Technology anxiety and social appearance anxiety as predictors of hearing aid outcomes

Berna Deniz Kuntman

University of Health Sciences, Gulhane Faculty of Health Sciences, Department of Audiology, Ankara, Türkiye

Introduction (background & aim): hearing aid outcomes are influenced by audiological, technological, and psychosocial factors. Technology anxiety may reduce users’ confidence in managing hearing aids, whereas social appearance anxiety may discourage hearing aid use because of concerns about social evaluation and stigma. However, their contribution to patient-reported hearing aid outcomes remains unclear. This study aimed to investigate whether technology anxiety and social appearance anxiety are associated with hearing aid outcomes in adult hearing aid users.

Material & methods: this quantitative, cross-sectional, correlational study was approved by the lokman hekim university scientific research ethics committee (project no. 2026060; decision no. 2026/078; february 25, 2026) and conducted in accordance with the declaration of helsinki. Adult hearing aid users attending the department of otolaryngology were recruited using consecutive sampling. Inclusion criteria were age ≥18 years, hearing aid use for ≥6 months and ≥1 hour/day, mild-to-severe hearing loss, voluntary participation, and absence of cognitive impairment. Participants underwent otolaryngological examination and audiological assessment and completed a demographic information form, abbreviated technology anxiety scale (ATAS), social appearance anxiety scale (SAAS), and international outcome inventory for hearing aids (IOI-HA). The primary outcome was the IOI-HA total score. ATAS and SAAS were examined as independent variables. Spearman correlation and multiple linear regression analyses were performed, with p<0.05 considered statistically significant.

Results: a total of 82 hearing aid users were included. Mean scores were 26.48±9.94 for ATAS, 32.38±13.60 for SAAS, and 27.30±5.78 for IOI-HA. SAAS was moderately and negatively correlated with IOI-HA scores (ρ=−0.550; p<0.001), whereas ATAS was not significantly correlated with IOI-HA scores (ρ=−0.145; p=0.211). In univariate regression analysis, SAAS significantly predicted IOI-HA scores (β=−0.572; p<0.001; r²=0.327). In the multiple regression model including SAAS and ATAS, the model explained 34.4% of the variance in IOI-HA scores (r²=0.344). SAAS remained a significant negative predictor (β=−0.572; p<0.001), whereas ATAS was not a significant predictor (β=−0.076; p=0.169). Older age was positively correlated with technology anxiety (ρ=0.333; p=0.003).

Conclusions: social appearance anxiety, but not technology anxiety, was independently associated with poorer patient-reported hearing aid outcomes. These findings highlight the importance of addressing social appearance concerns in hearing aid rehabilitation and counseling.