Communication Disability Centre, University of Queensland, Brisbane, Australia.
J Speech Lang Hear Res. 2011 Oct;54(5):1385-99. doi: 10.1044/1092-4388(2011/10-0116). Epub 2011 Mar 8.
This study investigated the predictors of rehabilitation intervention decisions in middle-age and older adults with acquired hearing impairment seeking help for the first time.
Using shared decision making, 139 participants were offered intervention options: hearing aids, communication programs (group or individual), and no intervention. Multivariate analysis (logistic regression) provided odds ratios and 95% confidence intervals for intervention decision predictors when all other variables were held constant.
Seven intervention decision predictors were identified: (a) application for subsidized hearing services (participants more likely to choose hearing aids and less likely to choose communication programs), (b) hearing impairment (hearing aids more likely and no intervention less likely), (c) communication self-efficacy (hearing aids less likely), (d) powerful others as locus of control (hearing aids less likely), (e) hearing disability perceived by others and self (hearing aids more likely), (f) perceived communication program effectiveness (communication programs more likely), and (g) perceived suitability of individual communication program (hearing aids less likely and communication programs more likely).
Findings suggest the need for clinicians to explicitly elicit the predictors identified by this study when involving adults with acquired hearing impairment in intervention decisions.
本研究旨在探讨首次寻求帮助的中年及老年后天性听力障碍患者康复干预决策的预测因素。
采用共同决策方法,为 139 名参与者提供了干预选择:助听器、沟通计划(小组或个人)和不干预。在所有其他变量保持不变的情况下,多变量分析(逻辑回归)提供了干预决策预测因素的优势比和 95%置信区间。
确定了七个干预决策预测因素:(a)申请补贴性听力服务(参与者更有可能选择助听器,不太可能选择沟通计划);(b)听力障碍(助听器更有可能,无干预可能性更小);(c)沟通自我效能感(助听器可能性较小);(d)他人为控制源(助听器可能性较小);(e)他人和自身感知的听力残疾(助听器更有可能);(f)感知沟通计划的效果(沟通计划更有可能);(g)感知个体沟通计划的适宜性(助听器可能性较小,沟通计划更有可能)。
研究结果表明,临床医生在让后天性听力障碍的成年人参与干预决策时,需要明确引出本研究确定的预测因素。