Stroebel Deidré, Swanepoel De Wet
Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa.
Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa; Ear Sciences Centre, School of Surgery, University of Western Australia, Nedlands, Australia; Ear Science Institute Australia, Subiaco, Australia.
Int J Pediatr Otorhinolaryngol. 2014 Dec;78(12):2210-5. doi: 10.1016/j.ijporl.2014.10.015. Epub 2014 Oct 22.
This study compared parental experience of the audiological diagnosis and intervention process in children with auditory neuropathy spectrum disorder and sensory neural hearing loss.
A matched group survey was used with parents of children with auditory neuropathy spectrum disorder (ANSD) matched with a control group of parents and children with sensorineural hearing loss (SNHL). The two groups were matched in terms of the child's gender, age, amplifications used, social background and utilisation of private or public health care sectors. An interview questionnaire, consisting of 45 questions in six categories (1. biographic information, 2. experiences of audiological diagnosis, 3. hearing aid benefit, 4. parental experience of the rehabilitation decision making process, 5. parental needs for emotional support and 6. parental needs for information) using a 5-point Likert scale for categories 2-7, was administered by the same audiologist.
Children with ANSD experienced a significantly longer waiting period from diagnosis to hearing aid fitting (p=0.025) and/or cochlear implantation (p=0.036). Parents of children with ANSD reported significantly different experiences of the diagnostic process (p=0.001) with poorer understanding of the diagnosis and reporting insufficient time allowed for asking questions. During the rehabilitation decision-making process 47% of parents with ANSD children (vs. 0% of parents with SNHL children) reported receiving conflicting information. Parents of children with ANSD were also less likely to recommend hearing aids to other parents. Information needs were similar between groups.
Parents of children with ANSD have different experiences and greater uncertainty during the diagnostic and rehabilitation process. Providing regular consultation and structured timelines through the diagnostic process and decision-making process may facilitate this process with less uncertainty.
本研究比较了患有听觉神经病谱系障碍和感音神经性听力损失儿童的家长在听力学诊断及干预过程中的经历。
采用匹配组调查,将患有听觉神经病谱系障碍(ANSD)儿童的家长与患有感音神经性听力损失(SNHL)儿童的家长及孩子组成的对照组进行匹配。两组在孩子的性别、年龄、使用的放大设备、社会背景以及私立或公立医疗保健部门的使用情况方面进行了匹配。由同一位听力学家发放一份访谈问卷,问卷包含45个问题,分为六个类别(1. 个人信息,2. 听力学诊断经历,3. 助听器益处,4. 家长在康复决策过程中的经历,5. 家长对情感支持的需求,6. 家长对信息的需求),其中类别2 - 7采用5点李克特量表。
患有ANSD的儿童从诊断到佩戴助听器(p = 0.025)和/或接受人工耳蜗植入(p = 0.036)的等待时间显著更长。患有ANSD儿童的家长报告称诊断过程的经历存在显著差异(p = 0.001),对诊断的理解较差,且报告提问时间不足。在康复决策过程中,47%患有ANSD儿童的家长(相比之下,患有SNHL儿童的家长为0%)报告收到相互矛盾的信息。患有ANSD儿童的家长也不太可能向其他家长推荐助听器。两组之间的信息需求相似。
患有ANSD儿童的家长在诊断和康复过程中有不同的经历且不确定性更大。在诊断过程和决策过程中提供定期咨询和结构化的时间安排可能会减少不确定性,从而促进这一过程。