山东大学学报 (医学版) ›› 2024, Vol. 62 ›› Issue (11): 96-104.doi: 10.6040/j.issn.1671-7554.0.2024.0527
• 公共卫生与预防医学 • 上一篇
王琼1,2,李欣宇1,2,徐磊2,周成超1,江帆1
WANG Qiong1,2, LI Xinyu1,2, XU Lei2, ZHOU Chengchao1, JIANG Fan1
摘要: 目的 评估包含非处方(over-the-counter, OTC)助听器和健康教育在内的社区听力康复方案对老年听力障碍患者沟通能力及与听力相关健康结局的干预效果。 方法 将符合纳入标准的106例老年听力障碍患者随机分为干预组和对照组,每组53例。干预组由社区卫生工作者验配OTC助听器并实施听力康复教育,康复教育包括“观念转变”“助听器的最佳使用”“沟通与应对”“行为自信”四部分内容。对照组在干预3个月后接受与干预组相同的综合干预内容。干预前、干预1个月、干预3个月后通过中文版老年听力障碍筛查量表(Hearing Handicap Inventory for the Elderly-Screening, HHIE-S)测量两组患者的沟通能力,通过社会网络量表简版(Lubben Social Network Scale-6, LSNS-6)评估社会隔离情况,采用简易体能状况量表(Short Physical Performance Battery, SPPB)评估平衡能力,采用蒙特利尔认知评估量表(Montreal Cognitive Assessment, MoCA)长沙版评估认知功能。使用成组t检验或Mann-Whitney U验检分析比较两组患者结局指标干预前后的差异。 结果 干预3个月后,干预组沟通能力得分低于对照组[18(10, 24)vs. 28(20, 34),P<0.001],干预组社会隔离得分高于对照组[18.04±5.60 vs. 14.9±5.91, P=0.011),干预组与对照组平衡能力和认知能力得分差异无统计学意义(P>0.05)。 结论 社区听力康复方案显著改善了老年听力障碍患者的沟通能力和社会隔离情况,值得在社区层面进一步推广。
中图分类号:
[1] Prieur Chaintré A, Couturier Y, Nguyen THT, et al. Influence of hearing loss on social participation in older adults: results from a scoping review[J]. Res Aging, 2024, 46(1): 72-90. [2] Assi S, Twardzik E, Deal JA, et al. Hearing loss and physical activity among older adults in the United States[J]. J Gerontol A Biol Sci Med Sci, 2024, 79(1): glad186. doi:10.1093/gerona/glad186. [3] Lawrence BJ, Jayakody DMP, Bennett RJ, et al. Hearing loss and depression in older adults: a systematic review and meta-analysis[J]. Gerontologist, 2020, 60(3): e137-e154. [4] 傅新星, 陈雪清, 王硕, 等. 社区老年人群听力损失与认知功能下降及焦虑抑郁情绪的相关性分析[J]. 中国听力语言康复科学杂志, 2022, 20(4): 246-251. FU Xinxing, CHEN Xueqing, WANG Shuo, et al. The relationship among hearing loss, cognitive decline, anxiety and depression in community-dwelling older adults[J]. Chinese Scientific Journal of Hearing and Speech Rehabilitation, 2022, 20(4): 246-251. [5] Goman AM, Lin FR. Hearing loss in older adults-from epidemiological insights to national initiatives[J]. Hear Res, 2018, 369: 29-32. doi:10.1016/j.heares.2018.03.031. [6] WHO. Addressing the rising prevalence of hearing loss.(2018-02-06)[2024-05-20]. https://www.who.int/publications/i/item/addressing-the-rising-prevalence-of-hearing-loss. [7] 常东旭, 徐春燕, 孟坤光, 等. 老年性听力损失患者助听器配戴效果研究进展[J]. 中国听力语言康复科学杂志, 2023, 21(6): 626-629. CHANG Dongxu, XU Chunyan, MENG Kunguang, et al. Research progress on the effect of hearing aid wearing in elderly patients with hearing loss[J]. Chinese Scientific Journal of Hearing and Speech Rehabilitation, 2023, 21(6): 626-629. [8] Reed NS, Garcia-Morales EE, Myers C, et al. Prevalence of hearing loss and hearing aid use among US medicare beneficiaries aged 71 years and older[J]. JAMA Netw Open, 2023, 6(7): e2326320. doi:10.1001/jamanetworkopen.2023.26320. [9] Assi L, Reed NS, Nieman CL, et al. Factors associated with hearing aid use among medicare beneficiaries[J]. Innov Aging, 2021, 5(3): igab021. doi:10.1093/geroni/igab021. [10] Sugiura S, Uchida Y, Nishita Y, et al. Prevalence of usage of hearing aids and its association with cognitive impairment in Japanese community-dwelling Elders with hearing loss[J]. Auris Nasus Larynx, 2022, 49(1): 18-25. [11] Zheng HL, Wong LLN, Hickson L. Barriers to hearing aid adoption among older adults in mainland China[J]. Int J Audiol, 2023, 62(9): 814-825. [12] 张慧, 单子丽, 李亚玲, 等. 