Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore.
Ann Acad Med Singap. 2020 Dec;49(12):978-989. doi: 10.47102/annals-acadmedsg.2020376.
This study aims to examine the factors associated with self-reported hearing disability and early reduction in disability after first-time hearing aid (HA) fitting in Singapore.
Retrospective record review of 1,068 subjects issued with HAs at a tertiary hospital from 2001 to 2013.
Subjects reporting ≥5 disabilities reduced from 90% to 24% after HA fitting. 'Difficulty hearing in noise' was the commonest disability before and after HA fitting, while 'needs to increase volume of TV/radio' was the disability with most improvement after fitting. In multivariable models, having worse pure tone audiometry (PTA) thresholds of the better hearing ear and being ethnically Chinese were associated with subjects reporting more hearing disabilities. A higher proportion of subjects reported a reduction rather than an absence of disability after HA fitting. In multivariable models, daily HA usage for ≥4 hours, sensorineural hearing loss (HL) and worse PTA thresholds of the better hearing ear were associated with reduction in more disabilities after HA fitting.
Hearing disability is high among first-time HA users in Singapore. Ethnicity and PTA thresholds were associated with self-reported hearing disability. After HA fitting, higher daily HA usage, sensorineural HL, and worse PTA thresholds of the better hearing ear were associated with early reduction in disability. Patient counselling on the benefits of HL rehabilitation could focus on hearing disability rather than PTA thresholds. The management of patients' expectations could focus on reducing rather than eliminating disability.
本研究旨在探讨新加坡初次佩戴助听器(HA)后,与自我报告听力障碍及残疾早期减轻相关的因素。
对 2001 年至 2013 年期间在一家三级医院验配助听器的 1068 名受试者进行回顾性病历记录审查。
报告≥5 项残疾的受试者从佩戴助听器前的 90%降至佩戴后的 24%。“在噪声中听辨困难”是佩戴前后最常见的残疾,而“需要调高电视/收音机音量”是佩戴后改善最明显的残疾。在多变量模型中,较好耳的纯音听阈较差(PTA)与报告更多听力障碍的受试者相关;种族为华人与报告更多听力障碍的受试者相关。更多受试者报告佩戴助听器后残疾程度减轻而非完全消除。在多变量模型中,每日佩戴助听器≥4 小时、感音神经性听力损失(HL)和较好耳的 PTA 阈值较差与佩戴助听器后残疾程度减轻相关。
新加坡初次佩戴助听器的患者听力障碍发生率较高。种族和 PTA 阈值与自我报告的听力障碍相关。佩戴助听器后,更高的每日助听器使用时间、感音神经性 HL 和较好耳的 PTA 阈值较差与残疾的早期减轻相关。对 HL 康复益处的患者咨询可以关注听力障碍而不是 PTA 阈值。患者期望的管理可以关注减少残疾而不是消除残疾。