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Hearing Aid Benefit and Satisfaction Results from the MarkeTrak 2022 Survey: Importance of Features and Hearing Care Professionals
MarkeTrak 2022 年調查的助聽器益處和滿意度結果：功能和聽力保健專業人員的重要性

Erin M. Picou, Au.D., Ph.D. 1 1 ^(1){ }^{1}
Erin M. Picou， Au.D.， Ph.D. 1 1 ^(1){ }^{1}

Abstract  抽象

The hearing aid market is rapidly evolving with advancements in features and potential changes in service delivery models, including the new over-the-counter device category. Data from the MarkeTrak 2022 survey indicate most hearing aid owners report regular quality-oflife benefits from hearing aids, even more than in previous surveys. The increased likelihood of hearing aid benefits might be attributable to modern hearing aid features advancements, such as wireless connectivity and rechargeable batteries. Hearing aid satisfaction rates have been relatively stable over the years, indicating that more than 80 % 80 % 80%80 \% of hearing aid owners are satisfied with their devices. Hearing aid satisfaction rates do not appreciably vary by fitting channel; hearing aid owners fitted in person, fitted remotely, or self-fit are similarly likely to report high satisfaction with their device. However, only respondents in the inperson channel gave establishment ratings (reflecting their willingness to recommend) that resulted and reflected a positive net promoter score. Given the potential for net promoter scores to be related to brand growth and customer loyalty, this finding has implications for the development of over-the-counter hearing aid service-delivery models. Additional work is warranted to explore the factors that negatively affect hearing aid owners’ satisfaction with the companies delivering limited services.
助聽器市場正在迅速發展，功能不斷進步，服務提供模式可能發生變化，包括新的非處方設備類別。MarkeTrak 2022 年調查的數據表明，大多數助聽器用戶報告說，助聽器對生活品質有定期的好處，甚至比以前的調查還要多。助聽器益處的可能性增加可能歸因於現代助聽器功能的進步，例如無線連接和可充電電池。多年來，助聽器滿意度一直相對穩定，這表明對他們的設備感到滿意的助聽器擁有者多於 80 % 80 % 80%80 \% 助聽器擁有者。助聽器滿意度不會因驗配管道而異;親自驗配、遠端驗配或自行驗配的助聽器用戶同樣可能對他們的設備表示高度滿意。然而，只有現場頻道的受訪者給出了機構評級（反映他們推薦意願），這導致並反映了積極的凈推薦值。鑒於凈推薦值可能與品牌增長和客戶忠誠度相關，這一發現對非處方助聽器服務提供模式的發展具有影響。需要開展更多工作來探索對助聽器擁有者對提供有限服務的公司滿意度產生負面影響的因素。

KEYWORDS: hearing aid, benefit, satisfaction, implant, direct-toconsumer
關鍵詞：助聽器，好處，滿意度，植入物，直接面向消費者
N ot all hearing aid users report hearing aid N ot all hearing aid users report hearing aid  N_("ot all hearing aid users report hearing aid ")\mathrm{N}_{\text {ot all hearing aid users report hearing aid }} benefit or satisfaction, despite documented advantages of hearing aid use for speech recognition, 1 1 ^(1){ }^{1} communication, 2 2 ^(2){ }^{2} and quality of life. 3 , 4 3 , 4 ^(3,4){ }^{3,4} There have been several recent publications on this subject, attempting to explain variability in hearing aid benefit and satisfaction. The results of these investigations generally support that benefit and satisfaction are distinct constructs, 5 5 ^(5){ }^{5} with benefit reflecting how hearing aids make improvements in particular areas (e.g., speech understanding, self-reported well-being) and satisfaction reflecting an affective appraisal of overall performance with a hearing aid. 6 , 7 6 , 7 ^(6,7){ }^{6,7} The results of numerous studies suggest hearing aid benefit is related to, among other things, prefitting expectations and perceived hearing ability without hearing aids. 8 − 11 8 − 11 ^(8-11){ }^{8-11} Determinants of satisfaction also include perceived hearing ability without hearing aids 8 8 ^(8){ }^{8} and pre-fitting expectations, 12 , 13 12 , 13 ^(12,13){ }^{12,13} in addition to the physical appearance of the hearing aid, cost, and frequency of issues encountered with the device. 6 6 ^(6){ }^{6}
