Skip to main content

What Motivates People to Seek Help for Their Hearing? Applying Self-Determination Theory to Hearing Healthcare

  • Chapter
  • First Online:
Book cover Self-Determination Theory and Healthy Aging

Abstract

A variety of motivational processes are thought to underlie the behaviors and actions of first-time hearing help-seekers. People with hearing impairment may delay help-seeking and may not adopt hearing aids despite being recommended them by practitioners. To explore what motivates people to seek hearing help and the impact of the practitioner’s role in the decision to adopt or not adopt hearing aids, a qualitative interview-based study was undertaken of 13 participants (six had adopted and seven had not adopted hearing aids). Participants were interviewed about their motivations for seeking help and experiences in the clinic. Data were analyzed using thematic analysis to enable structured analysis of interview content. An inductive/deductive method was applied when interpreting and coding data. The most important motivational processes for seeking help were (1) Communication Experiences, which encompassed conversation difficulties, impact on family, social participation, and participants’ emotional responses, and (2) Personal Influences, which comprised preconceptions about hearing aids, self-perceived difficulties, self-image, encouragement from family, and promotion of service. A second analysis, using self-determination theory (SDT) as a guiding theoretical framework, revealed participants’ motivation for help-seeking fell along a continuum of internalization and need satisfaction could be described in terms of autonomy, competence and relatedness. Practitioner support was less evident when self-reported communication difficulties were minimized or dismissed, when rehabilitation options did not include communication strategies, and when family members were not involved in hearing aid adoption decisions. In summary, this research provides evidence to support the application of SDT in hearing rehabilitation involving hearing aids. A variety of motives along the SDT continuum were evident among people seeking services, from internalized forms of motivation (“I feel…good within myself”; “I feel relieved knowing I’m going to get something done”), to external (“I don’t think it’s necessary but I’ll go anyhow”; “my family kept on suggesting that I get my hearing tested”). Autonomy was reported to be important throughout rehabilitation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    Source: https://www.who.int/mediacenter/factsheets/fs300/en/ Disabling hearing loss is defined by the World Health Organisation here.

  2. 2.

    Source: https://www.who.int/mediacenter/factsheets/fs300/en/.

  3. 3.

    Embedded in social constructivism, the philosophical stance taken in the current study, the term ‘proximal influences’ relates to the social and cultural conditions within which participants constructed knowledge and understanding about hearing rehabilitation and their communication experiences. Use of the term in psychology can be traced to Vygotsky (19301944/1978), whose ‘Zone of Proximal Development’ relates to the ways people communicate with and learn from others close to them.

References

  • Beach, M. C., & Inui, T. (2006). Relationship-centered care: A constructive reframing. Journal of General Internal Medicine, 21, S3–S8.

    Article  Google Scholar 

  • Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101.

    Article  Google Scholar 

  • Chia, E.-M., Wang, J. J., Rochtchina, E., Cumming, R. R., Newall, P., & Mitchell, P. (2007). Hearing impairment and health-related quality of life: The blue mountains hearing study. Ear and Hearing, 28, 187–195.

    Article  Google Scholar 

  • Clark, J. G., Maatman, C., & Gailey, L. (2012). Moving patients forward: Motivational engagement. Seminars in Hearing, 33, 35–45.

    Article  Google Scholar 

  • Corrigan, P. W., & Rao, D. (2012). On the self-stigma of mental illness: Stages, disclosure, and strategies for change. Canadian Journal of Psychiatry. Revue canadienne de psychiatrie, 57(8), 464–469.

    Google Scholar 

  • Cox, R. M., & Alexander, G. C. (2002). The international outcome inventory for hearing aids (IOI-HA): Psychometric properties of the English version. International Journal of Audiology, 41, 30–35.

    Article  Google Scholar 

  • Crabtree, B. F., & Miller, W. L. (1999). Doing qualitative research (2nd ed.). Thousand Oaks, USA: Sage.

    Google Scholar 

  • Deci, E. L., & Ryan, R. M. (2000). The ‘what’ and ‘why’ of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11(4), 227–268.

    Article  Google Scholar 

  • Deci, E. L., & Ryan, R. M. (2008). Facilitating optimal motivation and psychological well-being across life’s domains. Canadian Psychology, 49(1), 14–23.

