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\def\RunningAuthor{Jyothi Singamsetty et al.}
\firstPage{184}
\articleType{Original Article}
\receivedDate{01 Nov 2020}
\acceptedDate{21 Dec 2020}
\revisedDate{05 Dec 2020}
\journalVolume{2020, 11 (SPL4)}
\journalDoi{ijrps.v11iSPL4.3766}
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\title{A Defective Sensor Persistent for Optimized Hearing Disabled Person using Hearing Aids}
\author{Jyothi~Singamsetty\textsuperscript{*}\textsuperscript{1},  
            Ravikumar~Raju\textsuperscript{2},  
            Sankaralingam~P\textsuperscript{3}, 
            Manoj~Reddy~P\textsuperscript{3}~\\[5pt]{\textsuperscript{1}Department of OBG, Konaseema Institute of Medical Sciences Research Foundation, Amalapuram, Andhra Pradesh, India}~\\{\textsuperscript{2}Department of ENT, Konaseema Institute of Medical Sciences Research Foundation, Amalapuram, Andhra Pradesh, India}~\\{\textsuperscript{3}Department of Orthopaedics, Meenakshi Academy of Higher Education and Research, Chennai, Tamil Nadu, India}}

\begin{abstract}
Hearing loss is one among the persistent sensory deficiency in human populaces, involving added 250 million public in the world. Hearing aids are electrical equipments that aid in optimizing acuity of speech or other sounds. Outcome measures have a rising concern to audiologists, customers and hearing aid producers. To assess the user gratification of  government-funded hearing aids. To assess the digital quality of free hearing aids provided by the government. Method: The study was done on patients who are providing by overdue the ear hearing aids in a free hearing aid distribution camp under Support to Disabled persons for obtaining / fitting of aids/appliances (ADIP) scheme. A survey was done for 100 subjects by administering the SADL. The SADL gratification scores showed high gratification ratings for almost all aspects of the questionnaire. Approximately 80 \% of the individuals using the hearing aids provided positive feedback and were tremendously satisfied with the performance of the hearing aid. Hence to conclude, ADIP scheme hearing aids do satisfy the users in most of the features such as speech understanding, speaking over the phone and enhanced hearing.
\end{abstract}\def\keywordstitle{Keywords}

\begin{keywords}Hearing aids,\newline Outcome measures,\newline Government-funded
\end{keywords}
\twocolumn[ \maketitle {\printKwdAbsBox}]
\makeatletter{\raggedright\textsuperscript{*}Corresponding Author\par Name:\ Jyothi~Singamsetty~\\ Phone:\ 8185833364~\\  Email:\ Jyothi64@gmail.com
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\section{Introduction}
Hearing is the capability to identify by detecting vibration differences in the environment, through an organ like the ear. Hearing loss is one among the persistent sensory deficiency in human populations, involving more than 250 million public in the world. India alone has 63 million people (6.3\%) enduring by hearing loss \unskip~\citep{962847:21040541}.The outcome of hearing impairment includes lack of ability to understand speech sounds, regularly producing a condensed capability to  communicate, hindrance in language attainment, educational difficulty, societal separation and stigmatization \unskip~\citep{962847:21040542}. According to 2005 survey of the World Health Organization, 278 million people have hearing loss. The incidence of hearing loss in the south-eastern region of Asia assortments by 4.6\% to 8.8\% \unskip~\citep{962847:21040542}. Keeping this in deliberation, the task of aural remedy exists. Aural rehabilitation is the process of reducing hearing loss persuaded problems in function, activity, contribution and excellence of life by a mixture of sensory rehabilitation, teaching, auditory training, and counselling \unskip~\citep{962847:21040543}.