N ot all hearing aid users report hearing aid N ot all hearing aid users report hearing aid  N_("ot all hearing aid users report hearing aid ")\mathrm{N}_{\text {ot all hearing aid users report hearing aid }} 獲益或滿意，儘管有記錄表明使用助聽器在語音辨識、 1 1 ^(1){ }^{1} 溝通 2 2 ^(2){ }^{2} 和生活品質方面具有優勢。 3 , 4 3 , 4 ^(3,4){ }^{3,4} 最近有幾篇關於這個主題的出版物，試圖解釋助聽器益處和滿意度的差異。這些調查的結果通常支援益處和滿意度是不同的結構， 5 5 ^(5){ }^{5} 益處反映了助聽器如何在特定領域（例如，言語理解、自我報告的幸福感）進行改善，而滿意度反映了對助聽器整體性能的情感評估。 6 , 7 6 , 7 ^(6,7){ }^{6,7} 大量研究的結果表明，助聽器的益處與預先擬合的期望和在沒有助聽器的情況下感知的聽力能力等因素有關。 8 − 11 8 − 11 ^(8-11){ }^{8-11} 滿意度的決定因素還包括沒有助聽器 8 8 ^(8){ }^{8} 的感知聽力能力和預先驗配的期望， 12 , 13 12 , 13 ^(12,13){ }^{12,13} 以及助聽器的物理外觀、成本和設備遇到的問題頻率。 6 6 ^(6){ }^{6}
Extant literature also points at the importance of service-delivery-related factors for hearing aid outcomes. Specifically, hearing aid benefit has been related to service setting, 8 8 ^(8){ }^{8} prefitting counseling, 14 14 ^(14){ }^{14} and verification of prescriptive targets. 15 15 ^(15){ }^{15} However, most of the aforementioned studies have focused on hearing aid benefit and satisfaction under traditional service delivery models, where a hearing care professional (e.g., an audiologist or dispenser) performs the fitting and counseling during an inperson appointment.
現存文獻還指出了服務提供相關因素對助聽器結果的重要性。具體來說，助聽器的好處與服務設置、 8 8 ^(8){ }^{8} 驗配諮詢 14 14 ^(14){ }^{14} 和規範目標的驗證有關。 15 15 ^(15){ }^{15} 然而，上述大多數研究都集中在傳統服務提供模式下的助聽器益處和滿意度上，在傳統服務提供模式下，聽力保健專業人員（例如，聽力學家或配藥師）在面對面預約期間進行驗配和諮詢。
The roles of professionals and in-person appointments are evolving, due in part to regulatory changes. Based in part on the Na tional Academies of Sciences, Engineering, and Medicine (NASEM) published report, 16 16 ^(16){ }^{16} the Federal Drug Administration (FDA) Over the Counter Act of 2017 mandated the creation of an “over-the-counter” hearing aid category for adults with perceived mild to moderate hearing loss. At the time of this writing, the FDA issued the proposed guidelines and requested comments. The final regulations are expected late summer or fall 2022. The general premise is hearing aids should be available to consumers with no professional involvement to reduce costs and expand hearing health care access.
專業人士和面對面預約的角色正在發生變化，部分原因是監管變化。部分基於國家科學、工程和醫學院 （NASEM） 發佈的報告， 16 16 ^(16){ }^{16} 聯邦藥品管理局 （FDA） 2017 年非處方藥法案要求為患有輕度至中度聽力損失的成年人創建“非處方”助聽器類別。在撰寫本文時，FDA 發佈了擬議的指南並徵求了意見。最終規定預計將於 2022 年夏末或秋季出臺。一般前提是應該向沒有專業人員參與的消費者提供助聽器，以降低成本並擴大聽力保健的機會。
The expectation of this regulatory hearing aid category has led professionals to prepare for hearing aid delivery models with limited or no hearing professional support by investigating direct-to-consumer models and by implementing alternative to traditional service models. Examples of alternatives to a traditional, inperson hearing aid fitting (e.g., a professional evaluates hearing and dispenses hearing aid(s) in person), include a fully direct-to-consumer service delivery model (e.g., a person buys a selffitting hearing aid with no professional support) or a remote model where the person receives only limited support (e.g., remote support for hearing aid selection or troubleshooting).
