Impact of face masks in public spaces during COVID-19 pandemic on daily life communication of cochlear implant users

The Impact of the COVID-19 Pandemic on Real-world Functioning in Adult Cochlear-implant Users

Hypothesis

As a result of COVID-19 lockdowns and the associated effects on the auditory-social environments of cochlear-implant (CI) users, we expected that adult CI users would report a decrease in real-world communication abilities, a decrease in social isolation, and a decrease in quality of life (QOL) from pre- to post-pandemic.

Background

The COVID-19 pandemic brought many changes to the environments in which adults with CIs interact and communicate. However, the impact of these changes on CI users' real-world functioning is not well understood. This study investigated the impact of the COVID-19 pandemic on real-world communication abilities, social isolation, and CI-related QOL in adult CI users.

Methods

Fourteen adult CI users completed self-report questionnaires assessing communication abilities, social isolation, and CI-related QOL at time points before and after the onset of the COVID-19 pandemic. Responses at the 2 time points were compared to evaluate changes in CI users' real-world functioning.

Results

Adult CI users showed a significant decrease in self-reported communication ability and a nonsignificant decline in CI-related QOL from before to during COVID-19. However, a nonsignificant trend of a decline in social isolation was also observed in adult CI users.

Conclusion

Findings showed a decrease in self-reported communication abilities and, to a lesser extent, CI-related QOL, suggesting that changes to the auditory-social environment brought on by the COVID-19 pandemic may have negatively impacted communication abilities in real-world, challenging environments. Yet, the potential decrease in social isolation suggests that these changes may have had an overall positive effect on social interaction, potentially with close family and friends in well-controlled environments. Assessing changes in real-world functioning in the same CI users from both before and during the COVID-19 pandemic provided a unique glimpse into how changes in the auditory-social environment may impact outcomes in adult CI users.

A comparison of the impact of the COVID-19 pandemic on communication among individuals with and without hearing impairment

Objective: This study assessed the impact of coronavirus disease-2019 (COVID-19) preventative measures on hearing and communication among individuals with normal and impaired hearing. We also evaluated the use of digital communication tools between these groups.Design: For this cross-sectional study, participants completed an online digits-in-noise test and survey. Survey topics included understanding through masks, behind plastic screens, from a 1.5-m distance, and use of social network sites/apps, direct messaging, and video calling. Logistic regressions assessed the odds of disagreeing versus agreeing with survey statements.Study Sample: A total of 880 adults from the National Longitudinal Study on Hearing completed a survey and hearing test. Based on speech reception threshold scores, participants were categorised into "good" (reference group for all analyses), "insufficient", or "poor" hearing groups.Results: Those with insufficient and poor hearing had more difficulty understanding others through facemasks, plastic screens, and from 1.5 m. Those with poor hearing had a higher odds of video calling more to contact family/friends/acquaintances during the pandemic, but also had more difficulty hearing sufficiently through video calls.Conclusions: This study addresses methodological weaknesses in previous studies. Results strengthen current evidence of the burden COVID-19 measures place on individuals with hearing impairment.

Effects on communication due to face mask use: an integrative review

OBJECTIVES

to integrate evidence from studies on auditory perceptual and speech production effects in communication situations with face mask use.

METHODS

an integrative literature review, in MEDLINE, Cochrane Library and Embase databases. The guiding question was: what effects on communication (perceptual-auditory and speech production) occur with face mask use?

RESULTS

searches in electronic databases resulted in 1,478 studies and filtering resulted in 29 final studies.

CONCLUSIONS

mask use has effects on communication, both in perception and speech production, factors that are also related to quality of life, stress and socio-emotional factors. These data can impact on indicators and alerts in favor of adopting strategies to manage mask use, involving speech production and perception when wearing a mask in health services.

The impact of COVID-19 on communicative accessibility and well-being in adults with hearing impairment: a survey study

BACKGROUND

COVID-19 measures, such as face masks, have clear consequences for the communicative accessibility of people with hearing impairment because they reduce speech perception. As communication is essential to participate in society, this might have impact on their mental well-being. This study was set out to investigate the impact of the COVID-19 measures on the communicative accessibility and well-being of adults with hearing impairment.

