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Elmazoska, I., Persson Waye, K., Mäki-Torkko, E. & Widén, S. (2026). Headphone Listening Levels, Attitudes to Noise, and Auditory Symptoms Among Children and Adolescents. Journal of Speech, Language and Hearing Research, 69(1), 347-361
Open this publication in new window or tab >>Headphone Listening Levels, Attitudes to Noise, and Auditory Symptoms Among Children and Adolescents
2026 (English)In: Journal of Speech, Language and Hearing Research, ISSN 1092-4388, E-ISSN 1558-9102, Vol. 69, no 1, p. 347-361Article in journal (Refereed) Published
Abstract [en]

PURPOSE: Music listening with headphones and at high sound levels is common among young people. Risky music listening may be influenced by behavioral factors, and investigating these could have implications for more effective prevention. The aim is to describe participants' hearing health and music listening habits and explore associations between attitudes to noise and measured sound pressure levels (SPLs) from participants' headphones and between perceived auditory symptoms with hearing and SPL measurements.

METHOD: This is a cross-sectional study including audiometry (0.125-16 kHz), distortion product otoacoustic emissions (DPOAEs), SPL measurements, and a questionnaire. The participants were 10-20 years old. Out of 71 respondents to the questionnaire, 53 also participated in the hearing and SPL measurements. RESULTS: Positive attitudes to noise were significantly associated with higher measured SPLs. Participants ≥ 15 years old had more positive attitudes, higher measured SPLs, and reported longer durations of headphone music listening. Most auditory symptoms were significantly correlated with self-reported music listening habits but not with measured SPLs, audiometry, or DPOAEs. Participants experiencing a greater need for auditory recovery had higher variation in DPOAE amplitude for both ears.

CONCLUSIONS: Attitudes to noise may play a role in shaping risky music listening behaviors. Perceived auditory symptoms may occur before detectable audiometric threshold shifts. Addressing these aspects could promote safer music listening behaviors. 

Place, publisher, year, edition, pages
American Speech-Language-Hearing Association, 2026
National Category
Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-125859 (URN)10.1044/2025_JSLHR-25-00397 (DOI)001688895100021 ()41401778 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and WelfareTysta Skolan FoundationOlle Engkvists stiftelse
Note

Funding:

Stingerfonden

Available from: 2025-12-22 Created: 2025-12-22 Last updated: 2026-02-26Bibliographically approved
Elander, J., Värendh, M., Ehinger, J. K., Stenfeldt, K. & Widén, S. (2026). Parental experience of whole genome sequencing for children with sensorineural hearing loss. International Journal of Qualitative Studies on Health and Well-being, 21(1), Article ID 2641802.
Open this publication in new window or tab >>Parental experience of whole genome sequencing for children with sensorineural hearing loss
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2026 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 21, no 1, article id 2641802Article in journal (Refereed) Published
Abstract [en]

Purpose: The purpose of this in-depth interview study was to explore how parents of children with sensorineural hearing loss (SNHL) experienced genetic testing and whether they experienced risks and benefits.

Background: Most children with SNHL have a genetic etiology, which can be identified through genetic sequencing. A genetic test does not influence treatment, and whether patients and parents perceived genetic tests as valuable is unclear.

Methods: In this study, 10 parents of children with SNHL who underwent genetic testing were interviewed, and the content was analyzed using inductive thematic analysis.

Results: Three global themes were identified. In the first theme, (1) Limited knowledge creates uncertainty, parents described uncertainty related to the information provided, the test result itself and child-related factors. The second theme, (2) Genetic knowledge is considered important for the family and the future, explored the importance of knowledge. Parents wanted an explanation to make the future predictable, and the test had practical implications. In the last category, (3) Knowledge adds complexity and can be challenging, ethical considerations and risks associated with knowledge were highlighted.

Conclusion: The main conclusion was that parents experienced that genetic testing provided valuable personal information and had practical implications. However, a genetic diagnosis can cause concern and may affect family planning.

