These empirical findings that link autonomous motivation to decisions of hearing help-seekers have implications for the ways practitioners may evaluate motivation and could inform discussions with clients about hearing aid adoption.
The SDT model is potentially useful in understanding how hearing aid adoption decisions are made, and how hearing health behaviour is internalized and maintained over time. Autonomy supportive practitioners may improve outcomes by helping hearing aid adopters maintain internalized change.
Relationships among motivation and sociodemographic factors highlight the importance of characterizing autonomous and controlled motivation in first-time hearing help-seekers. Attention to personal characteristics in order to understand motivational processes involved in rehabilitation decisions such as hearing aid adoption may aid in consultations.
Adults with hearing impairment do not always seek help for their hearing or adopt hearing aids and some people who adopt hearing aids do not use or gain benefit from them.Psychosocial factors that influence help-seeking, hearing aid adoption and outcomes illustrate the importance of addressing client experiences and motivation. Although models of health behaviour have been recommended to understand client behaviour, motivation has not been explored in detail. To investigate motivation in hearing rehabilitation, the research in this thesis applied self-determination theory (SDT) as the guiding theoretical framework.The research comprised three quantitative studies and one qualitative study, which together followed an explanatory sequential mixed methods design. The thesis research aims were to (1) identify motivational characteristics of first time hearing help-seekers and determine relationships between these characteristics and the decision whether or not to adopt hearing aids; (2) For the quantitative studies, a total of 253 participants completed a series of questionnaires adapted from SDT. In the first study, associations between autonomous and controlled motivation, personal and audiometric variables and hearing aid adoption were explored with multivariate regression analysis. Three factors were positively associated with increased hearing aid adoption: autonomous motivation, perceived hearing difficulty and poorer hearing. Controlled motivation was not associated with hearing aid adoption.The second study reported outcomes for 216 of the 253 participants with respect to autonomy support. Multivariate regression models were formed that examined associations between autonomous and controlled motivation, personal and audiometric variables, autonomy support and hearing aid fitting outcomes. Autonomy support was not associated with increased hearing aid adoption, but was associated with three outcomes: increased perceived competence for hearing aids, reduced activity limitations and iii increased hearing aid satisfaction. Autonomous motivation was positively associated with one outcome, hearing aid satisfaction.The patterns of effect of autonomous and controlled motivation on hearing aid adoption and hearing aid fitting outcomes prompted the third quantitative study, which sought to examine personal characteristics associated with motivation. Multivariate regression indicated that, in the 253 participants, those who were younger, wanted hearing aids more and reported greater hearing difficulty also reported higher autonomous motivation.Participants with higher controlled motivation were more often referred by others and wanted hearing aids more than those reporting lower controlled motivation.Together, the three quantitative studies revealed a variety of motivational processes that underlie behaviours and actions of participants. Practitioners may benefit from evaluating motivation in order to better understand how help-seekers engage with hearing services
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