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接受助听犬对听力损失患者心理健康和健康状况的有效性及成本效益:一项随机对照试验方案

Effectiveness and Cost-Effectiveness of Receiving a Hearing Dog on Mental Well-Being and Health in People With Hearing Loss: Protocol for a Randomized Controlled Trial.

作者信息

Stuttard Lucy, Hewitt Catherine, Fairhurst Caroline, Weatherly Helen, Walker Simon, Longo Francesco, Maddison Jane, Boyle Philip, Beresford Bryony

机构信息

Social Policy Research Unit, Department of Social Policy and Social Work, Alcuin B Block, University of York, York, United Kingdom.

York Trials Unit, Department of Health Sciences, University of York, York, United Kingdom.

出版信息

JMIR Res Protoc. 2020 Apr 17;9(4):e15452. doi: 10.2196/15452.

Abstract

BACKGROUND

People with hearing loss, particularly those who lose their hearing in adulthood, are at an increased risk of social isolation, mental health difficulties, unemployment, loss of independence, risk of accidents, and impaired quality of life. In the United Kingdom, a single third-sector organization provides hearing dogs, a specific type of assistance dog trained to provide sound support to people with hearing loss. These dogs may also deliver numerous psychosocial benefits to recipients. This has not previously been fully investigated.

OBJECTIVE

The study aims to evaluate the impact of a hearing dog partnership on the lives of individuals with severe or profound hearing loss.

METHODS

A 2-arm, randomized controlled trial will be conducted within the United Kingdom with 162 hearing dog applicants, aged 18 years and older. Participants will be randomized 1:1 using a matched-pairs design to receive a hearing dog sooner than usual (intervention arm: arm B) or to receive a hearing dog within the usual timeframe (comparator arm: arm A). In the effectiveness analysis, the primary outcome is a comparison of mental well-being 6 months after participants in arm B have received a hearing dog (arm A have not yet received a hearing dog), measured using the Short Warwick Edinburgh Mental Well-Being Scale. Secondary outcome measures include the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Work and Social Adjustments Scale. An economic evaluation will assess the cost-effectiveness, including health-related quality-adjusted life years using the EuroQol 5 Dimensions and social care-related quality-adjusted life years. Participants will be followed up for up to 2 years. A nested qualitative study will investigate the impacts of having a hearing dog and how these impacts occur.

RESULTS

The study is funded by the National Institute for Health Research's School for Social Care Research. Recruitment commenced in March 2017 and is now complete. A total of 165 participants were randomized. Data collection will continue until January 2020. Results will be published in peer-reviewed journals and at conferences. A summary of the findings will be made available to participants. Ethical approval was received from the University of York's Department of Social Policy and Social Work Research Ethics Committee (reference SPSW/S/17/1).

CONCLUSIONS

The findings from this study will provide, for the first time, strong and reliable evidence on the impact of having a hearing dog on people's lives in terms of their quality of life, well-being, and mental health.

TRIAL REGISTRATION

International Standard Randomised Controlled Trial Number Registry ISRCTN36452009; http://www.isrctn.com/ISRCTN36452009.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/15452.

摘要

背景

听力损失患者,尤其是成年后失聪的人,面临社交孤立、心理健康问题、失业、失去独立能力、意外风险增加以及生活质量受损等风险。在英国,一个第三部门组织专门提供助听犬,这是一种经过特殊训练为听力损失患者提供声音支持的特定类型的辅助犬。这些犬只可能还会为接受者带来诸多心理社会方面的益处。此前这方面尚未得到充分研究。

目的

本研究旨在评估助听犬陪伴对重度或极重度听力损失个体生活的影响。

方法

将在英国对162名年龄在18岁及以上的助听犬申请者进行一项双臂随机对照试验。参与者将采用配对设计以1:1的比例随机分组,一组比通常情况更快获得助听犬(干预组:B组),另一组在通常时间范围内获得助听犬(对照组:A组)。在有效性分析中,主要结局是比较B组参与者获得助听犬6个月后(A组尚未获得助听犬)的心理健康状况,使用简短版沃里克 - 爱丁堡心理健康量表进行测量。次要结局指标包括患者健康问卷 - 9、广泛性焦虑障碍量表 - 7以及工作和社会适应量表。一项经济评估将评估成本效益,包括使用欧洲五维度健康量表计算与健康相关的质量调整生命年以及与社会护理相关的质量调整生命年。参与者将接受长达2年的随访。一项嵌套的定性研究将调查拥有助听犬的影响以及这些影响是如何发生的。

结果

本研究由英国国家卫生研究院社会护理研究学院资助。招募工作于2017年3月开始,现已完成。共有165名参与者被随机分组。数据收集将持续到2020年1月。研究结果将在同行评审期刊和会议上发表。研究结果摘要将提供给参与者。该研究已获得约克大学社会政策与社会工作研究伦理委员会(参考编号SPSW/S/17/1)的伦理批准。

结论

本研究结果将首次就拥有助听犬对人们生活质量、幸福感和心理健康方面的影响提供有力且可靠的证据。

试验注册

国际标准随机对照试验编号注册库ISRCTN36452009;http://www.isrctn.com/ISRCTN36452009。

国际注册报告识别码(IRRID):DERR1 - 10.2196/15452。

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