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社区中非专业卫生工作者的移动医疗听力筛查儿童

Mhealth hearing screening for children by non-specialist health workers in communities.

机构信息

Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa.

Ear Sciences Centre, School of Surgery, University of Western Australia, Nedlands, Australia.

出版信息

Int J Audiol. 2021 Apr;60(sup1):S23-S29. doi: 10.1080/14992027.2020.1829719. Epub 2020 Oct 12.

Abstract

OBJECTIVES

To compare outcomes of a community-based hearing screening programme using smartphone screening audiometry operated by specialist (School Health Nurses - SHNs) and non-specialist health workers (Community Health Workers - CHWs) in school children.

DESIGN

This study used a two-group comparison of screening outcomes as conducted by SHNs and CHWs using smartphone screening for children in communities.

STUDY SAMPLE

The study included 71 CHWs and 21 SHNs who conducted community-based hearing screening on 6805 children. One thousand one hundred and fifteen hearing screening tests were conducted by the CHWs and 5690 tests by the SHNs.

RESULTS

No significant difference in screening outcome was evident between CHWs and SHNs using a binomial logistic regression analysis considering age, test duration and noise levels as independent variables. Final screening result was significantly affected by age ( < 0.005), duration of test ( < 0.005) and noise levels exceeding at 1 kHz in at least one ear ( < 0.005). Test failure was associated with longer test duration ( < 0.005; : 119.98; 95% CI: 112.65-127.30). CHWs had significantly ( < 0.005) longer test durations (68.70 s; 70 SD) in comparison to SHNs (55.85 s; 66.1 SD).

CONCLUSION

Low-cost mobile technologies with automated testing facilitated from user-friendly interfaces allow minimally trained persons to provide community-based screening comparable to specialised personnel.

摘要

目的

比较由专科医生(学校保健护士-SHNs)和非专科卫生工作者(社区卫生工作者-CHWs)使用智能手机筛查听力在学校儿童中进行的社区基础听力筛查项目的结果。

设计

本研究使用了智能手机筛查社区儿童的 SHNs 和 CHWs 进行筛查结果的两组比较。

研究样本

该研究包括 71 名 CHWs 和 21 名 SHNs,他们对 6805 名儿童进行了社区基础听力筛查。1150 次听力筛查测试由 CHWs 进行,5690 次测试由 SHNs 进行。

结果

考虑到年龄、测试持续时间和噪声水平作为独立变量,使用二项逻辑回归分析,CHWs 和 SHNs 的筛查结果之间没有明显差异。最终的筛查结果受到年龄( < 0.005)、测试持续时间( < 0.005)和至少一只耳朵的噪声水平超过 1kHz( < 0.005)的显著影响。测试失败与测试持续时间较长有关( < 0.005;:119.98;95%CI:112.65-127.30)。与 SHNs(55.85 s;66.1 SD)相比,CHWs 的测试持续时间明显更长(68.70 s;70 SD)( < 0.005)。

结论

具有自动化测试功能的低成本移动技术,通过用户友好的界面实现,允许经过最少培训的人员提供与专业人员相当的社区基础筛查。

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