Place, publisher, year, edition, pages
Taylor & Francis, 2026
Keywords
Sensorineural hearing loss, genetic sequencing, parental experiences, thematic analysis, interview study
National Category
Public Health, Global Health and Social Medicine
Research subject
Disability research
Identifiers
urn:nbn:se:oru:diva-127950 (URN)10.1080/17482631.2026.2641802 (DOI)001714011300001 ()41820818 (PubMedID)
Funder
Hörselskadades Riksförbund, FA22- 0001
Available from: 2026-03-13 Created: 2026-03-13 Last updated: 2026-03-20Bibliographically approved
Karlsson, E., Granberg, S., Mäki-Torkko, E., Widén, S. & Gustafsson, J. (2025). International Classification of Functioning, Disability and Health as a Foundation for Instrument Development: Translation and Field Testing of the Swedish Version of the Hearing and Functioning in Everyday Life Questionnaire. Journal of Speech, Language and Hearing Research, 68(7), 3369-3384
Open this publication in new window or tab >>International Classification of Functioning, Disability and Health as a Foundation for Instrument Development: Translation and Field Testing of the Swedish Version of the Hearing and Functioning in Everyday Life Questionnaire
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2025 (English)In: Journal of Speech, Language and Hearing Research, ISSN 1092-4388, E-ISSN 1558-9102, Vol. 68, no 7, p. 3369-3384Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The aim of the current study was to translate the English original version of the Hearing and Functioning in Everyday Life Questionnaire (HFEQ) to Swedish, evaluate the translation in terms of comprehensibility and relevance from a patient perspective, and culturally adapt the Swedish version (HFEQ-SWE).

METHOD: A six-step methodology including translation into Swedish according to best practice methodology, evaluation, and cultural adaptation of the HFEQ-SWE using qualitative focus group interviews was used in this study. Thirteen adults with hearing loss were recruited from the audiological clinic in Örebro, Sweden. Their mean age was 57 years, and the four-frequency pure-tone average for the best ear ranged from 5 to 115 dB HL.

RESULTS: The results demonstrated that most of the items in the HFEQ-SWE were viewed as relevant by the informants. Not all items were considered relevant for all people, which also reflect the individual variability of everyday functioning. Most items were recognized as comprehensible without any changes needed.

CONCLUSIONS: Overall, the results indicate that the translation is semantically and culturally valid from the patient's perspective. Some revisions were suggested that need to be addressed in the further validation process of the HFEQ, and one item was removed.

Place, publisher, year, edition, pages
American Speech-Language-Hearing Association, 2025
National Category
Other Clinical Medicine
Identifiers
urn:nbn:se:oru:diva-121631 (URN)10.1044/2025_JSLHR-24-00620 (DOI)001541995700021 ()40460383 (PubMedID)
Funder
Hörselskadades Riksförbund
Available from: 2025-06-16 Created: 2025-06-16 Last updated: 2025-08-13Bibliographically approved
Elmazoska, I., Bengtsson, S. & Widén, S. (2025). "It's about wanting to disappear from the world… " - an interpretative phenomenological analysis on the meaning of music and hearing-related risks. International Journal of Qualitative Studies on Health and Well-being, 20(1), Article ID 2480966.
Open this publication in new window or tab >>"It's about wanting to disappear from the world… " - an interpretative phenomenological analysis on the meaning of music and hearing-related risks
2025 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 20, no 1, article id 2480966Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To explore the role and meaning of music in adolescents' lives and the adolescents' ways of understanding how music listening can impact hearing-health.

METHODS: Open-ended interviews and Interpretative Phenomenological Analysis (IPA). The analysis involves both individual and more generalized investigations based on the contributions from seven participants.

FINDINGS: The findings show that music is an integrated and habitual aspect of the adolescents' daily lives, used as a tool for emotion regulation, cognitive enhancement, and creating personal space where one can be free from outside criticisms and distractions. There is a preference for music listening in headphones which creates a more intense and private experience. There are varying levels of awareness of the potential hearing-health risks, but the profound meaning of music for their well-being often overshadows any concerns.

CONCLUSIONS: Despite awareness of potential hearing-health risks, the adolescents prioritize the immediate emotional and cognitive benefits of music. Technological advancements and increased social media interactions contribute to a trend towards more personalized music listening. These insights call for more complex intervention strategies and models for health promotion which account for the positive aspects of music listening, instead of merely focusing on the potential risks of loud music.

Place, publisher, year, edition, pages
Taylor & Francis, 2025
Keywords
Music, adolescent, health promotion, hearing health, meaning, risk awareness, well-being
National Category
Public Health, Global Health and Social Medicine
Identifiers
urn:nbn:se:oru:diva-120107 (URN)10.1080/17482631.2025.2480966 (DOI)001449102600001 ()40103436 (PubMedID)2-s2.0-105000728738 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and WelfareTysta Skolan Foundation
Note

This study is a part of a dissertation project funded by the following funding agencies; Swedish Research Council for Health, Working Life, and Welfare (FORTE) and Tysta Skolan. Forskningsrådet om Hälsa, Arbetsliv och Välfärd Stiftelsen Tysta Skolan.

