Development and preliminary evaluation of a German version of the active communication education group aural rehabilitation training program.
Sybille Seybold, Frauke Koppelin, Nerina Scarinci and 1 others
Communication strategy use and acceptance of hearing loss improved significantly after a group training program, but perceived hearing difficulty and quality of life did not change, and anxiety scores rose slightly.
Key findings
1Communication strategy use improved significantly after the program (p = .007), with a moderate effect size (d = 0.50) at post-program and a small effect (d = 0.38) at follow-up.
2Acceptance of hearing loss improved significantly (p = .048), with small effect sizes (d = 0.31 at post-program, d = 0.35 at follow-up).
3Perceived hearing difficulty and quality of life showed no significant change over time, while anxiety scores increased significantly (p = .047) immediately after the program.
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What it does not show
No control group, so it is impossible to tell whether the changes were caused by the program or by practice effects, natural change, or simply the passage of time. Small sample (30 participants) with 73% women, so the results may not generalise to men or to a broader population. Nine of the 30 participants missed at least one session, and one attended only three of five sessions. The anxiety increase immediately after the program is unexplained and could reflect the emotional work of confronting communication difficulties rather than a negative effect of the program. The authors note that participants may have started with lower perceived hearing difficulty than in other ACE studies, leaving less room for measurable improvement on that measure.
Declared interests
The study was funded by the governmental initiative 'Niedersächsisches Vorab' (Ministry for Science and Culture of Lower Saxony, Germany). Sonova AG, a hearing-aid manufacturer, provided financial support for running the ACE groups. The authors state the funder was not involved in study design, data collection, analysis, interpretation, writing, or the decision to publish.
The easy way to misread this
Do not read the significant gains in communication strategy use and acceptance as proof the program reduces hearing-related difficulty or improves quality of life — those measures showed no significant change, anxiety actually increased, and there was no control group to rule out practice effects or natural change over time.
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