    Article  Google Scholar 

  • Ekberg, K., Grenness, C., & Hickson, L. (2014). Addressing patients’ psychosocial concerns regarding hearing aids within audiology appointments for older adults. American Journal of Audiology, 23, 337–350.

    Article  Google Scholar 

  • Ekberg, K., Grenness, C., & Hickson, L. (2016). Application of the transtheoretical model of health behavior change for identifying older clients’ readiness for hearing rehabilitation during history-taking in audiology appointments. International Journal of Audiology, 55, S42–S51.

    Article  Google Scholar 

  • Francis, J. J., Johnston, M., Robertson, C., Glidewell, L., Entwistle, V., Eccles, M. P., & Grimshaw, J. M. (2010). What is an adequate sample size? Operationalising data saturation for theory-based interview studies. Psychology & Health, 25(10), 1229–1245.

    Article  Google Scholar 

  • Goffman, E. (2009). Stigma: Notes on the management of spoiled identity. New York, USA: Simon and Schuster.

    Google Scholar 

  • Granberg, S., Swanepoel, D.-W., Englund, U., Moller, C., & Danermark, B. (2014). The ICF core sets for hearing loss project: International expert survey on functioning and disability of adults with hearing loss using the international classification of functioning, disability and health (ICF). International Journal of Audiology, 53, 497–506.

    Article  Google Scholar 

  • Grenness, C., Hickson, L., Laplante-Lévesque, A., & Davidson, B. (2014). Patient-centered audiological rehabilitation: Perspectives of older adults who own hearing aids. International Journal of Audiology, 53, S68–S75.

    Google Scholar 

  • Heffernan, E., Coulson, N. S., Henshaw, H., Barry, J. G., & Ferguson, M. A. (2016). Understanding the psychosocial experiences of adults with mild-moderate hearing loss: An application of Leventhal’s self-regulatory model. International Journal of Audiology, 55, S3–S12.

    Article  Google Scholar 

  • Hickson, L., Allen, J., Beswick, R., Fulton, M., Wolf, D., Worrall, L., & Scarinci, N. (2008). Relationships between hearing disability, quality of life and well-being in older community-based Australians. The Australian and New Zealand Journal of Audiology, 30(2), 99–112.

    Article  Google Scholar 

  • Hickson, L., Laplante-Lévesque, A., & Wong, L. (2013). Evidence-based practice in audiology: Rehabilitation options for adults with hearing impairment. American Journal of Audiology, 22(2), 329–331.

    Google Scholar 

  • Hickson, L., Meyer, C., Lovelock, K., Lampert, M., & Khan, A. (2014). Factors associated with success with hearing aids in older adults. International Journal of Audiology, 53, S15–S27.

    Google Scholar 

  • Hickson, L., & Scarinci, N. (2007). Older adults with acquired hearing impairment: Applying the ICF in rehabilitation. Seminars in Speech and Language, 28(4), 283–290.

    Article  Google Scholar 

  • Hogan, A., Phillips, R. L., Brumby, S. A., Williams, W., & Mercer-Grant, C. (2015). Higher social distress and lower psycho-social well-being: Examining the coping capacity and health of people with hearing impairment. Disability and Rehabilitation, 37(22), 2070–2075.

    Google Scholar 

  • Hseih, H.-F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9), 1277–1288.

    Article  Google Scholar 

  • Kochkin, S. (2009). MarkeTrak VIII: 25-year trends in the hearing health market. Hearing Review, 16(11), 12–31.

    Google Scholar 

  • Kovarsky, D., Duchan, J., & Maxwell, M. (1999). Constructing (in)competence: Disabling evaluations in clinical and social interaction. Mahwah, NJ: Erlbaum.

    Google Scholar 

  • Kramer, S. E., Kapteyn, T. S., Kuik, D. J., & Deeg, D. J. H. (2002). The association of hearing impairment and chronic diseases with psychosocial health status in older age. Journal of Aging and Health, 14(1), 122–137.

    Article  Google Scholar 

  • Laplante-Lévesque, A., Hickson, L., & Worrall, L. (2010). A qualitative study of shared decision making in rehabilitative audiology. Journal of the Academy of Rehabilitative Audiology, 43, 27–43.

    Google Scholar 

  • Laplante-Lévesque, A., Hickson, L., & Worrall, L. (2012). What makes adults with hearing impairment take up hearing aids or communication programs and achieve successful outcomes? Ear and Hearing, 33(1), 79–93.

