Michaud Helen N, Duchesne Louise
Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale - Institut de réadaptation en déficience physique de Québec (CIUSSS-IRDPQ), QC, Canada.
Département d'orthophonie, Université du Québec à Trois-Rivières, QC, Canada.
J Am Acad Audiol. 2017 Jul/Aug;28(7):596-609. doi: 10.3766/jaaa.15090.
Few systematic reviews have been conducted regarding aural rehabilitation for adults with hearing loss, with none specifically targeting the older adult population. With prevalence rates of hearing loss being highest in older adults, examining the effects of aural rehabilitation on this population is warranted.
To evaluate the effects of aural rehabilitation on quality of life in an older adult population presenting with hearing loss.
Studies with adults presenting with hearing loss, ≥50 yr of age, with or without hearing aids, receiving interventions such as auditory training, speech-reading, communication strategies training, speech tracking, counseling, or a combination of approaches, and measuring outcomes related to quality of life, in an individual or group format, with or without significant others and with no limitations as to year of publication.
Searches in six databases, as well as results from hand-searching, gray literature, and cross-referencing of articles, yielded 386 articles. Of the 145 assessed as full-text articles for eligibility, 8 studies met inclusion criteria.
A component-based risk of bias assessment, as recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
No effect sizes were found in group interventions measuring outcomes related to quality of life, such as mental and emotional functions, environmental factors, participation restrictions, and activity limitations. An intervention effect regarding participation was found for a self-administered home training program, but an effect size was unavailable. Small-to-medium effect sizes were found in one of two individual communication training programs, for which outcomes related to quality of life, such as emotional functions, activities, participation, and environmental factors were measured. The results of the component-based risk of bias assessment indicated that the quality of reporting was poor, thus compromising the internal validity of included primary studies.
Our results indicate that the combined body of evidence in support of aural rehabilitation for older adults with hearing loss is not sufficient to draw any firm conclusions. We identify a need for more rigorous research to guide clinical decision-making.
针对成年听力损失患者的听觉康复，所开展的系统评价较少，且尚无专门针对老年人群体的研究。鉴于老年人听力损失患病率最高，因此有必要研究听觉康复对此群体的影响。
评估听觉康复对老年听力损失人群生活质量的影响。
研究对象为年龄≥50岁的成年听力损失患者，无论是否佩戴助听器，接受诸如听觉训练、言语阅读、沟通策略训练、言语跟踪、咨询或多种方法组合的干预措施，并采用个体或小组形式测量与生活质量相关的结局，无论是否有重要他人参与，且对发表年份无限制。
在六个数据库中进行检索，并结合手工检索、灰色文献及文章交叉引用的结果，共获得386篇文章。在评估为符合纳入标准的145篇全文文章中，有8项研究符合纳入标准。
采用系统评价和Meta分析的首选报告项目（PRISMA）声明推荐的基于成分的偏倚风险评估。
在测量与生活质量相关结局（如心理和情感功能、环境因素、参与限制和活动受限）的小组干预中，未发现效应量。对于一项自我管理的家庭训练计划，发现了对参与方面的干预效果，但未提供效应量。在两项个体沟通训练计划中的一项中发现了小到中等的效应量，该计划测量了与生活质量相关的结局，如情感功能、活动、参与和环境因素。基于成分的偏倚风险评估结果表明，报告质量较差，从而损害了纳入的原始研究的内部效度。
我们的结果表明，支持老年听力损失患者听觉康复的综合证据不足以得出任何确凿结论。我们认为需要更严格的研究来指导临床决策。