Hearing aids are electrical  equipments that aid in optimizing acuity of speech or other sounds \unskip~\citep{962847:21040545}. Result measures bring been of climbing concern with audiologists, consumers, portable amplifier manufacturers, third-party payers, Also analysts alike, in spite of the fact that not in the least times to the comparable motivations \unskip~\citep{962847:21040546,962847:21040549,962847:21040548} administration suppliers have built that self-reports about handicap and handicap gatherings give important knowledge under those impact of a hindrance with respect to every day living and support preparation and implementation of a reconstructive plan that sensibly addresses the necessities of the  individual with hearing loss. Additionally, self-assessed conclusion data is utilized to text the advantage of the management plan and can opinion to parts that are meeting prospects by those that require improvement \unskip~\citep{962847:21040550}.Numerous questionnaires are intended to know the degree of gratification on the whole. Gratification changes with practice, usage, expectations, attitude, personality, hearing aid types, sound quality and listening environments.

The Gratification with Intensification in Daily Life (SADL), a self-assessmenttest \unskip~\citep{962847:21040552}. Accomplishes the need for a clinically practical tool by providing useful insight to  the multidimensional aspects of gratification. The scale has 15 items connected to prospects like usage of hearing aid and gives a global score representing total gratification, as well as four subscales scores about gratification in the areas of ``Positive Effect'', ``Service and Cost'', ``Negative Features'', and ``Personal Image'' \unskip~\citep{962847:21040552}.Respondents are asked to point to their rank of gratification on a scale from one (not at all) to seven (extremely) \unskip~\citep{962847:21040550}.

\textbf{Objectives}
  
  \begin{enumerate}
  \item \relax To assess the gratification of government-funded hearing aids
  \item \relax To assess the digital quality of free hearing aids provided by the government
  \end{enumerate}
  
    
\section{Materials and Methods}
\textbf{Participants}

The study was done on  patients who are providing by free overdue the ear hearing aids in a free hearing aid distribution camp under Help to  Disabled persons for purchasing/fitting of aids/appliances (ADIP) scheme. It was  mandatory for the patients to have Disability Certificate (Disability of {\textgreater}40\%), BPL card  (A low-income group certificate) and  ADHAAR Card (Address and identity proof) to avail the hearing aids under the free hearing aid scheme. ALPS TURBO III CAP Hearing aid was provided during the camp. A total of 200 patients were benefited. Under this service, including both pediatric and adult patients.

\textbf{Inclusion criteria}

Individuals within the age range of 20 to 70 years who are using a hearing aid for more than six months were included.

\textbf{Exclusion criteria}

Individuals less than 20 years of age and subjects who have not used hearing aids for more than two months were excluded from this study.

\textbf{Procedure}

Questionnaire Gratification with  Amplification in Daily Life (SADL) (Appendix 1) is utilized in this study.  Questionnaire was translated into Kannada from English by professional translators and was verified by authors\textbf{. } We conducted a survey for 100 subjects by administering a questionnaire consisting of 15 items which  were rated under 7-point rating scale, where A designated not at all and G designated  tremendously. The questionnaire was  divided into four subtests based on the type of  questions Positive Effect (Items 1,3,5,6,9 and 10), Service and Cost(Items 12,14 and 15), Negative Features (2.7 and 11), and Personal Image (4, 8 and 13). Question 15  in service and cost was not considered as the hearing aid provided was free of cost. For the subtests, negative features`` and personal image``, scoring was considered in a reverse mode where A indicated tremendously and G indicated not at all. Subjects were instructed to listen to the questions and options and then to rate their experience with the hearing aid. Responses were recorded and tabulated.
    
\section{Results and Discussion}
Descriptive statistics were carried out to find out the frequency of responses for each question across 100 subjects. The following figures show the percentage of responses for each question based on ratings given by the hearing aid users.

\textbf{Positive Effect}

The Positive Effect subscale includes questions 1, 3, 5, 6, 9, and 10 of the SADL. Participants reported tremendous  contentment levels for items involving enhancement in understanding familiar conversation (80\%). 75\% of the hearing aid  users indicated that frequency of repetitions asked by the hearing aid user greatly reduced after wearing the aid and of the  sound resulting from their hearing aids were  rated as considerably natural by 70\%of the participants. Almost 80 \% of the beneficiaries pointed out a tremendous level of gratification for better self-confidence and 75\% of the individuals were greatly pleased when asked whether gaining their hearing aids was in their best attention and whether having it was worth the intricacy in Figure~\ref{f-d9f589d5fbb9}.