    Google Scholar 

  • Lin, F. R., Yaffe, K., Xia, J., …, Simonsick, E. M. (2013). Hearing loss and cognitive decline in older adults. JAMA Internal Medicine, 173(4), 293–299.

    Google Scholar 

  • Lind, C., Hickson, L., & Erber, N. (2010). Who said what? Sampling conversation repair behavior involving adults with acquired hearing impairment. Seminars in Hearing, 31(2), 104–115.

    Article  Google Scholar 

  • Markland, D., Ryan, R., Tobin, V. J., & Rollnick, S. (2005). Motivational interviewing and self-determination theory. Journal of Social and Clinical Psychology, 24, 811–831.

    Article  Google Scholar 

  • Mehta, K. M., Simonsick, E. M., Penninx, B. W., Schulz, R., Rubin, S. M., Satterfield, S., & Yaffe, K. (2003). Prevalence and correlates of anxiety symptoms in well-functioning older adults: Findings from the health aging and body composition study. Journal of the American Geriatric Society, 51(4), 499–504.

    Article  Google Scholar 

  • Mener, D. J., Betz, J., Genther, D. J., Chen, D., & Lin, F. R. (2013). Hearing loss and depression in older adults. Journal of the American Geriatric Society, 61(9), 1627–1629.

    Article  Google Scholar 

  • Meyer, C., & Hickson, L. (2012). What factors influence help-seeking and hearing aid adoption in older adults? International Journal of Audiology, 51(2), 66–74.

    Article  Google Scholar 

  • Meyer, C., Hickson, L., Lovelock, K., Lampert, M., & Khan, A. (2014). An investigation of factors that influence help-seeking for hearing impairment in older adults. International Journal of Audiology, 53, S3–S17.

    Article  Google Scholar 

  • Ng, J. Y. Y., Ntoumanis, N., Thøgersen-Ntoumani, C., Deci, E. L., Ryan, R. M., Duda, J. L., & Williams, G. C. (2012). Self-determination theory applied to health contexts: A meta-analysis. Perspectives on Psychological Science, 7(4), 325–340.

    Google Scholar 

  • Patrick, H., & Williams. G. C. (2012). Self-determination theory: Its application to health behavior and complementarity with motivational interviewing. International Journal of Behavioral Nutrition and Physical Activity, 9, Article ID 18.

    Google Scholar 

  • Patton, M. Q. (2015). Qualitative research and evaluation methods (4th ed.). London, UK: Sage Publications Inc.

    Google Scholar 

  • Poost-Foroosh, L., Jennings, M. B., & Cheesman, M. F. (2015). Comparisons of client and clinician views of the importance of factors in client-clinician interaction in hearing aid adoption. Journal of the American Academy of Audiology, 26(3), 247–259.

    Google Scholar 

  • Poost-Foroosh, L., Jennings, M. B., Shaw, L., Meston, C. N., & Cheesman, F. (2011). Factors in client-clinician interaction that influence hearing aid adoption. Trends in Amplification, 15(3), 127–139.

    Google Scholar 

  • Preminger, J. E., Oxenbøll, M., Barnett, M. B., Jensen, L. D., & Laplante-Lévesque, A. (2015). Perceptions of adults with hearing impairment regarding the promotion of trust in hearing healthcare service delivery. International Journal of Audiology, 54, 20–28.

    Google Scholar 

  • Ridgway, J., Hickson, L., & Lind, C. (2013). Self-determination theory: Motivation and hearing aid adoption. Journal of the Academy of Rehabilitative Audiology, 46, 11–37.

    Google Scholar 

  • Ridgway, J., Hickson, L., & Lind, C. (2015). Autonomous motivation is associated with hearing aid adoption. International Journal of Audiology, 54(7), 476–484.

    Article  Google Scholar 

  • Ridgway, J., Hickson, L., & Lind, C. (2016). Decision-making and outcomes of hearing help-seekers: A self-determination theory perspective. International Journal of Audiology, 55(Suppl 3), S13–S22.

    Google Scholar 

  • Ridgway, J., Hickson, L., & Lind, C. (2017). What factors are associated with autonomous and controlled motivation of hearing help-seekers? Journal of the American Academy of Audiology, 28(7), 644–654.

    Article  Google Scholar 

  • Ridgway, J. S. (2017). Self-determination theory and hearing rehabilitation: The role of motivation in help-seeking, hearing aid adoption and hearing aid fitting outcomes. Retrieved from https://espace.library.uq.edu.au/view/UQ:530503.