老年性耳聋患者未选配助听器的影响因素分析[J]. 中华耳科学杂志, 2022, 20(2): 257-260. ZHANG Hui, SHAN Zili, LI Yaling, et al. Factors influencing rejection of hearing aids in patients with presbycusis[J]. Chinese Journal of Otology, 2022, 20(2): 257-260. [13] Jorbonyan A, Momtaz YA, Foroghan M, et al. Factors affecting the adoption and use of hearing aids among older adults: a systematic review[J]. Curr Psychiatry Res Rev, 2021, 17(3): 172-187. [14] 郗昕, 公泽忠, 曾凡钢. 非处方助听器: 机遇与挑战并存[J]. 听力学及言语疾病杂志, 2023, 31(4): 293-299. [15] Nieman CL, Betz J, Garcia Morales EE, et al. Effect of a community health worker-delivered personal sound amplification device on self-perceived communication function in older adults with hearing loss: a randomized clinical trial[J]. JAMA, 2022, 328(23): 2324-2333. [16] 王克芳, 吴臣. 慢性病管理依从问题研究的困境及 “破局” 思路[J]. 山东大学学报(医学版), 2021, 59(9): 124-129. WANG Kefang, WU Chen. Dilemmas and thoughts on solutions of adherence to chronic disease management[J]. Journal of Shandong University(Health Sciences), 2021, 59(9): 124-129. [17] Harris PA, Taylor R, Minor BL, et al. The REDCap consortium: building an international community of software platform partners[J]. J Biomed Inform, 2019, 95: 103208. doi:10.1016/j.jbi.2019.103208. [18] Boutron I, Guittet L, Estellat C, et al. Reporting methods of blinding in randomized trials assessing nonpharmacological treatments[J]. PLoS Med, 2007, 4(2): e61. doi:10.1371/journal.pmed.0040061. [19] 傅新星, 莫玲燕. 《耳及听力初级保健教材》——WHO旨在改进发展中国家听力保健水平的培训手册 [J]. 中国医学文摘(耳鼻咽喉科学), 2010, 25(3): 161. doi: 10.19617/j.issn1001-1307.2010.03.019. [20] 谢鼎华, 卜行宽. 听力保健与耳聋防控技术纲要 [M]. 北京: 中国妇女出版社, 2013: 120. [21] 全国防聋治聋技术指导组, 中华医学会耳鼻咽喉头颈外科学分会, 中华耳鼻咽喉头颈外科杂志编辑委员会, 等. 老年听力损失诊断与干预专家共识(2019)[J]. 中华耳鼻咽喉头颈外科杂志, 2019, 54(3): 166-173. National Committee for the Prevention of Hearing Loss, National Health Commission of the Peoples Republic of China, Society of Otorhinolaryngology Head and Neck Surgery, Chinese Medical Association, Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery, et al. Expert consensus on diagnosis and intervention of hearing loss in the elderly(2019)[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2019, 54(3): 166-173. [22] 中国听力语言康复研究中心, 解放军总医院耳鼻咽喉头颈外科医学部, 国家耳鼻咽喉疾病临床医学研究中心. 助听器验配服务规范[S]. T/CARD 019-2021. 北京: 中国残疾人康复协会, 2021. [23] 余艳萍, 于文永, 杨向茹, 等. 中文版老年听力障碍筛查量表评分与纯音听阈测试的比较研究[J]. 听力学及言语疾病杂志, 2020, 28(3): 253-256. YU Yanping, YU Wenyong, YANG Xiangru, et al. A comparative study of the Chinese version of the hearing handicap inventory for the elderly-screening and pure tone audiometry[J]. Journal of Audiology and Speech Pathology, 2020, 28(3): 253-256. [24] Lubben J, Blozik E, Gillmann G, et al. Performance of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older adult populations[J]. Gerontologist, 2006, 46(4): 503-513. [25] Mijnarends DM, Meijers JMM, Halfens RJG, et al. Validity and reliability of tools to measure muscle mass, strength, and physical performance in community-dwelling older people: a systematic review[J]. J Am Med Dir Assoc, 2013, 14(3): 170-178. [26] 涂秋云, 靳慧, 丁斌蓉, 等. 