Available from: 2025-03-21 Created: 2025-03-21 Last updated: 2025-09-08Bibliographically approved
Badache, A., Mäki-Torkko, E., Widén, S. & Fors, S. (2024). A descriptive epidemiological study of the prevalence of self-reported sensory difficulties by age group, sex, education, disability, and migration status in Sweden in 2020. BMC Public Health, 24(1), Article ID 2773.
Open this publication in new window or tab >>A descriptive epidemiological study of the prevalence of self-reported sensory difficulties by age group, sex, education, disability, and migration status in Sweden in 2020
2024 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 24, no 1, article id 2773Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The objective of this study is to estimate the prevalence of self-reported hearing difficulties, vision difficulties and combined vision and hearing difficulties in a Swedish adult population that varies according to migration status, sex, age, disability measured by ADL and IADL and educational attainment level.

METHODS: The study utilised data from the Survey of Health, Ageing and Retirement in Europe, which consisted of 2257 individuals aged 60 and above that were interviewed in Sweden in the 2019/2020, SHARE wave 8. To determine the prevalence of sensory difficulties (hearing, vision and dual-sensory difficulties) among various subgroups of the population, a multinomial logistic regression was used. The results of these analyses are presented in terms of predicted probabilities.

RESULTS: The study findings indicate that foreign-born older adults experience a lower prevalence of visual difficulties (6.2% [3.3-11.5] in comparison to their Swedish-born counterparts. Moreover, older adults with higher levels of education tend to report a lower prevalence of sensory difficulties overall. Furthermore, sex differences are apparent, with males reporting a higher prevalence of hearing difficulties (18.9% [15.5-22.8] vs. 12.8% [10.7-15.3]) and females reporting a higher prevalence of vision difficulties (12.7% [10.7-15.1] vs. 8.5%[6.8-10.5]).

CONCLUSION: The findings highlight disparities in the prevalence and type of perceived sensory difficulties experienced by older adults, by factors such as age, sex, education and migration status. It is important to consider these demographic factors in healthcare planning and interventions aimed at mitigating sensory difficulties in the older population.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024
Keywords
Cross-sectional, Hearing difficulties, Older adults, Prevalence, Sweden
National Category
Public Health, Global Health and Social Medicine
Identifiers
urn:nbn:se:oru:diva-116686 (URN)10.1186/s12889-024-20217-1 (DOI)001336869700001 ()39390404 (PubMedID)2-s2.0-85206021969 (Scopus ID)
Funder
EU, Horizon 2020
Note

The project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No 754285. The financial sponsor played no role in the design, execution, analysis and interpretation of data or the writing of the manuscript.

Correction: A descriptive epidemiological study of the prevalence of self-reported sensory difficulties by age group, sex, education, disability, and migration status in Sweden in 2020. Badache, AC., Mäki-Torkko, E., Widen, S. et al. BMC Public Health 25, 70 (2025). https://doi.org/10.1186/s12889-024-21186-1

Available from: 2024-10-14 Created: 2024-10-14 Last updated: 2025-02-25Bibliographically approved
Elmazoska, I., Mäki-Torkko, E., Granberg, S. & Widén, S. (2024). Associations Between Recreational Noise Exposure and Hearing Function in Adolescents and Young Adults: A Systematic Review. Journal of Speech, Language and Hearing Research, 67(2), 688-710
Open this publication in new window or tab >>Associations Between Recreational Noise Exposure and Hearing Function in Adolescents and Young Adults: A Systematic Review
2024 (English)In: Journal of Speech, Language and Hearing Research, ISSN 1092-4388, E-ISSN 1558-9102, Vol. 67, no 2, p. 688-710Article, review/survey (Refereed) Published
Abstract [en]

PURPOSE: There is an increasing concern regarding hazardous recreational noise exposure among adolescents and young adults. Daily exposure to loud sound levels over a long period of time can increase the risk of noise-induced hearing loss. The full extent of the impact of recreational noise on hearing is not yet fully understood. The purpose of this review was to synthesize research that investigated hearing function in relation to recreational noise exposure in adolescents and young adults.

METHOD: A systematic literature search of five databases covering the years 2000-2023 was performed. The articles included investigated audiological measurements of hearing function in relation to recreational noise exposure.

RESULTS: Four hundred sixty records were identified, of which 20 met the inclusion criteria and were included in the results. This review showed that although some recreational noise activities can be potentially harmful, there is an unclear relationship between exposure and outcome. Some findings indicated hearing threshold shifts or reduced otoacoustic emission amplitudes after recreational noise exposure, but most changes were short term and in the extended high-frequency range.

