Bush Matthew L, Hardin Bryan, Rayle Christopher, Lester Cathy, Studts Christina R, Shinn Jennifer B
*Department of Otolaryngology-Head and Neck Surgery, University of Kentucky Medical Center, Lexington †University of Kentucky College of Medicine, Lexington; ‡Cabinet for Health and Family Services Commission for Children With Special Health Care Needs, Louisville; and §Department of Health Behavior, College of Public Health, University of Kentucky, Lexington, Kentucky, U.S.A.
Otol Neurotol. 2015 Jan;36(1):93-8. doi: 10.1097/MAO.0000000000000636.
The purpose of this study was to assess regional parental barriers in the diagnostic and therapeutic process after abnormal newborn hearing screening (NHS) testing.
Cross-sectional questionnaire study.
Tertiary medical center.
Parents of infants who failed NHS in Kentucky from January 2009 to February 2012.
Demographic information, county of origin, attitudes and perceptions regarding NHS, and barriers in the NHS diagnostic process.
There were 460 participants in the study, which included 25.4% of parents from the Appalachian region. Twenty-one percent of Appalachian parents found the process on newborn hearing testing difficult. Appalachian parents were more likely to have no more than 12 years of education (odds ratio [OR], 1.7; p = 0.02) and Medicaid insurance (OR, 2.3; p < 0.001) compared with non-Appalachian parents. A higher percentage of Appalachian parents were unaware of the NHS results at the time of hospital discharge than non-Appalachians (14% versus 7%, p = 0.03). Distance from the diagnostic/therapeutic center represented was a significant barrier for Appalachian parents (OR, 2.8; p = 0.001). Compared with urban parents, a greater percentage of rural parents had never heard of a cochlear implant (p = 0.01). Appalachian parents expressed a strong interest in telemedicine and a desire for closer services.
Multiple barriers including education, distance, accessibility, and socioeconomic factors can affect timely diagnosis and treatment of congenital hearing loss for children residing in rural areas. Educational and telemedicine programs may benefit parents in Appalachia as well as parents in other rural areas.
本研究旨在评估新生儿听力筛查（NHS）结果异常后诊断和治疗过程中存在的地区性家长障碍。
横断面问卷调查研究。
三级医疗中心。
2009年1月至2012年2月在肯塔基州新生儿听力筛查未通过的婴儿的家长。
人口统计学信息、原籍县、对新生儿听力筛查的态度和认知以及新生儿听力筛查诊断过程中的障碍。
本研究有460名参与者，其中25.4%的家长来自阿巴拉契亚地区。21%的阿巴拉契亚地区家长认为新生儿听力检测过程困难。与非阿巴拉契亚地区家长相比，阿巴拉契亚地区家长受教育年限不超过12年的可能性更大（优势比[OR]，1.7；p = 0.02），且拥有医疗补助保险的可能性更大（OR，2.3；p < 0.001）。与非阿巴拉契亚地区家长相比，更高比例的阿巴拉契亚地区家长在出院时不知道新生儿听力筛查结果（14%对7%，p = 0.03）。对阿巴拉契亚地区家长来说，与诊断/治疗中心的距离是一个重大障碍（OR，2.8；p = 0.001）。与城市家长相比，更高比例的农村家长从未听说过人工耳蜗（p = 0.01）。阿巴拉契亚地区家长对远程医疗表现出浓厚兴趣，并希望获得更便捷的服务。
包括教育、距离、可及性和社会经济因素在内的多种障碍会影响农村地区儿童先天性听力损失的及时诊断和治疗。教育和远程医疗项目可能会使阿巴拉契亚地区以及其他农村地区的家长受益。