METHOD

Two groups of adults took part in this study, with (N = 150) and without (N = 50) hearing loss. The participants answered statements on a five point Likert-scale. Statements regarding communicative accessibility involved speech perception abilities, behavioral changes and access to information. Well-being was measured at the overall level in daily community life and at work, and in particular also with respect to perceived stress. We asked participants with hearing impairment on their audiological needs during the pandemic.

RESULTS

Significant group differences were found on speech perception abilities due to COVID-19 measures. Behavioral changes were observed to compensate for the loss in speech perception. Hearing loss was associated with an increased request for repetition or for removal of the face mask. Using information technology (e.g. Zoom) or contacting colleagues did not pose any major problems for the hearing group, whereas participants with hearing loss gave mixed responses. A significant difference emerged between groups on well-being in daily life, but not on well-being at work or perceived stress.

CONCLUSIONS

This study shows the detrimental effect of COVID-19 measures on the communicative accessibility of individuals with hearing loss. It also shows their resilience as only partial group differences were found on well-being. Protective factors are indicated, such as access to information and audiological care.

Challenging Times for Cochlear Implant Users - Effect of Face Masks on Audiovisual Speech Understanding during the COVID-19 Pandemic

Unhindered auditory and visual signals are essential for a sufficient speech understanding of cochlear implant (CI) users. Face masks are an important hygiene measurement against the COVID-19 virus but disrupt these signals. This study determinates the extent and the mechanisms of speech intelligibility alteration in CI users caused by different face masks. The audiovisual German matrix sentence test was used to determine speech reception thresholds (SRT) in noise in different conditions (audiovisual, audio-only, speechreading and masked audiovisual using two different face masks). Thirty-seven CI users and ten normal-hearing listeners (NH) were included. CI users showed a reduction in speech reception threshold of 5.0 dB due to surgical mask and 6.5 dB due to FFP2 mask compared to the audiovisual condition without mask. The greater proportion of reduction in SRT by mask could be accounted for by the loss of the visual signal (up to 4.5 dB). The effect of each mask was significantly larger in CI users who exclusively hear with their CI (surgical: 7.8 dB, p = 0.005 and FFP2: 8.7 dB, p = 0.01) compared to NH (surgical: 3.8 dB and FFP2: 5.1 dB). This study confirms that CI users who exclusively rely on their CI for hearing are particularly susceptible. Therefore, visual signals should be made accessible for communication whenever possible, especially when communicating with CI users.

Psychosocial Impact of the COVID-19 Pandemic on Children With Cochlear Implants and Their Parents/Family Members

Purpose:

The purpose of this study was to describe hearing health care and education experiences of children with cochlear implants (CIs) during the COVID-19 pandemic and the potential psychosocial effects of the pandemic on these children and their parents/family members.

Method:

The study used a cross-sectional survey design. The study sample comprised two groups, namely, parents/family members of children with CIs (study group, n = 70, M age = 44.6 ± 12.4 years) and parents/family members of children with normal hearing (control group, n = 58, M age = 43.8 ± 11.5 years). Parents/family members completed the Perceived Stress Scale (PSS), the Coronavirus Anxiety Scale (CAS), and the Family Perspective Profile form, as well as the Demographic Information form.

Results:

The PSS scores of the study group were higher than those of the control group ( p = .001). However, there was no statistically significant difference between groups in the CAS scores ( p = .896). According to the Family Perspective Profile form, almost half of the parents/family members of children with CIs reported that their children experienced difficulties in education and hearing health care services during the pandemic and showed some changes in their attitudes and behaviors.

Conclusions:

During the pandemic, the stress levels of parents/family members of children with CIs were higher than parents/family members of children with normal hearing. In addition to the challenges posed by the pandemic, the difficulties that parents/family members of children with CIs experience in meeting their children's additional needs related to accessing education and hearing health care services may have contributed to increased stress levels.

