Preminger Jill E, Meeks Suzanne
Program in Audiology, University of Louisville, KY 40292, USA.
J Am Acad Audiol. 2010 May;21(5):315-28. doi: 10.3766/jaaa.21.5.4.
Since the psychosocial effects of hearing loss are different in the spouse (SP) than in the person with hearing loss (PHL), it seems reasonable that rehabilitation programs designed for PHLs may need to be adapted to benefit SPs.
To evaluate the effectiveness of training in communication strategies and psychosocial exercises for SPs of PHLs by determining whether SPs who completed the group class had improved mood, reduced stress, improved marital communication, and greater awareness of their partners' hearing loss-related quality of life (HL-QOL) in comparison with SPs who did not participate in a group class. Additionally, to determine whether PHLs of SPs who participated in a group audiological rehabilitation (AR) class had significantly improved mood, reduced stress, improved marital communication, and better HL-QOL scores in comparison with PHLs whose SPs did not participate in a group class.
A randomized controlled study.
A total of 72 individuals participated in the study, 36 PHLs and 36 SPs. The PHLs were hearing aid users or cochlear implant users; the SPs had normal or near normal hearing.
PHLs in the control group participated in a traditional group AR program while their SPs received no treatment. PHLs in the experimental group also participated in a traditional group AR program while their SPs participated in a treatment program designed for SPs of PHLs. Classes consisted of 90 min sessions meeting once a week for four weeks.
All participants completed questionnaires measuring HL-QOL (the SPs filled out third-party reports of HL-QOL), stress, mood (positive affect and negative affect), and communication in the marriage. Scales were completed three times: prior to the AR program, within two weeks after completing the AR program, and 6 mo later. SP awareness of their PHL's HL-QOL was measured by comparing preclass and 6 mo scores with reported critical difference values. Preclass, postclass and 6 mo data were examined with repeated measures ANOVAs.
All SPs reported significant improvements in third-party HL-QOL between the preclass and postclass visit. At the 6 mo visit, these reports remained consistent in the control SPs but declined in the experimental SPs. Awareness of HL-QOL in PHLs was improved in SPs who participated in AR classes and remained consistent in SPs who did not. All SPs demonstrated a trend (moderate effect sizes) for decreased stress and decreased negative affect after they and/or their partners completed the AR program. All PHLs demonstrated significant improvements in HL-QOL, significant reductions in stress, significant decreases in negative affect, and significant improvements in marital communication. There were no differences in outcome across the experimental and control PHLs.
When PHLs participate in an AR program, they receive significant improvements in QOL (quality of life). Congruence (as defined by similar scores) between SP and PHL assessments of HL-QOL improved in the experimental group, suggesting that the principal impact of the AR program on SPs was improved understanding of PHL experiences with hearing loss.
由于听力损失对配偶(SP)的心理社会影响与对听力损失者(PHL)的影响不同,因此为PHL设计的康复计划可能需要进行调整以惠及SP,这似乎是合理的。
通过确定完成小组课程的SP与未参加小组课程的SP相比,是否有改善的情绪、减轻的压力、改善的婚姻沟通以及对其伴侣听力损失相关生活质量(HL-QOL)的更高认识,来评估针对PHL的SP进行沟通策略和心理社会练习培训的效果。此外,确定参加小组听力康复(AR)课程的SP的PHL与未参加小组课程的SP的PHL相比,是否有显著改善的情绪、减轻的压力、改善的婚姻沟通以及更好的HL-QOL分数。
一项随机对照研究。
共有72人参与研究,36名PHL和36名SP。PHL为助听器使用者或人工耳蜗使用者;SP听力正常或接近正常。
对照组的PHL参加传统的小组AR计划,而他们的SP不接受治疗。实验组的PHL也参加传统的小组AR计划,而他们的SP参加为PHL的SP设计的治疗计划。课程包括每周一次、每次90分钟的课程,共四周。
所有参与者完成了测量HL-QOL(SP填写HL-QOL的第三方报告)、压力、情绪(积极情绪和消极情绪)以及婚姻沟通的问卷。量表在AR计划之前、完成AR计划后的两周内以及6个月后完成三次。通过将课前和6个月后的分数与报告的临界差值进行比较,来测量SP对其PHL的HL-QOL的认识。课前、课后和6个月的数据用重复测量方差分析进行检验。
所有SP报告称,课前和课后访视之间第三方HL-QOL有显著改善。在6个月的访视中,这些报告在对照组SP中保持一致,但在实验组SP中有所下降。参加AR课程的SP对PHL的HL-QOL的认识有所提高,而未参加的SP则保持一致。所有SP在他们和/或其伴侣完成AR计划后,都表现出压力降低和消极情绪减少的趋势(中等效应量)。所有PHL在HL-QOL方面都有显著改善,压力显著降低,消极情绪显著减少,婚姻沟通也有显著改善。实验组和对照组的PHL在结果上没有差异。
当PHL参加AR计划时,他们的生活质量(QOL)有显著改善。实验组中SP和PHL对HL-QOL评估的一致性(以相似分数定义)有所提高,这表明AR计划对SP的主要影响是对PHL听力损失经历的更好理解。