Understanding Hearing Aid Use and Nonuse of Adult Hearing Aid Recipients: A Qualitative Content Analysis

Purpose: Hearing loss results in various challenges that can be mitigated by the use of hearing aids. Despite their benefits, hearing aids are often not worn consistently. Improved use of hearing aids can be supported by understanding the challenges and motivations that users experience. This study explored hearing aid recipients’ reasons for hearing aid use and nonuse. Method: A cross-sectional survey design was used and a qualitative content analysis was applied to responses from an open-ended question in an online survey distributed to American hearing aid users in the Hearing Tracker and Lexie Hearing databases. Results: The study included 680 hearing aid recipients 18 to 93 years of age. The findings were structured around two domains, namely, reasons for hearing aid use and reasons for hearing aid nonuse. Within these two domains, the following three categories were identified: (1) personal factors; (2) situational aspects; and (3) hearing device-related factors. These three categories consisted of 11 subcategories within the use domain and 24 subcategories within the nonuse domain. Personal motivations for use included reliance on hearing aids for essential daily functioning and communication, whereas nonuse was often driven by self-consciousness and discomfort. Device-related aspects highlighted the positive impact of streaming and connectivity features, whereas nonuse was frequently attributed to the users’ perceived need for fine-tuning. Situational factors were also important. Users valued their hearing aids for environmental awareness and safety; however, concerns about fear of damage (e.g., moisture damage) led to decreased hearing aid use. Conclusions: Addressing personal apprehensions, improving device comfort and functionality, and acknowledging situational preferences are essential for supporting adherence and satisfaction among hearing aid users.