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

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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.

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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.

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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

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