分也显著增加；然而，没有观察到独立和辅助主观评分之间的差异。主观和客观听力努力与精神疲劳之间的相关分析显示，两者之间没有强烈或一致的关系。同样，受试者变量，如年龄和听力损失程度，与听力努力或精神疲劳的主观或客观测量没有强烈或一致的关系。结论：主观和选择性客观测量的结果表明，持续的语音处理需求会导致听力损失患者的精神疲劳。值得注意的是，使用临床适合的助听器可能会减少听力努力和对持续语音处理需求相关的精神疲劳的易感性。目前的研究设计并没有显示出定向处理和数字降噪算法在减少听力努力或疲劳方面的额外好处。然而，实验设计的限制表明，在这一领域需要进一步的工作。最后，由于持续的语音处理需求，主观和客观的听力努力和精神疲劳的测量没有很强的相关性，这表明这些测量可能评估听力努力和精神疲劳的不同方面。
Objectives: To maintain optimal understanding, persons with sensorineural hearing loss (SNHL) often report a need for increased attention, concentration, and "listening effort" compared with persons without hearing loss. It is generally assumed that this increased effort is related to subjective reports of mental fatigue in persons with hearing loss. Although the benefits of hearing aids for improving intelligibility are well documented, their impact on listening effort and mental fatigue are less clear. This study used subjective and objective measures to examine the effects of hearing aid use and advanced hearing aid features on listening effort and mental fatigue in adults with SNHL.Design: Sixteen adults (aged 47-69 years) with mild to severe sloping SNHL participated. A dual-task paradigm assessed word recognition, word recall, and visual reaction times (RTs) to objectively quantify listening effort and fatigue. Mental fatigue was operationally defined as a decrement in performance over the duration of the experiment (approximately 1hr). Participants were fitted with study hearing aids and tested unaided and in two aided conditions (omnidirectional and with directional processing and digital noise reduction active). Subjective ratings of listening effort experienced during the day and ratings of fatigue and attentiveness immediately before and after the dual-task were also obtained.Results: Word recall was better and dual-task RTs were significantly faster in the aided compared with unaided conditions, suggesting a decrease in listening effort when listening aided. Word recognition and recall in unaided and aided conditions remained relatively stable over the duration of the dual-task, suggesting these processes were resistant to mental fatigue. In contrast, dual-task RTs systematically increased over the duration of the speech task when listening unaided, consistent with development of mental fatigue. However, dual-task RTs remained stable over time in both aided conditions suggesting that hearing aid use reduced susceptibility to mental fatigue. Subjective ratings of fatigue and attentiveness also increased significantly after completion of the dual-task; however, no differences between unaided and aided subjective ratings were observed. Correlation analyses between subjective and objective measures of listening effort and mental fatigue showed no strong or consistent relationship. Likewise, subject variables such as age and degree of hearing loss showed no strong or consistent relationship to either subjective or objective measures of listening effort or mental fatigue.Conclusions: Results from subjective and select objective measures suggest sustained speech-processing demands can lead to mental fatigue in persons with hearing loss. It is important to note that the use of clinically fit hearing aids may reduce listening effort and susceptibility to mental fatigue associated with sustained speech-processing demands. The present study design did not reveal additional benefits, in terms of reduced listening effort or fatigue, from use of directional processing and digital noise-reduction algorithms. However, experimental design limitations suggest further work in this area is needed. Finally, subjective and objective measures of listening effort and mental fatigue due to sustained speech-processing demands, were not strongly associated, suggesting that these measures may assess different aspects of listening effort and mental fatigue.