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利用患者对相对益处和愉悦感的认知来评估听觉训练。

Using patient perceptions of relative benefit and enjoyment to assess auditory training.

作者信息

Tye-Murray Nancy, Sommers Mitchell S, Mauzé Elizabeth, Schroy Catherine, Barcroft Joe, Spehar Brent

机构信息

Department of Otolaryngology, Washington University School of Medicine, St. Louis, MO, USA.

出版信息

J Am Acad Audiol. 2012 Sep;23(8):623-34. doi: 10.3766/jaaa.23.8.7.

Abstract

BACKGROUND

Patients seeking treatment for hearing-related communication difficulties are often disappointed with the eventual outcomes, even after they receive a hearing aid or a cochlear implant. One approach that audiologists have used to improve communication outcomes is to provide auditory training (AT), but compliance rates for completing AT programs are notoriously low.

PURPOSE

The primary purpose of the investigation was to conduct a patient-based evaluation of the benefits of an AT program, I Hear What You Mean, in order to determine how the AT experience might be improved. A secondary purpose was to examine whether patient perceptions of the AT experience varied depending on whether they were trained with a single talker's voice or heard training materials from multiple talkers.

RESEARCH DESIGN

Participants completed a 6 wk auditory training program and were asked to respond to a posttraining questionnaire. Half of the participants heard the training materials spoken by six different talkers, and half heard the materials produced by only one of the six talkers.

STUDY SAMPLE

Participants included 78 adult hearing-aid users and 15 cochlear-implant users for a total of 93 participants who completed the study, ages 18 to 89 yr (M = 66 yr, SD = 16.67 yr). Forty-three females and 50 males participated. The mean better ear pure-tone average for the participants was 56 dB HL (SD = 25 dB).

INTERVENTION

Participants completed the single- or multiple-talker version of the 6 wk computerized AT program, I Hear What You Mean, followed by completion of a posttraining questionnaire in order to rate the benefits of overall training and the training activities and to describe what they liked best and what they liked least.

DATA COLLECTION AND ANALYSIS

After completing a 6 wk computerized AT program, participants completed a posttraining questionnaire. Seven-point Likert scaled responses to whether understanding spoken language had improved were converted to individualized z scores and analyzed for changes due to AT. Written responses were coded and categorized to consider both positive and negative subjective opinions of the AT program. Regression analyses were conducted to examine the relationship between perceived effort and perceived benefit and to identify factors that predict overall program enjoyment.

RESULTS

Participants reported improvements in their abilities to recognize spoken language and in their self-confidence as a result of participating in AT. Few differences were observed between reports from those trained with one versus six different talkers. Correlations between perceived benefit and enjoyment were not significant, and only participant age added unique variance to predicting program enjoyment.

CONCLUSIONS

Participants perceived AT to be beneficial. Perceived benefit did not correlate with perceived enjoyment. Compliance with computerized AT programs might be enhanced if patients have regular contact with a hearing professional and train with meaning-based materials. An unheralded benefit of AT may be an increased sense of control over the hearing loss. In future efforts, we might aim to make training more engaging and entertaining, and less tedious.

摘要

背景

寻求听力相关沟通困难治疗的患者,即便在佩戴了助听器或植入了人工耳蜗后,往往仍对最终结果感到失望。听力学家用于改善沟通效果的一种方法是提供听觉训练(AT),但完成AT项目的依从率极低。

目的

本研究的主要目的是基于患者对一个名为“我懂你意思”的AT项目的益处进行评估,以确定如何改进AT体验。次要目的是考察患者对AT体验的认知是否因训练时使用单一说话者的声音还是多个说话者的训练材料而有所不同。

研究设计

参与者完成了一个为期6周的听觉训练项目,并被要求对训练后的问卷做出回应。一半参与者听取由六个不同说话者朗读的训练材料,另一半只听取六个说话者中一人朗读的材料。

研究样本

参与者包括78名成年助听器使用者和15名人工耳蜗使用者,共计93名完成研究的参与者,年龄在18至89岁之间(M = 66岁,SD = 16.67岁)。43名女性和50名男性参与。参与者较好耳的平均纯音听阈为56 dB HL(SD = 25 dB)。

干预措施

参与者完成了为期6周的计算机化AT项目“我懂你意思”的单说话者或多说话者版本,随后完成一份训练后问卷,以评估整体训练和训练活动的益处,并描述他们最喜欢和最不喜欢的内容。

数据收集与分析

在完成为期6周的计算机化AT项目后,参与者完成一份训练后问卷。对关于口语理解是否有所改善的7点李克特量表回答转换为个体化z分数,并分析AT带来的变化。对书面回答进行编码和分类,以考虑对AT项目的正面和负面主观意见。进行回归分析,以考察感知努力与感知益处之间的关系,并确定预测项目整体满意度的因素。

结果

参与者报告称,参与AT后他们识别口语的能力和自信心有所提高。在使用一名说话者与六名不同说话者训练的参与者报告之间,未观察到明显差异。感知益处与满意度之间的相关性不显著,只有参与者年龄在预测项目满意度方面增加了独特的方差。

结论

参与者认为AT有益。感知益处与感知满意度不相关。如果患者能定期与听力专业人员接触并使用基于意义的材料进行训练,可能会提高对计算机化AT项目的依从性。AT一个未被重视的益处可能是对听力损失的控制感增强。在未来的工作中,我们可以致力于使训练更具吸引力和趣味性,减少枯燥感。

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