\bgroup
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\makeatother 
\caption{\boldmath {Graphical Representation of the percentage of responses for Positive Effect.}}
\label{f-d9f589d5fbb9}
\end{figure}
\egroup
\textbf{Service and Cost}

This subscale is made up of questions 12 and 14. All individuals who participated in the study (100\%) opined that the services they obtained while receiving the aids were tremendous and. Specially, users were, to a great extent, satisfied with the proficiency of the audiologist and indicated a great level of gratification with the reliability of their hearing aids in Figure~\ref{f-ec5746d91221}.


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\makeatother 
\caption{\boldmath {Graphical Representation of the percentage of responses for Service and Cost.}}
\label{f-ec5746d91221}
\end{figure}
\egroup

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\makeatother 
\caption{\boldmath {Graphical Representation of the percentage of responses for Negative features.}}
\label{f-16ba92de4d2d}
\end{figure}
\egroup

\bgroup
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\makeatother 
\caption{\boldmath {Graphical Representation of the percentage of responses for Negative features}}
\label{f-96713c752cb7}
\end{figure}
\egroup
\textbf{Negative Features}

This subset has Items 2 and 7 which are reversed items and 11. 70 \% of individuals opined that there was no difficulty while using the provided hearing aid and only 20\% of them reported a slight discomfort, mainly due to feedback and cosmetic appearance in Figure~\ref{f-16ba92de4d2d}. Participants were a little troubled with environmental sounds amplified by the hearing aids. However, the patients complained of poor build quality and frequent physical damage of the hearing aid, which was not included in the questionnaire and hence couldn't be quantified. Clients also had difficulty in adverse environments, such as noisy situations and group discussion. This complication can be attributed to limited programming options available in the aid which in turn hinders the accessibility and hence restricting the audiologist for further fine-tuning in Figure~\ref{f-96713c752cb7}.

\textbf{Personal Image}

The subscale consists of questions 4, 8, and 13 which are scored in a reverse manner. Participants reported great levels of gratification on this. Furthermore, 80\% of individuals were not much concerned about the appearance of the aid. 75\% of the hearing aid users disagreed on question 4, which shows that the hearing did not make them seems less capable rather made them more independent and capable in Figure~\ref{f-96cecb54e1e4}.


\bgroup
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\makeatother 
\caption{\boldmath {Graphical Representation of the percentage of responses for Personal Image.}}
\label{f-96cecb54e1e4}
\end{figure}
\egroup
The results determined that in  general, there was a great level of partaker contentment with amplification of the  hearing aid. This is in agreement with abundant other studies done on Australian hearing aid users. Outcome of the current study is in agreement to the SADL data, which had participants of almost similar age and gender. In contrast, SADL scores for the current study is high than  12-24 month post fitting group, probably since the data remained together in the current study was at an earlier stage post fitting. The gratification for the individuals in the current study may more strongly be similar to the normative data if restrained at a later stage post fitting as was the case while it was correlated their 12{\textendash}24 month post fitting contributor group by interim norms.
    
\section{Conclusions}
This research has contributed SADL data for the hearing aid users provided with free hearing aids through the ADIP scheme of the Indian government. Relatively a few variables that can persuade gratification levels were recognized amongst all SADL subscales and those are an apparent degree of  hearing intricacy with no hearing aids,  a quantity of earlier hearing aid practice, and style of hearing aid. The SADL gratification scores were appreciably correlated to all other measures inspected, as well as single- item gratification, hearing aid use, hearing aid benefits, and its challenges. Hence to conclude, ADIP scheme hearing aids do satisfy the users in most of the features such as speech understanding, speaking over the phone and enhanced overall hearing. Further improvements will be of great leverage for the users and providers, which makes using hearing aid more affordable and consumer-friendly.

\textbf{Conflict of Interest }

The authors declare that they have no conflict of interest for this study.

\textbf{Funding Support }

The authors declare that they have no funding support for this study.
    

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