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Factors relating to the under-use of postaural hearing aids.

All adult patients issued at Withington Hospital with NHS postaural hearing aids in 1980 (n = 731) were reviewed. Efforts were made to determine the reasons for under-use and dissatisfaction among those who were not using the aid at all or using it minimally and with low satisfaction. The major presenting reason for non-use, accounting for over a quarter of all non-users, was inability to insert the earmould. The next most common reason for non-use and the major reason for poor satisfaction in low level users was related to difficulty in coping with signals in noise. Other significant factors contributing to poor or non-use were (1) lack of recognition of hearing impairment, (2) advanced age and poor health, (3) less than ideal matching of the aid to the loss of hearing. The percentage of under-users was significantly reduced by hearing aid orientation and counselling. Further reduction might be achieved if attitudes to hearing loss among those affected and concerned professionals could be improved so that early referral and treatment became the norm rather than the exception.