Responses to listening difficulty in in-person conversation: a survey-based synthesis of communication strategies used by people with hearing loss, communication partners, and hearing-care professionals.

To explore communication strategies employed or recommended in everyday listening situations by people with hearing loss (PHL), communication partners (CPs), and healthcare professionals (HCPs), and to evaluate which strategies the groups thought were most helpful for PHL. An online survey with open-ended questions was completed by 95 PHL, 49 CPs, and 86 HCPs. Qualitative analyses of responses were conducted. Responses from PHL and CPs were inductively coded. Codes were combined into categories and subcategories. Next, the responses of HCPs were analysed deductively using the categories and subcategories identified in the PHL and CP data. These analyses were then used to develop themes and a framework for understanding how PHL and CPs manage hearing difficulties. The four themes are: "Signal," "Repair," "Relations," and "Preparation and Recuperation." Some strategies were identified as being used but not helpful, and vice versa. There was sometimes a disconnect between strategies PHL find helpful and the extent to which they request others use them. This framework for understanding the perspectives of three key stakeholder groups on the use of communication strategies will be used to develop evidence-based rehabilitation/counselling programs for PHL.