對這一監管助聽器類別的期望促使專業人士通過研究直接面向消費者的模式和實施傳統服務模式的替代方案，為聽力專業支援有限或沒有聽力專業支援的助聽器交付模式做準備。傳統現場驗配助聽器的替代方案示例（例如，專業人員評估聽力並親自配發助聽器），包括完全直接面向消費者的服務交付模式（例如，一個人在沒有專業支持的情況下購買了自動驗配助聽器）或遠端模式，該人僅獲得有限的支援（例如，助聽器選擇或故障排除的遠端支援）。
In general, the existing evidence demonstrates that the use of direct-to-consumer or selffitting hearing devices can result in similar speech recognition performance as conventionally fit hearing aids, especially for high-quality over-the-counter devices with broad bandwidths, advanced features, and appropriate gain. 17 − 21 17 − 21 ^(17-21){ }^{17-21} In addition, differences between conventionally fit hearing aids (with full support of a hearing care professional) and self-fit hearing aids (with limited support of a hearing care professional) are evident in satisfaction ratings, where ratings of satisfaction are higher when people have the full support of a hearing care professional, despite similar ratings of benefit between the two groups. 18 , 22 , 23 18 , 22 , 23 ^(18,22,23){ }^{18,22,23} Although some of the differences in satisfaction have been attributed to physical device differences, rather than purely the service delivery models, 23 23 ^(23){ }^{23} others note differences in satisfaction perseverate even when the devices are physically identical. 18 , 22 18 , 22 ^(18,22){ }^{18,22} Combined, these data point to the importance of high-quality instruments and adequate gain for speech understanding and perceived benefit, but suggest the hearing care professional might have an important influence on the overall experience from start to finish.
一般來說，現有證據表明，使用直接面向消費者或自擬合的助聽器可以產生與傳統安裝的助聽器相似的語音辨識性能，特別是對於具有寬頻寬、高級功能和適當增益的高品質非處方設備。 17 − 21 17 − 21 ^(17-21){ }^{17-21} 此外，常規安裝的助聽器（在聽力保健專業人員的全力支援下）和自安裝的助聽器（在聽力保健專業人員的有限支援下）之間的差異在滿意度評級中很明顯，當人們得到聽力保健專業人員的全力支援時，滿意度評級更高，儘管兩組之間的收益評級相似。 18 , 22 , 23 18 , 22 , 23 ^(18,22,23){ }^{18,22,23} 儘管滿意度的一些差異歸因於物理設備的差異，而不僅僅是服務交付模型，但 23 23 ^(23){ }^{23} 其他人指出，即使設備在物理上相同，滿意度的差異仍然存在。 18 , 22 18 , 22 ^(18,22){ }^{18,22} 綜合起來，這些數據表明瞭高品質儀器和足夠的增益對言語理解和感知益處的重要性，但表明聽力保健專業人員可能對從頭到尾的整體體驗產生重要影響。
The current MarkeTrak 2022 survey results have the potential to offer insights into the role of the hearing care provider and its influence on satisfaction ratings and overall perceptions. The survey, whose methods are described in detail elsewhere (Powers et al, this issue), resulted in ratings of satisfaction for hearing aid owners in three different channels: traditionally fit (with in-person hearing care
目前的 MarkeTrak 2022 調查結果有可能深入瞭解聽力保健提供者的作用及其對滿意度評級和整體認知的影響。這項調查的方法在別處有詳細描述（Powers et al， this issue），結果從三個不同的管道對助聽器擁有者的滿意度進行評分：傳統聽力保健（通過面對面的聽力保健
professional such as an audiologist or hearing instrument specialist), remote fit (with virtual or remote hearing care professional support via the Internet, video call, or app), or self-fit (with no professional support). Although the exact devices likely varied across channels, the devices in these categories are all officially “hearing aids,” meeting the FDA’s requirements for labeling at the time of survey data collection. Examples of potential devices in the remote fitting channel include those sold by Lively and examples of those in the self-fit category include the Bose devices available at the time (currently distributed by Lexie). None of the devices in these channels reported to be “personal sound amplifiers,” designed for people with normal hearing and ordered directly online, nor were the devices with specific “hearing-improvement” features (e.g., Apple AirPods Pro or Nuheara earbuds with “conversation boost”), which were asked about separately in this survey.