  • Ryan, R. M., & Connell, J. P. (1989). Perceived locus of causality and internalization: Examining reasons for acting in two domains. Journal of Personality and Social Psychology, 57, 749–761.

    Article  Google Scholar 

  • Ryan, R. M., & Deci, E. L. (2017). Chapter 1: Self-determination theory: An introduction and overview. In Self-determination theory. Basic psychological needs in motivation, development and wellness. New York, NY: The Guilford Press.

    Google Scholar 

  • Ryan, R. M., & La Guardia, J. G. (2000). What is being optimized over development? A self-determination theory perspective on basic psychological needs across the life span. In Qualls & Abeles (Eds.), Psychology and the aging revolution (pp. 145–172). Washington DC, USA: APA Books.

    Google Scholar 

  • Ryan, R. M., Lynch, M. F., Vansteenkiste, M., & Deci, E. L. (2011). Motivation and autonomy in counseling, psychotherapy, and behavior change: A look at theory and practice. The Counseling Psychologist, 39(2), 193–260.

    Article  Google Scholar 

  • Ryan, R. M., Patrick, H., Deci, E. L., & Williams, G. C. (2008). Facilitating health behavior change and its maintenance: Interventions based on self-determination theory. The European Health Psychologist, 10, 2–5.

    Google Scholar 

  • Scarinci, N., Worrall, L., & Hickson, L. (2012). Factors associated with third-party disability in spouses of older people with hearing impairment. Ear and Hearing, 33, 698–708.

    Article  Google Scholar 

  • Schneider, J. M., Gopinath, B., McMahon, C. M., Britt, H. C., Harrison, C. M., Usherwood, T., ..., Mitchell, P. (2010). Role of general practitioners in managing age-related hearing loss. Medical Journal of Australia, 192, 20–23.

    Google Scholar 

  • Tye-Murray, N., Purdy, S. C., & Woodworth, G. G. (1992). Reported use of communication strategies by SHHH members: Client, talker, and situational variables. Journal of Speech and Language Research, 35, 708–717.

    Google Scholar 

  • Vansteenkiste, M., Williams, G., C., & Resnicow, K. (2012). Toward systematic integration between self-determination theory and motivational interviewing as examples of top-down and bottom-up intervention development: Autonomy or volition as a fundamental theoretical principle. International Journal of Behavioral Nutrition and Physical Activity, 9, Article ID 23.

    Google Scholar 

  • Vuorialho, A., Petri-Karinen, P., & Sorri, M. (2006). Effect of hearing aids on hearing disability and quality of life in the elderly. International Journal of Audiology, 45, 400–405.

    Google Scholar 

  • Vygotsky, L. (1930–1944/1978). Interaction between learning and development. In Gauvain & Cole (Eds.), Readings on the development of children (pp. 34–40). New York, USA: Scientific American Books.

    Google Scholar 

  • Williams, G. C., Frankel, R. M., Campbell, T. L., & Deci, E. L. (2000). Research on relationship-centered care and healthcare outcomes from the Rochester biopsychosocial program: A self-determination theory integration. Families, Systems and Health, 18(1), 79–90.

    Article  Google Scholar 

  • Williams, G. C., Freedman, Z. R., & Deci, E. L. (1998). Supporting autonomy to motivate glucose control in patients with diabetes. Diabetes Care, 21, 1644–1651.

    Article  Google Scholar 

  • Williams, G. C., Grow, V. M., Freedman, Z., Ryan, R. M., & Deci, E. L. (1996). Motivational predictors of weight loss and weight-loss maintenance. Journal of Personality and Social Psychology, 70, 115–126.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jason Ridgway .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Ridgway, J., Lind, C., Hickson, L. (2020). What Motivates People to Seek Help for Their Hearing? Applying Self-Determination Theory to Hearing Healthcare. In: Ng, B., Ho, G. (eds) Self-Determination Theory and Healthy Aging. Springer, Singapore. https://doi.org/10.1007/978-981-15-6968-5_8

Download citation

  • DOI: https://doi.org/10.1007/978-981-15-6968-5_8

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-15-6967-8

  • Online ISBN: 978-981-15-6968-5

  • eBook Packages: Social SciencesSocial Sciences (R0)

Publish with us

Policies and ethics