长沙版蒙特利尔认知评估量表的信度、效度检测与血管性认知障碍理想划界分值[J]. 中国神经精神疾病杂志, 2012, 38(6): 339-345. TU Qiuyun, JIN Hui, DING Binrong, et al. The study on reliability, validity of Montreal Cognitive Assessment(Changsha Version)and preliminary exploration of its optimal cutoff score for detecting vascular cognitive impairment[J]. Chinese Journal of Nervous and Mental Diseases, 2012, 38(6): 339-345. [27] Reed NS, Ferrante LE, Oh ES. Addressing hearing loss to improve communication during the COVID-19 pandemic[J]. J Am Geriatr Soc, 2020, 68(9): 1924-1926. [28] Gao JM, Hu HW, Yao L. The role of social engagement in the association of self-reported hearing loss and health-related quality of life[J]. BMC Geriatr, 2020, 20(1): 182. doi:10.1186/s12877-020-01581-0. [29] Lin FR, Pike JR, Albert MS, et al. Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA(ACHIEVE): a multicentre, randomised controlled trial[J]. Lancet, 2023, 402(10404): 786-797. [30] WHO. World report on hearing.(2021-03-03)[2024-05-20]. https://www.who.int/publications/i/item/9789240020481. [31] 金燕萍, 胡静超, 祝彩莹. 听觉认知训练对老年性聋患者认知功能及生活质量的改善作用[J]. 中国听力语言康复科学杂志, 2023, 21(3): 252-256. JIN Yanping, HU Jingchao, ZHU Caiying. Effects of auditory cognitive training on cognitive function and quality of life in senile deaf patients[J]. Chinese Scientific Journal of Hearing and Speech Rehabilitation, 2023, 21(3): 252-256. [32] 胡敏, 李彩红, 罗甜, 等. 心理护理结合保健操训练对听力下降患者听力及语言交流能力的影响[J]. 检验医学与临床, 2017, 14(16): 2441-2443. HU Min, LI Caihong, LUO Tian, et al. Effect of psychological nursing combined with aerobics training on hearing and language communication ability of patients with hearing loss[J]. Laboratory Medicine and Clinic, 2017, 14(16): 2441-2443. [33] Ng JHY, Loke AY. Determinants of hearing-aid adoption and use among the elderly: a systematic review[J]. Int J Audiol, 2015, 54(5): 291-300. [34] 王昌阳, 慈军, 管骅. 老年性聋患者助听器停用情况及与听觉和社会因素的相关性[J]. 中华全科医学, 2023, 21(1): 37-40. WANG Changyang, CI Jun, GUAN Hua. Relationship between hearing aid discontinuance and auditory and social factors in patients with senile deafness[J]. Chinese Journal of General Practice, 2023, 21(1): 37-40. [35] 刘杰, 周茵, 谢方红, 等. 同伴教育在老年听力损失患者配戴助听器后的应用研究[J]. 中国听力语言康复科学杂志, 2023, 21(1): 86-88. LIU Jie, ZHOU Yin, XIE Fanghong, et al. The application of peer education after wearing hearing aids for the elderly with hearing loss[J]. Chinese Scientific Journal of Hearing and Speech Rehabilitation, 2023, 21(1): 86-88. [36] Zarenoe R, Söderlund LL, Andersson G, et al. Motivational interviewing as an adjunct to hearing rehabilitation for patients with tinnitus: a randomized controlled pilot trial[J]. J Am Acad Audiol, 2016, 27(8): 669-676. |
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