title: Decision-making and outcomes of hearing help-seekers: A self-determination theory perspective.
abstract: To explore the explanatory power of a self-determination theory (SDT) model of health behaviour change for hearing aid adoption decisions and fitting outcomes.
  
  
  
  A quantitative approach was taken for this longitudinal cohort study. Participants completed questionnaires adapted from SDT that measured autonomous motivation, autonomy support, and perceived competence for hearing aids. Hearing aid fitting outcomes were obtained with the international outcomes inventory for hearing aids (IOI-HA). Sociodemographic and audiometric information was collected.
  
  
  
  Participants were 216 adult first-time hearing help-seekers (125 hearing aid adopters, 91 non-adopters).
  
  
  
  Regression models assessed the impact of autonomous motivation and autonomy support on hearing aid adoption and hearing aid fitting outcomes. Sociodemographic and audiometric factors were also taken into account. Autonomous motivation, but not autonomy support, was associated with increased hearing aid adoption. Autonomy support was associated with increased perceived competence for hearing aids, reduced activity limitation and increased hearing aid satisfaction. Autonomous motivation was positively associated with hearing aid satisfaction.
  
  
  
  The SDT model is potentially useful in understanding how hearing aid adoption decisions are made, and how hearing health behaviour is internalized and maintained over time. Autonomy supportive practitioners may improve outcomes by helping hearing aid adopters maintain internalized change.
authors.affiliation: a School of Health and Rehabilitation Sciences, The University of Queensland , Brisbane , Australia and.
authors.forename: Jason
authors.initials: J
authors.lastname: Ridgway
authors.affiliation: a School of Health and Rehabilitation Sciences, The University of Queensland , Brisbane , Australia and.
authors.forename: Louise
authors.initials: L
authors.lastname: Hickson
authors.affiliation: b Speech Pathology and Audiology, Flinders University , Adelaide , Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Lind
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001299:Audiometry; D001307:Auditory Perception; D002755:Choice Behavior; D012048:Correction of Hearing Impairment / Q000295:instrumentation* / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006310:Hearing Aids; D006311:Hearing Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009042:Motivation; D010342:Patient Acceptance of Health Care; D010358:Patient Participation; D017060:Patient Satisfaction; D026684:Personal Autonomy; D019986:Persons with Hearing Disabilities / Q000523:psychology* / Q000534:rehabilitation*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Hearing impairment; autonomy; autonomy support; hearing aid adoption; hearing aids; motivation; self-determination theory