“When My Cup Overflows”: A Qualitative Examination of the Listening Effort Experience of Adults With Hearing Loss

Purpose: Increased listening effort and fatigue are common complaints of individuals with hearing loss. However, the listening effort experience from the patient perspective is not well understood. Current models note the importance of cognitive factors in listening effort. Research, primarily quantitative, has shown equivocal findings regarding auditory signals that may cause increased listening effort, technologies that may ameliorate the listening effort experience, and the effects of listening effort on sensory systems. Limited work has explored the personal aspects of listening effort. As a whole, investigations of listening effort fail to define the experience from the patient's view or offer suggestions for clinical treatment based on those experiences. Method: A qualitative inquiry into listening effort was conducted to elucidate this phenomenon. Nineteen adult users of hearing aids were interviewed. Transcripts of interviews were analyzed for common themes related to both unique characteristics of listening effort and mediators. Results: Across participants, eight main themes and eight subthemes were identified. Main themes identified were signals (in reference to listening effort), characteristics of environments that increased listening effort, having a “toolbox” of strategies used to ameliorate listening effort, the social ramifications of listening effort, the emotional consequences of listening effort, the physical effects of listening effort, the cognitive effects of listening effort, the time course of listening effort, and other facets of listening efforts. Conclusions: Results of this study provide insight into the subjective experience of listening effort. Evidence suggests a need for further research regarding factors intrinsic to the individual as mediators of listening effort. Future qualitative works should look at the impacts of listening effort on these elements more in depth and approaches to improve coping with listening effort.