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小儿人工耳蜗使用者设备使用情况不一致:患病率及危险因素

Inconsistent device use in pediatric cochlear implant users: Prevalence and risk factors.

作者信息

Wiseman Kathryn B, Warner-Czyz Andrea D

机构信息

a Department of Communication Sciences and Disorders, Callier Advanced Hearing Research Center , The University of Texas at Dallas , 1966 Inwood Road, Dallas , TX 75235 , USA.

b Dallas Cochlear Implant Program , 1966 Inwood Road, Dallas , TX 75235 , USA.

出版信息

Cochlear Implants Int. 2018 May;19(3):131-141. doi: 10.1080/14670100.2017.1418161. Epub 2018 Jan 4.

Abstract

OBJECTIVES

Cochlear implants (CIs) afford an opportunity for children with a significant hearing loss to access spoken language through auditory input, but challenges post-implantation could impede success. Inconsistent device use occurs when a child wears their device less than full-time (<8 hours per day). Previous studies may underestimate the prevalence of inconsistent device use in pediatric CI users due to methodological issues (subjective parent report vs. objective measures).

METHODS

This retrospective chart review identifies risk factors (demographic, audiologic, and device) associated with poorer daily device use in children with CI using objective datalogging. Non-parametric correlations, Mann-Whitney U, and Kruskal-Wallis H tests were used to evaluate effects of demographic, audiologic, and device factors on daily device use via datalogging.

RESULTS

Participants included 71 children (age M = 7.0 years) with mean implantation age of 4.0 years and mean device experience of 3.0 years. Children with CIs used their device, on average, 7.6 hours/day (range: 0.1-15.5 hours). Half of the participants wore their device less than full-time. Fewer hours of device use coincided with younger chronologic age, presence of additional disabilities, lower maternal education, younger age at CI, use of Medicaid, and smaller dynamic range.

DISCUSSION

The prevalence of inconsistent device use may exceed previous estimations based on parent report.

CONCLUSION

Professionals working with pediatric CI users should consider incorporating datalogging into clinical practice to counsel families at risk for poorer device use. Future studies should compare objective device use with communication outcomes in pediatric CI users.

摘要

目的

人工耳蜗(CI)为重度听力损失儿童提供了通过听觉输入获取口语的机会,但植入后的挑战可能会阻碍成功。当儿童佩戴设备的时间少于全天(每天<8小时)时,就会出现设备使用不一致的情况。由于方法学问题(家长主观报告与客观测量),先前的研究可能低估了小儿人工耳蜗使用者中设备使用不一致的患病率。

方法

本回顾性病历审查使用客观数据记录来确定与人工耳蜗儿童每日设备使用较差相关的风险因素(人口统计学、听力学和设备因素)。使用非参数相关性、曼-惠特尼U检验和克鲁斯卡尔-沃利斯H检验,通过数据记录评估人口统计学、听力学和设备因素对每日设备使用的影响。

结果

参与者包括71名儿童(平均年龄M = 7.0岁),平均植入年龄为4.0岁,平均设备使用经验为3.0年。人工耳蜗儿童平均每天使用设备7.6小时(范围:0.1 - 15.5小时)。一半的参与者佩戴设备的时间少于全天。设备使用时间较少与年龄较小、存在其他残疾、母亲教育程度较低、人工耳蜗植入时年龄较小、使用医疗补助以及动态范围较小有关。

讨论

设备使用不一致的患病率可能超过先前基于家长报告的估计。

结论

与小儿人工耳蜗使用者合作的专业人员应考虑将数据记录纳入临床实践,为设备使用较差风险的家庭提供咨询。未来的研究应比较小儿人工耳蜗使用者的客观设备使用情况与沟通结果。

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