專業人士，例如聽力學家或助聽器專家）、遠端 Fit（通過互聯網、視頻通話或應用程式提供虛擬或遠端聽力保健專業支援）或 Self-Fit（沒有專業支援）。儘管確切的設備可能因管道而異，但這些類別中的設備都是官方的“助聽器”，符合 FDA 在收集調查數據時的標籤要求。遠端驗配管道中的潛在設備範例包括 Lively 銷售的設備，而自安裝類別中的設備範例包括當時可用的 Bose 設備（目前由 Lexie 分銷）。這些頻道中的設備都沒有報告為「個人聲音放大器」，專為聽力正常的人設計並直接在線訂購，也沒有具有特定“聽力改善”功能的設備（例如，Apple AirPods Pro 或具有“對話增強”功能的 Nuheara 耳塞），這些設備在本次調查中單獨被詢問。
In addition to satisfaction ratings by fitting channel, the MarkeTrak 2022 survey results offer indirect insights into hearing aid benefits and the use of hearing aid features. The hearing aid marketplace is rapidly evolving with the development and advancement of advanced features, especially wireless streaming, rechargeable batteries, and noise cleaning algorithms. 24 24 ^(24){ }^{24} The survey respondents (hearing aid owners and non-owners) rated their ability to hear in many different situations, allowing for the comparison of people with hearing difficulties who do and do not use hearing aids and providing insights into where the devices are beneficial. Respondents also provided information about the features their hearing aids have and the frequency of use of some of the features (e.g., wireless streaming, smartphone apps, and microphone directionality).
除了按驗配渠道劃分的滿意度評級外，MarkeTrak 2022 調查結果還提供了對助聽器益處和助聽器功能使用的間接見解。隨著高級功能的發展和進步，尤其是無線流媒體、可充電電池和噪音清除演算法，助聽器市場正在迅速發展。 24 24 ^(24){ }^{24} 調查受訪者（助聽器擁有者和非擁有者）對他們在許多不同情況下的聽力能力進行了評分，從而可以比較使用和不使用助聽器的聽力障礙者，並深入瞭解這些設備在哪些方面是有益的。受訪者還提供了有關他們的助聽器功能以及某些功能（例如，無線流媒體、智慧手機應用程式和麥克風方向性）的使用頻率的資訊。
Therefore, the purposes of this article were to (1) describe hearing aid benefits noted in the data and (2) describe current hearing aid satisfaction rates. Whenever possible, the satisfaction rates will be compared across the three channels queried in the MarkeTrak 2022 survey (in person, remote, or self-fit) to investigate the importance of the hearing care professional in the fitting of hearing aids. Hearing aid feature use will also be related to benefit whenever
因此，本文的目的是 （1） 描述數據中提到的助聽器益處，以及 （2） 描述當前的助聽器滿意度。只要有可能，將比較 MarkeTrak 2022 調查中查詢的三個管道（面對面、遠端或自行安裝）的滿意度，以調查聽力保健專業人員在驗配助聽器方面的重要性。助聽器功能的使用也將與任何時候的好處有關
possible. The survey also included questions specific to the hearing aid owners’ perception of the role of hearing care professionals; thus, a third purpose is to summarize hearing aid owners’ views on the roles of hearing care professionals. To contextualize the findings, a descriptive sample of the hearing aids used by survey respondents is described first.
可能。該調查還包括針對助聽器擁有者對聽力保健專業人員角色的看法的特定問題;因此，第三個目的是總結助聽器擁有者對聽力保健專業人員角色的看法。為了將調查結果置於上下文中，首先描述了調查受訪者使用的助聽器的描述性樣本。

DESCRIPTIVE HEARING AID SAMPLE
描述性助聽器樣本

Most of the survey respondents reported being fit in person by a hearing health care professional ( 81 % 81 % 81%81 \% ) and far fewer were fit remotely by a professional (12%) or self-fit (7%). The most popular style continues to be behind-the-ear (64%) and, among those, receiver in the canal is the most popular ( 54 % 54 % 54%54 \% of total respondents). The most popular in-the-ear style was full shell (12%), followed by half shell (9%), invisible in the canal (7%), and completely in the canal (5%). The median hearing aid age was 2.0 years ( M = 3.5 M = 3.5 M=3.5M=3.5 years). Hearing aid costs were mostly bundled, with 66 % 66 % 66%66 \% of respondents paying a single price for hearing aids and only 16 % 16 % 16%16 \% of respondents reporting unbundled services; the remaining were unsure of the cost structure.