The Influence of the COVID-19 Pandemic on the Hearing Impaired

Background In this study, we aimed to investigate the effect of the coronavirus disease 2019 (COVID-19) pandemic-induced social restrictions, including face masks, on patients with hearing problems. Methodology This cross-sectional survey study was conducted in an ENT tertiary care center. After signing the consent form, we invited study subjects with hearing disabilities who were using unilateral or bilateral hearing aids to participate in filling out the study survey. The study questionnaire was completed by 80 subjects. The questionnaire included various questions about the respondent's demographics, hearing aids, and communication with a face mask during COVID-19 restrictions. All statistical analyses were performed using SPSS version 19 (IBM Corp., Armonk, NY, USA). Results Overall, 40% of the study sample agreed that understanding people wearing face masks is harder because their speech is muffled, whereas 10% disagreed, and 50% were neutral. While 41.3% agreed that understanding is harder because they cannot see their mouth moving, 23.8% disagreed, and 35% were neutral. More than half of the study sample (55%) agreed that they are worried about how they will communicate with others if wearing face masks becomes more common. However, 50% of the participants thought that they can still hear people when they speak to them from a safe distance. Of note, 71.3% of subjects disagreed about tinnitus being worse since the lockdown. Conclusions The widespread use of face masks had a significant impact on the daily communication and interactions of people with hearing impairments. More research is needed to find creative ways to help these patients improve their daily communication and social interactions.

The contribution of respiratory and hearing protection use to psychological distress in the workplace: a scoping review

OBJECTIVE

Workers from various industries use personal protective equipment (PPE) including masks, respirators, and hearing protection to reduce their exposures to workplace hazards. Many studies have evaluated the physiological impacts of PPE use, but few have assessed the psychological impacts. The aim of the present study was to carry out a scoping review to compile existing evidence and determine the extent of knowledge on workplace mask, respirator or hearing protection use as a psychosocial hazard (stressor) that could result in a stress response and potentially lead to psychological injury.

METHODS

The scoping review followed recognized methods and was conducted using Ovid Emcare, PubMed, Sage Journals, ScienceDirect, Scopus, SpringerLink, Google Scholar and preprint databases (OSF Preprints and medRxiv). Articles on the stressors associated with the use of masks, respirators, and hearing protection were included. The extracted data included author(s) name, year of publication, title of article, study design, population data, stressors assessed, and key findings.

RESULTS

We retrieved 650 articles after removal of duplicates, of which 26 were deemed eligible for inclusion for review. Identified factors associated with PPE use that could potentially create a stress response were identified: communication impacts, physical impacts, psychological illness symptoms, cognitive impacts, and perceived PPE-related impacts. Evidence for respirators suggest that there may be psychological injury associated with their use. However, hearing protection appears to have a protective effect in reducing psychological symptoms such as anxiety, depression, and aggression.

CONCLUSIONS

Mask or respirator use may lead to an increase in work-related stress. Whereas hearing protection may have protective effects against psychological symptoms and improves speech intelligibility. More research is needed to better understand potential psychosocial impacts of mask, respirator and/or hearing protection use.

Communication with face masks during the COVID-19 pandemic for adults with hearing loss

Face masks have become common protective measures in community and workplace environments to help reduce the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Face masks can make it difficult to hear and understand speech, particularly for people with hearing loss. An aim of our cross-sectional survey was to investigate the extent that face masks as a health and safety protective measure against SARS-CoV-2 have affected understanding speech in the day-to-day lives of adults with deafness or hearing loss, and identify possible strategies to improve communication accessibility. We analyzed closed- and open-ended survey responses of 656 adults who self-identified as D/deaf or hard of hearing. Over 80% of respondents reported difficulty with understanding others who wore face masks. The proportion of those experiencing difficulty increased with increasing hearing loss severity. Recommended practical supports to facilitate communication and social interaction included more widespread use of clear face masks to aid lip-reading; improved clarity in policy guidance on face masks; and greater public awareness and understanding about ways to more clearly communicate with adults with hearing loss while wearing face masks.