Motivational Interviewing: Something to Consider When Fitting Hearing Aids to Patients with Tinnitus?
Zarenoe and colleagues (2016) evaluated motivational interviewing (MI) as a supplement to the traditional hearing fitting delivery model for patients with both hearing loss and tinnitus. MI is a counseling style designed to enhance one’s motivation towards making a behavior change (Miller and Rollnick, 2012).
In this study, 50 patients were originally enrolled into the study, with 25 randomized to receive MI and 25 randomized to “standard practice (SP).” None of these subjects had prior use of hearing aids.
Final outcome measures were collected three months after the hearing aid fitting on 23 subjects in each group. Outcome measures included the Tinnitus Handicap Inventory (THI) (Newman et al, 1998) and the International Outcome Inventory for Hearing Aids (IOI-HA) (Cox et al, 2000). Baseline measures for the THI were collected at the hearing aid fitting (i.e., Visit #1), while the IOI-HA baseline measure was collected at a fine-tuning appointment done after the hearing aid fitting (i.e., Visit #2). Both groups obtained statistically significant improvements on the THI and the IOI-HA compared to baseline. The subjects who received MI obtained an improvement on the THI that was significantly better than the improvement obtained by those who received SP. The difference in improvement between groups was not statistically significant for the IOI-HA.
There are a number of limitations that the authors would like us to keep in mind. These limitations include: (1) small sample size; (2) a statistically significant difference between groups in terms of hearing loss; (3) a borderline significant difference between groups in terms of age; (4) a significant difference in the number of study visits between groups; and (5) no long-term outcome measures. Future studies are recommended.
In conclusion, the authors found that the use of hearing aids was beneficial for this patient population, regardless of experimental group. The addition of MI though may have the potential to further reduce tinnitus handicap.
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Cox R, Hyde M, Gatehouse S, Noble W, Dillon H, Bentler R, Stephens D, Arlinger S, Beck L, Wilkerson D, Kramer S, Kricos P, Gagné J, Bess F, Hallberg L. (2000) Optimal outcome measures, research priorities, and international cooperation. Ear Hear 21(4, Suppl):106S-115S.
Miller W, Rollnick S, eds. (2012) Motivational Interviewing: Helping People Change. 3rd ed. New York, NY: Guilford Publications.
Newman C, Sandridge S, Jacobson G. (1998) Psychometric adequacy of the Tinnitus Handicap Inventory (THI) for evaluating treatment outcomes. J Am Acad Audiol 9(2): 153-160.
Zarenoe R, Sőderlund L, Andersson G, Ledin T. (2016) Motivational interviewing as an adjunct to hearing rehabilitation for patients with tinnitus: a randomized controlled pilot trial. J Am Acad Audiol 27(8): 669-676.