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Susan Hellyer, MD
Does Audiologic Rehabilitation Really Work?
A&A Maryland Hearing Center

Does Audiologic Rehabilitation Really Work?

Part 2
Investigations in other health-related fields reveal better outcomes for those patients where self-efficacy was stressed. The higher the self-efficacy the more likely the individual will be to persist in spite of set-backs. They will see the set-backs as temporary and not as a lack in themselves. They would continue to pursue the task until they had accomplished it. For those with low self-efficacy, they tend to give up almost immediately. However, self-efficacy can be encouraged and improved.
There are four sources involved in self-efficacy. The first is Mastery Experience. This is the most influential of all the self-efficacy sources. Mastery experience is based on an individuals attempts to complete a task and how they view their success or lack of success. A person with high self-efficacy who fails at a task will tend to view their failure, not as a lack of skill on their part, but rather as due to poor strategy, for example. They would continue to persevere until the challenge was met. A person with poor self-efficacy who fails at a task would tend to see it as a lack of ability on their part and quickly get discouraged. Building self-efficacy by dividing tasks into smaller goals may help individuals who are easily discouraged.
The second source is Vicarious Experience. People will sometimes judge their own skills by their observations of others trying to perform the same tasks. If they see their peers struggling with their hearing aids on a regular basis they may determine that they also may have to struggle. One method to improve self-efficacy through vicarious experience is to have the patient view instructional videos that show individuals succeeding at a given task. The patient would need to judge the individual they are viewing as equal or better in terms of personal characteristics (gender, age, etc.) in order for self-efficacy to improve. Other methods used to improve self-efficacy through vicarious experience are self-modeling and group role playing.
The third source is Verbal Persuasion. This is the most commonly used of the four sources. It involves encouraging individuals that they have the skills necessary to complete the given task. Positive feedback is critical to this self-efficacy strategy. Verbal persuasion can also come in the form of written materials designed to help improve given skills, as well as diagrams, videos, etc. Significant others are also an invaluable asset to improve self-efficacy and should be encouraged to be involved as much as possible in the hearing aid fitting process.
The fourth source improve self-efficacy is Physiological & Affective States. If a person attempts a task that results in high anxiety and stress their self-efficacy will suffer. The more positive the emotion related to a task, the higher the self-efficacy. Patients should take regular breaks from the activity they are attempting so that the stress level doesnt get too high. Also, they should attempt easier skills first so they can experience the positive emotions related to success, then move on the more difficult tasks. The individual should create a calming atmosphere around themselves before attempting the task.
AR has been shown to be an effective measure to help individuals adjust more quickly to their hearing aids and to be more successful in their hearing aid use.

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