Hearing impairment.

The purpose of this chapter is to review the literature on hearing impairment, specifically the impact of hearing impairment on the functioning of elders, interventions that minimize the impact of hearing loss on functioning, and identification of issues raised by the review for nursing research. Computerized (MEDLINE, PsychINFO, and CINAHL) and manual searches were used to obtain research reports from a range of disciplines. Research articles including elders (> or = 60) and published between 1989 and 2001 were included. Twenty-five articles were selected for critical review, four written by nurses. The diversity of methodologies, the criteria used to define hearing impairment, the range of sample characteristics, and the assessment measures make comparisons across studies difficult. Most studies, however, support the negative impact of hearing impairment, especially on psychosocial functioning. Measures that are condition specific are generally more effective in capturing the impact of hearing loss than generic measures. Findings related to physical disability are less consistent. The results of intervention studies suggest that hearing devices can improve psychosocial and communication outcomes, but behavioral interventions have not shown long lasting benefit. For nurses to assist elders and their families manage the impact of hearing impairment, further research is needed in several areas that have been poorly explored. These include the dyadic experience of hearing impairment, the way in which culture influences the experience of hearing loss, the needs of hearing impaired individuals across settings, the long-term impact of ototoxic medications, and strategies to assist elders in coping with hearing impairment and utilizing available technologies.