Determinants of quality of life amongst hearing impaired patients in a rural district of South Africa: a cross-sectional study

Hearing loss is one of the leading causes of disability worldwide, affecting individuals across all age groups. Its impact extends beyond auditory function, influencing overall health-related quality of life (HRQoL) and presenting significant social, emotional, and communication challenges. Understanding the interplay between hearing loss, its determinants, and HRQoL is critical for developing effective interventions, particularly in underserved rural settings. A cross-sectional study was conducted from May 2019 to August 2019 in the rural Eastern Cape, South Africa, involving 210 adults with hearing loss. Data were collected using the RAND 36-Item Health Survey 1.0, administered in English or IsiXhosa, to assess HRQoL. Additional data on socio-demographic characteristics, audiological profiles (including degree of hearing loss and hearing aid use), and communication status were collected. Descriptive statistics, bivariate analyses, and multivariate linear regression models were employed to analyse the data, with significance set at p < 0.05. Key determinants of better HRQoL included younger age, male gender, and higher income, with older participants (age 58 years and above) showing significantly reduced odds of good health (OR 0.38, 95% CI 0.16–0.91, p = 0.033). Hearing aid use (OR 1.59, 95% CI 0.87–2.94, p = 0.135) was not associated with improved overall HRQoL. The current research showed that both biological and social factors significantly impact the quality of life of patients living with hearing loss in the rural Eastern Cape. While physical health was relatively preserved, social and emotional health were impaired. These findings emphasise the urgent need for further research to confirm the associations to provide targeted health interventions for individuals with hearing loss in rural settings. This study promotes the rights of people with disabilities by highlighting factors affecting the quality of life for deaf or hard of hearing patients in rural South Africa, a group with little research available. It shows the need to focus on resource allocation in public healthcare to improve services for people with hearing loss, which can enhance their communication, relationships, and quality of life. It supports policies for the inclusivity of deaf or hard of hearing individuals in the economic activities of the country to enhance their quality of life.