## 6 Conclusions  
This study demonstrates the feasibility and benefits of using a smartphone app for the self-adjustment of hearing aids and cochlear implants in daily life. All participants were able to use the app effectively and integrate it into their routine. A total of 13 out of the 15 participants used the app during the entire study period. The increased creation of new programs at the beginning of this study and their sustained use over time highlight the value of personalized self-adjustments for improving the auditory experience in real-world settings. The positive ratings of the self-created programs and personal feedback from the participants during the second study session further underscore the app's utility. The participants reported that the app frequently supported them in challenging acoustic scenarios, contributing to their overall satisfaction. Notably, 13 out of 15 participants indicated that they would continue to use the app beyond this study, suggesting that the app has significant potential to enhance patient satisfaction in everyday life. However, two participants did not use the app throughout the entire study and withdrew early. These participants were included in this study shortly after their first activation of the cochlear implant. Additionally, they reported using only the AutoSense OS(tm) program and did not engage with manually switchable programs in general. These findings suggest that factors such as the duration of CI use and the overall acceptance of manually adjustable programs may influence the adoption of the app. Unlike the findings from [PERSON]'s [9] laboratory-based study, the prevailing acoustic environment did not significantly influence frequency settings during self-adjustments in real-life scenarios. Instead, the choice of user interface (EQ UI or 2D-Surface UI) was significantly impacted by the acoustic environment, with participants preferring the intuitive 2D-Surface UI in noisier conditions and the EQ UI in quieter settings, probably due to time constraints in challenging situations. Moreover, this study revealed that approximately 80% of all self-adjustments exhibited different parameter sets between the left and right sides. Bimodal users demonstrated a higher tendency for side-dependent adjustments, with nearly 86% of their programs showing differences between sides, compared to just under 69% for bilateral users. This finding suggests a more pronounced need for individualized adjustments among bimodal users. Overall, the app's ability to enable users to make self-adjustments in their daily lives is a promising development, offering significant benefits for user satisfaction and strong potential for broader adoption. Nevertheless, participant feedback during the study appointments pointed out areas for enhancement, including the demand for more intuitive guidance during the adjustment process and clearer communication of the effects of parameter changes, especially for the 2D-Surface UI. To address these issues, future versions of the app should prioritize improved user support, such as incorporating contextual guidance or interactive tutorials directly within the interface. Design updates should also emphasize accessibility, ensuring the app remains user-friendly for individuals with varying levels of technological expertise. Further studies are necessary to evaluate the app's effectiveness across more diverse user groups, particularly unilateral CI users and those with limited smartphone proficiency. A promising avenue for future development of the app could be the integration of features beyond self-adjustment. For instance, therapeutic modules could be included to provide users with targeted auditory training or rehabilitation exercises. Moreover, the app could play a role in monitoring users' medical health by collecting data on user behavior or acoustic challenges in various environments. Such insights could help identify potential deficits at an early stage, enabling timely intervention.