CONCLUSIONS: There seemed to be inconsistencies regarding the utilization of methods of measuring exposure and outcome between studies. This might be one reason for the differing results in studies on the reported impact on hearing function from recreational noise exposure. To draw more certain conclusions about long-term effects, there is a need for longitudinal research that utilizes sound level measurements to assess low and high degrees of recreational noise exposure in relation to hearing function.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25114193.

Place, publisher, year, edition, pages
American Speech-Language-Hearing Association, 2024
National Category
Otorhinolaryngology
Identifiers
urn:nbn:se:oru:diva-111467 (URN)10.1044/2023_JSLHR-23-00397 (DOI)001208295700016 ()38324255 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2024-02-08 Created: 2024-02-08 Last updated: 2025-09-03Bibliographically approved
Karlsson, E., Manchaiah, V., Mäki-Torkko, E., Granberg, S., Gustafsson, J., Dahlström, Ö. & Widén, S. (2024). Hearing and Functioning in Everyday Life Questionnaire: Psychometric Evaluation and Revision. American Journal of Audiology, 33(2), 330-342
Open this publication in new window or tab >>Hearing and Functioning in Everyday Life Questionnaire: Psychometric Evaluation and Revision
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2024 (English)In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 33, no 2, p. 330-342Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The aim of the current study was to explore the construct validity and internal consistency reliability of the International Classification of Functioning, Disability and Health (ICF)-based original English version of the Hearing and Functioning in Everyday Life Questionnaire (HFEQ) and to revise the HFEQ based on the results.

METHOD: This study used a cross-sectional survey design. The data were collected using an online survey. Adults with self-reported hearing disability (n = 513) from the United States were included. The ICF components of body functions, activity and participation, and environmental factors were tested as the underlying structure of the HFEQ using confirmatory factor analysis and then adjusted by triangulation with previous content validation.

RESULTS: The results of the current study confirmed the ICF components of body functions, activity and participation, and environmental factors as underlying constructs of the HFEQ. However, after triangulation with previous content validation, fine adjustments were made. The revised version of the HFEQ includes two removed items and a fine-tuned factor structure.

CONCLUSION: The results confirm that the structure of the HFEQ aligns with the ICF, and the overall results indicate that HFEQ has acceptable construct validity and internal consistency.

Place, publisher, year, edition, pages
American Speech-Language-Hearing Association, 2024
National Category
Occupational Therapy
Identifiers
urn:nbn:se:oru:diva-112424 (URN)10.1044/2024_AJA-23-00171 (DOI)001288118700003 ()38497711 (PubMedID)2-s2.0-85195226923 (Scopus ID)
Available from: 2024-03-20 Created: 2024-03-20 Last updated: 2024-08-29Bibliographically approved
Granberg, S., Widén, S. & Gustafsson, J. (2024). How to remain in working life with hearing loss: health factors for a sustainable work situation. Work: A journal of Prevention, Assessment and rehabilitation, 79(3), 1391-1406
Open this publication in new window or tab >>How to remain in working life with hearing loss: health factors for a sustainable work situation
2024 (English)In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 79, no 3, p. 1391-1406Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Persons with hearing loss (HL) are a vulnerable group in working life. Studies have shown that they are more likely than the general population to be in part-time work, to be unemployed, receive disability pension, and to be on sick leave. Many workers with HL also experience unhealthy work conditions, such as jobs where they experience high demands combined with low control as well as safety concerns and social isolation. There is a lack of studies that focus on factors that promote a healthy, sustainable work situation for the target group.

OBJECTIVE: To investigate health factors that contribute to a sustainable work situation for employees with HL.

METHODS: The current study was a comparative, observational study with a cross-sectional design including a clinical population of adults with HL. Comparisons were made between workers with HL "in work" and workers with HL on "HL-related sick leave".

RESULTS: Seven health factors were identified. Those "in work" experienced a healthier work environment as well as lower levels of mental strain, hearing-related work characteristics and content, cognitively demanding work content, hearing-related symptoms, energy-demanding activities, and bodily aches and pain than those on "HL-related sick leave".

CONCLUSION: The results demonstrate a clear pattern regarding health factors for a sustainable working life. The type of job was not related to whether an individual was on sick leave or working. Rather, the work climate and the content of the work mattered.

