title: Gender and hearing aids: patterns of use and determinants of nonregular use.
abstract: OBJECTIVE
  Research addressing gender and hearing has focused mainly on differences in the auditory systems of men and women, communication, and psychological issues. Differences between men and women in the use of hearing aids are less clear. To date, no study has examined the effects of gender on hearing aid use as a primary aim. However, use patterns and underlying reasons for not using hearing aids may differ between men and women, or there might be a gender difference in the impact of some determinants on hearing aid use. A consideration of such factors could increase hearing aid use. Therefore, the aim of the present investigation was to provide information about gender-related influences on hearing aid use by examining differences in usage patterns and determinants of nonregular use.
  
  
  METHODS
  This study used cross-sectional survey data from 4979 adult male and 3410 adult female hearing aid owners in Switzerland in 2005. The survey data, including self-reported hearing aid use, were matched to the hearing loss data and the hearing aid technical information. Descriptive analyses were performed for the use patterns, age at first fitting, and audiogram slope. The determinants of nonregular use were examined using logistic regression models that were stratified by gender.
  
  
  RESULTS
  Compared with men, women reported a higher prevalence of daily and regular use and a longer daily duration of use of hearing aids. Men more commonly indicated a limited benefit as a reason for nonregular use. The multivariate analyses showed that nonregular use was significantly less likely in women. The audiogram slope strongly contributed to this difference. Stratified analyses showed that for both men and women, poor handling and low satisfaction were associated with a higher likelihood for nonregular hearing aid use. Associations were discrepant for asymmetric hearing loss, which was a risk factor in women but a protective factor in men. Higher risks of nonregular use were found in men with steeper audiogram slopes and longer durations of ownership of their current aids, in women fitted with their first aid in the previous 2 to 5 yr, and in women older than 65 yr.
  
  
  CONCLUSIONS
  Overall, the present study provides evidence of gender-specific factors that influence hearing aid use patterns in men and women and of groups at higher risk for nonregular hearing aid use. Men with steeper audiogram slopes and the other subgroups of men and women with an increased risk for nonregular use should given particular attention when fitting their aids. As common risk factors for nonregular use, poor handling and low satisfaction should be addressed during the fitting process for all users. Further research is needed to clarify the differential influence of asymmetric hearing loss on hearing aid use in men and women. This information could improve hearing aid use and should be incorporated into daily clinical practice.
authors.affiliation: Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, University Hospital Zurich, Switzerland. katharina.staehelin@unibas.ch
authors.forename: Katharina
authors.initials: K
authors.lastname: Staehelin
authors.forename: Sibylle
authors.initials: S
authors.lastname: Bertoli
authors.forename: Rudolf
authors.initials: R
authors.lastname: Probst
authors.forename: Christian
authors.initials: C
authors.lastname: Schindler
authors.forename: Julia
authors.initials: J
authors.lastname: Dratva
authors.forename: Elisabeth Zemp
authors.initials: EZ
authors.lastname: Stutz
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001309:Auditory Threshold; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006310:Hearing Aids / Q000706:statistics & numerical data*; D034381:Hearing Loss / Q000453:epidemiology* / Q000534:rehabilitation*; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D012727:Sex Characteristics; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D013557:Switzerland / Q000453:epidemiology