Gitte Engelund
Principal Scientist , Denmark
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How can empowerment transform hearing health and improve lives?
The challenge
Unlocking hearing health empowerment for better outcomes
Hearing loss is more than a physical condition – it affects communication, social participation, and emotional well-being, impacting millions of people worldwide.
While advancements in hearing technology have improved auditory function, many individuals struggle to engage in their own hearing care, make informed decisions, and navigate daily life with hearing loss.
Despite growing recognition of person-centered care, hearing rehabilitation often focus mainly on technology and lacks a structured approach to empower individuals in managing their hearing challenges.
Traditional hearing care often focuses on technology rather than empowering individuals to take an active role in managing their hearing health.
This gap highlights the need for a structured approach to measuring and fostering empowerment in hearing rehabilitation.
Our approach
Developing the EmpAQ
To address these challenges, we collaborated with The National Acoustic Laboratories, Curtin University, and Örebro University to develop the EmpAQ (Empowerment Assessment Questionnaire) – a validated self-report measure designed to assess and enhance empowerment in hearing care.
The EmpAQ is designed to bridge the gap between hearing technology, person-centred rehabilitation, and better everyday outcomes. The short EmpAQ-5 version is particularly suited for clinical use, helping hearing care professionals identify where clients may need more support in knowledge, skills and strategies, self-efficacy, participation, or control.
It is available in two versions:
- A comprehensive 15-item tool for detailed evaluations, ideal for research purposes and more comprehensive clinical assessments.
- A concise 5-item version for clinical use, ideal for pre- and post-intervention assessments, focusing on key aspects of empowerment without referencing specific hearing services or devices.
The OFS links:
Download here English EmpAQ-5 & 15
Download here Swedish EmpAQ-5 & 15
Our insights
The five dimensions of hearing empowerment
Our qualitative research identified five core dimensions of empowerment, which form the foundation of the EmpAQ:
- Knowledge – Understanding hearing challenges, available solutions, and rehabilitation options to make informed decisions.
- Skills & Strategies – Using effective communication techniques, managing hearing instruments, and adapting to listening environments.
- Self-Efficacy – Confidence in managing hearing-related difficulties and using hearing solutions.
- Participation – Actively engaging in hearing care, making decisions, and maintaining social connections.
- Control – Feeling empowered to manage hearing challenges and make informed choices in daily life.
These dimensions provide a structured approach to empowerment, guiding both clinical interventions and personal hearing management strategies.
By integrating these dimensions into everyday hearing care, the EmpAQ bridges the gap between hearing loss and a better quality of life, enabling individuals to thrive with confidence and control.
Questionaire validation
Validating the EmpAQ
Through a rigorous process, the EmpAQ has become a scientifically robust tool for use in both clinical and research settings.
We followed a multi-stage research process to ensure the EmpAQ effectively measures hearing empowerment:
- Concept Development – Through interviews and focus groups with individuals with hearing loss, clinicians, and researchers, we identified core themes of empowerment.
- Questionnaire Design & Refinement – We developed an initial set of items, refined through expert reviews and cognitive interviews to ensure clarity and relevance.
- Psychometric Validation – The EmpAQ underwent large-scale testing to establish:
- Reliability – Ensuring consistency in responses over time.
- Construct Validity – Comparing EmpAQ scores with established hearing outcome measures.
- Responsiveness – Tracking changes after clinical interventions to assess empowerment improvements.
Listen actively to clients and establish rapport to understand their needs and concerns
From validation to implementation in everyday hearing care
From validation to implementation in everyday hearing care
Recent research has moved EmpAQ beyond questionnaire development and into real-world clinical practice. A multi-site implementation study tested EmpAQ-5 across 10 audiology centres using a structured six-phase rollout, including co-designed resources, training, workflow adaptation, implementation support, and feedback loops.
The study found that EmpAQ-5 was feasible, appropriate, and acceptable in routine audiology settings, with significant improvements in perceived feasibility and appropriateness after implementation.
This shifts the role of EmpAQ-5 from a measurement tool alone to a practical conversation guide that helps clinicians explore empowerment, goal-setting, wellbeing, and psychosocial adjustment during client reviews.
Correlation study
What recent studies show
A recent clinical study of 693 adults with hearing loss found that hearing-specific empowerment is associated with hearing aid use, hearing aid benefit, social satisfaction, emotional functioning, and cognition.
People who wore hearing aids were consistently more empowered than those who did not, while greater residual hearing difficulty and listening-related fatigue were linked with lower empowerment.
Importantly, empowerment was not simply explained by hearing thresholds, age, or demographics.
This suggests that EmpAQ can help clinicians look beyond audiograms and technology outcomes to better understand how people manage hearing challenges in daily life.
Real-world impact
Empowering clients, clinicians, and researchers
The EmpAQ provides a structured framework for fostering empowerment in hearing care, benefiting:
- Clients – Builds confidence, encourages self-management, and empowers individuals to take control of their hearing health.
- Clinicians – Enhances personalized care, supports shared decision-making, and improves hearing health outcomes.
- Researchers – Serves as a validated tool for studying empowerment and its impact on long-term hearing outcomes.
- In practice – EmpAQ-5 helps make empowerment visible. Clinicians reported that it supported richer conversations, better goal-setting, and clearer reflection on what they already do to support clients.
By bridging the gap between care, research, and empowerment, the EmpAQ advances person-centered hearing health, ensuring individuals not only receive care but actively participate in their own hearing journey.
Related Publications
Read our empowerment papers for deeper insights
Reseachers
Researchers involved
Research area Facilitating solution adoption
Partners Universities