大多數調查受訪者表示，他們是由聽力保健專業人員親自進行健身的 （ 81 % 81 % 81%81 \% ），而由專業人士遠程進行健身 （12%） 或自行健身 （7%） 的人數要少得多。最受歡迎的款式仍然是耳後式 （64%），其中耳道中的接收器是最受歡迎的 （ 54 % 54 % 54%54 \% 在所有受訪者中）。最受歡迎的耳內式耳罩是全殼式 （12%），其次是半殼式 （9%），在耳道中隱形 （7%） 和完全在耳道中 （5%）。助聽器年齡中位為2.0歲（ M = 3.5 M = 3.5 M=3.5M=3.5 歲）。助聽器費用大多是捆綁式的， 66 % 66 % 66%66 \% 受訪者為助聽器支付單一價格，只有 16 % 16 % 16%16 \% 受訪者報告非捆綁式服務;其餘的對成本結構不確定。
The survey respondents consisted of both first-time and established hearing aid owners approximately equally represented ( 51 % 51 % 51%51 \% firsttime owners), with slight variations in the percent of first-time owners by channel (in person [51%], remote [47%], or self-fit [53%]). Most of the hearing aid owners in the study have a pair of devices ( 67 % 67 % 67%67 \% of the sample). However, the number of bilateral fittings varied by service delivery model, with 71 % 71 % 71%71 \% of respondents reporting bilateral hearing aids when fitted in person, but fewer reporting bilateral solutions for the other fitting channels (self-fitting [66%], remote fitting [39%]). These bilateral adoption rates reflect people with hearing loss in one or both ears. For those with bilateral losses, 84 % 84 % 84%84 \% of respondents reported bilateral fitting. The high bilateral adoption rate is consistent with previous survey data, but also reflects that bilateral fittings are not the preferred solution for all people. 25 − 27 25 − 27 ^(25-27){ }^{25-27}
調查受訪者包括首次使用助聽器和已建立的助聽器擁有者，比例大致相等（ 51 % 51 % 51%51 \% 首次擁有者），按管道（親自 [51%]、遠端 [47%] 或自行安裝的 [53%]）首次擁有者的百分比略有不同。研究中的大多數助聽器擁有者都有一對設備（ 67 % 67 % 67%67 \% 樣本）。然而，雙側驗配的數量因服務提供模式而異， 71 % 71 % 71%71 \% 受訪者報告說親身驗配時雙側助聽器，但較少報告其他驗配管道的雙側解決方案（自驗配 [66%]、遠端驗配 [39%]）。這些雙側收養率反映了單耳或雙耳聽力損失的人。對於雙側丟失的患者， 84 % 84 % 84%84 \% 受訪者報告了雙側驗配。雙邊採用率高與之前的調查數據一致，但也反映出雙邊驗配並不是所有人的首選解決方案。 25 − 27 25 − 27 ^(25-27){ }^{25-27}
  1. 1 1 ^(1){ }^{1} Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.
    1 1 ^(1){ }^{1} 田納西州納什維爾范德堡大學醫學中心聽力和言語科學系。
    Address for correspondence: Erin M. Picou, Au.D., Ph.D., 1215 21st Avenue S, Room 8310, Nashville, TN 37232 (e-mail: erin.picou@vanderbilt.edu).
    通信位址：Erin M. Picou， Au.D.， Ph.D.， 1215 21st Avenue S， Room 8310， Nashville， TN 37232（電子郵件：erin.picou@vanderbilt.edu）。
    MarkeTrak 2022: Insights into the Evolving Hearing Market; Guest Editors, Thomas A. Powers, Ph.D. and Jan Kihm, M.S.
    MarkeTrak 2022：洞察不斷發展的聽力市場;客座編輯 Thomas A. Powers 博士和 Jan Kihm 碩士
    Semin Hear 2022;43:301-316. © 2022. The Author(s).
    塞明·赫爾 2022;43：301-316。© 2022 年。作者。