Purpose: Hearing loss results in various challenges, which can be mitigated by the use of hearing aids. Despite the benefits, hearing aids are often not worn consistently. Improved use of hearing aids can be supported by understanding the challenges and motivations users experience. This study explored hearing aid recipients’ reasons for hearing aid use and non-use.

Method: A cross-sectional survey design was employed, with qualitative content analysis applied to responses from an open-ended question in an online survey distributed to American hearing aid users from the Hearing Tracker and Lexie Hearing databases.

Results: The study included 680 hearing aid recipients aged 18 to 93 years. The findings were structured around two domains namely, reasons for hearing aid use and hearing aid non-use. Within these two domains, three categories were identified: (a) personal factors, (b) situational aspects, and (c) hearing device-related factors. The 3 categories consisted of 11 sub-categories within the use domain, and 24 sub-categories within the non-use domain. Personal motivations for use included a reliance on hearing aids for essential daily functioning and communication, while non-use was often driven by self-consciousness and discomfort. Device-related aspects highlighted the positive impact of streaming and connectivity features, whereas non-use was frequently attributed to the users perceived need for fine-tuning. Situational factors were also important, with users valuing their hearing aids for environmental awareness and safety, while concerns about fear of damage (e.g., moisture damage) led to decreased hearing aid use.

Conclusions: Addressing personal apprehensions, improving device comfort and functionality, and acknowledging situational preferences are essential for supporting adherence and satisfaction among hearing aid users.