社区听力康复对老年听力障碍患者沟通能力的干预效果评估:一项随机对照试验  

Effectiveness evaluation of a community-based rehabilitation intervention on communication function of older adults with hearing impairment: a randomized controlled trial

作　　者：王琼 李欣宇 徐磊 周成超[1] 江帆 WANG Qiong;LI Xinyu;XU Lei;ZHOU Chengchao;JIANG Fan(Department of Public Health,Shandong University,Jinan 250012,Shandong,China;Department of Otolaryngology-Head and Neck Surgery,Shandong Provincial ENT Hospital,Jinan 250022,Shandong,China)

机构地区：[1]山东大学公共卫生学院,山东济南250012 [2]山东省耳鼻喉医院耳鼻咽喉头颈外科,山东济南250022

出　　处：《山东大学学报（医学版）》2024年第11期96-104,共9页Journal of Shandong University:Health Sciences

基　　金：国家自然科学基金(72204143)。

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。Objective To elucidate the effect of the community-based rehabilitation intervention program comprised of over-the-counter(OTC)hearing aids and health education on communication function and other hearing-related health outcomes among older adults with hearing impairment.Methods A total of 106 older adults with hearing impairment who met the inclusion criteria were randomly divided into the intervention group(n=53)and the control group(n=53).OTC hearing aids fitting and hearing rehabilitation education were implemented by community health workers.Rehabilitation education included concept change,optimal use of hearing aids,communication and coping,and behavioral confidence.The control group accepted the same comprehensive intervention components as the intervention group after 3 months of intervention.Before the intervention,1 month after the intervention,and 3 months after the intervention,communication function,social isolation,balance function and cognitive function were measured by the Chinese version of the Hearing Handicap Inventory for the Elderly-Screening(HHIE-S),the Lubben Social Network Scale-6(LSNS-6),Short Physical Performance Battery(SPPB)scale,and the Changsha version of Montreal Cognitive Assessment(MoCA)scale,respectively.Differences of outcome indicators between two groups before and after the intervention were analyzed using t test or Mann-Whitney U test.Results After 3 months of intervention,HHIE-S score in the intervention group was lower than that in the control group[18(10,24)vs.28(20,34),P<0.001].Social isolation score in the intervention group was higher than that in the control group(18.04±5.60 vs.14.90±5.91,P=0.011).In terms of balance function and cognitive function,statistical differences were not significant between the two groups(P>0.05).Conclusion The community-based rehabilitation intervention program significantly improves communication function and social isolation of older adults with hearing impairment and deserves further replication in the community.

关 键 词：听力障碍 老年人 非处方助听器 健康教育 社区康复 临床随机对照试验 

分 类 号：R195[医药卫生—卫生统计学]