Place, publisher, year, edition, pages
IOS Press, 2024
Keywords
Hearing loss, health, occupational health, salutogenesis, working conditions, workplace
National Category
Occupational Health and Environmental Health Public Health, Global Health and Social Medicine
Identifiers
urn:nbn:se:oru:diva-114253 (URN)10.3233/WOR-230377 (DOI)001368360900031 ()38875067 (PubMedID)2-s2.0-85208772265 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2024-06-17 Created: 2024-06-17 Last updated: 2025-02-20Bibliographically approved
Badache, A., Rehnberg, J., Mäki-Torkko, E., Widén, S. & Fors, S. (2024). Longitudinal associations between sensory and cognitive functioning in adults 60 years or older in Sweden and Denmark. Archives of gerontology and geriatrics (Print), 121, Article ID 105362.
Open this publication in new window or tab >>Longitudinal associations between sensory and cognitive functioning in adults 60 years or older in Sweden and Denmark
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2024 (English)In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 121, article id 105362Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The objective of this study is to explore the bidirectional, longitudinal associations between self-reported sensory functions (hearing/vision) and cognitive functioning among older adults in Sweden and Denmark during the period 2004-2017.

METHODS: The study is based on data from The Survey of Health, Ageing and Retirement in Europe and consists of 3164 persons aged 60 to 93 years. Within-person associations between sensory and cognitive functions were estimated using random intercept cross-lagged panel models.

RESULTS: The results indicated that cognitive and sensory functions were associated within their respective domains over time. The results on the bidirectional associations between sensory functions and cognition over time showed weak and statistically non-significant estimates.

CONCLUSION: Our study showed no clear evidence for cross-lagged effects between sensory functions and cognitive functioning. Important to note, however, is that using longitudinal data to estimate change within persons is a demanding statistical test and various factors may have contributed to the absence of conclusive evidence in our study. We discuss several of these factors.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Cognition, Hearing, Older adults, Scandinavia, Sensory functions, Vision
National Category
Gerontology, specialising in Medical and Health Sciences Public Health, Global Health and Social Medicine
Identifiers
urn:nbn:se:oru:diva-111831 (URN)10.1016/j.archger.2024.105362 (DOI)001197399500001 ()38382171 (PubMedID)2-s2.0-85185553793 (Scopus ID)
Funder
EU, Horizon 2020, 754285
Available from: 2024-02-22 Created: 2024-02-22 Last updated: 2025-03-12Bibliographically approved
Karlsson, E., Mäki-Torkko, E., Granberg, S., Widén, S., Manchaiah, V., Swarnalatha Nagaraj, V., . . . Gustafsson, J. (2023). Hearing and Functioning in Everyday Life Questionnaire: Development and Validation of an ICF-Based Instrument. Ear and Hearing, 44(6), 1498-1506
Open this publication in new window or tab >>Hearing and Functioning in Everyday Life Questionnaire: Development and Validation of an ICF-Based Instrument
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2023 (English)In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 44, no 6, p. 1498-1506Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Self-assessment instruments are commonly used in audiological rehabilitation. However, several studies highlight the lack of multidimensionality in existing outcome measures, with the consequence that they only partially capture aspects of functioning in everyday life for people living with hearing loss. This study aimed to develop and investigate the content validity of a self-assessment instrument based on the validated Brief International Classification of Functioning, Disability, and Health Core Set for Hearing Loss.

DESIGN: The design was a two-part instrument development study. The first part focused on the item-generation process of the instrument, named the Hearing and Functioning in Everyday Life Questionnaire (HFEQ) during an experts' workshop. The second part focused on international content validation of the instrument using group interviews. Strategic sampling was used and 30 adults with hearing loss from India, South Africa, and the United States participated in the group interviews.

RESULTS: The expert's workshop resulted in the first version of the HFEQ containing 30 items. The results from group interviews show that the content of the HFEQ was considered to be valid concerning its relevance, comprehensiveness, and comprehensibility. A majority (73%) of the HFEQ items were perceived by the participants as relevant and easy to comprehend. For the remaining 27% of the items, the content was perceived to be relevant in all countries, but some terms and expressions were reported to require rewording or clearer examples. These modifications will be made in the next step of the development process.

CONCLUSION: Content validation of the HFEQ demonstrates promising results, with participants perceiving the content as relevant and comprehensible. Further psychometric validation is required to investigate other psychometric properties, such as construct validity and reliability. The HFEQ has the potential to become a valuable new instrument for assessing everyday functioning in people with hearing loss in audiological rehabilitation and in research.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2023
Keywords
Audiological rehabilitation, Content validity, Cross-cultural validation, Cross-national, Hearing loss, International Classification of Functioning Disability and Health, Outcome measures, Survey instruments, Validation
National Category
Occupational Therapy
Identifiers
urn:nbn:se:oru:diva-106579 (URN)10.1097/AUD.0000000000001391 (DOI)001086366300018 ()37340534 (PubMedID)2-s2.0-85174642335 (Scopus ID)
Available from: 2023-06-27 Created: 2023-06-27 Last updated: 2024-01-15Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-9184-6989

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