VA New York Harbor Healthcare System, New York, New York, USA.
Division of Geriatrics and Palliative Care, Department of Medicine, NYU Grossman School of Medicine, New York, New York, USA.
J Am Geriatr Soc. 2021 Apr;69(4):1071-1078. doi: 10.1111/jgs.17037. Epub 2021 Feb 11.
BACKGROUND/OBJECTIVES: Poor communication is a barrier to care for people with hearing loss. We assessed the feasibility and potential benefit of providing a simple hearing assistance device during an emergency department (ED) visit, for people who reported difficulty hearing.
Randomized controlled pilot study.
The ED of New York Harbor Manhattan Veterans Administration Medical Center.
One hundred and thirty-three Veterans aged 60 and older, presenting to the ED, likely to be discharged to home, who either (1) said that they had difficulty hearing, or (2) scored 10 or greater (range 0-40) on the Hearing Handicap Inventory-Survey (HHI-S).
Subjects were randomized (1:1), and intervention subjects received a personal amplifier (PA; Williams Sound Pocketalker 2.0) for use during their ED visit.
Three survey instruments: (1) six-item Hearing and Understanding Questionnaire (HUQ); (2) three-item Care Transitions Measure; and (3) three-item Patient Understanding of Discharge Information. Post-ED visit phone calls to assess ED returns.
Of the 133 subjects, 98.3% were male; mean age was 76.4 years (standard deviation (SD) = 9.2). Mean HHI-S score was 19.2 (SD = 8.3). Across all HUQ items, intervention subjects reported better in-ED experience than controls. Seventy-five percent of intervention subjects agreed or strongly agreed that ability to understand what was said was without effort versus 56% for controls. Seventy-five percent of intervention subjects versus 36% of controls said clinicians provided them with an explanation about presenting problems. Three percent of intervention subjects had an ED revisit within 3 days compared with 9.0% controls.
Veterans with hearing difficulties reported improved in-ED experiences with use of PAs, and were less likely to return to the ED within 3 days. PAs may be an important adjunct to older patient ED care but require validation in a larger more definitive randomized controlled trial.
背景/目的：沟通不畅是听力障碍患者护理的障碍。我们评估了在急诊科 (ED) 就诊期间为自述听力困难的患者提供简单听力辅助设备的可行性和潜在益处。
随机对照试点研究。
纽约港曼哈顿退伍军人事务医疗中心的 ED。
133 名年龄在 60 岁及以上、可能出院回家的退伍军人，他们要么 (1) 表示听力有困难，要么 (2) 在听力障碍问卷-调查 (HHI-S) 中得分为 10 或更高（范围 0-40）。
受试者随机分为（1:1），干预组接受个人放大器（PA；Williams Sound Pocketalker 2.0），在 ED 就诊期间使用。
三种调查工具：（1）六项目听力和理解问卷 (HUQ)；(2)三项护理过渡措施；以及 (3) 三项患者对出院信息的理解。ED 就诊后进行电话随访以评估 ED 复诊情况。
133 名受试者中，98.3%为男性；平均年龄为 76.4 岁（标准差 (SD) = 9.2）。平均 HHI-S 评分为 19.2（SD = 8.3）。在所有 HUQ 项目中，干预组报告的 ED 就诊体验优于对照组。75%的干预组表示理解所说的话毫不费力，而对照组为 56%。75%的干预组表示临床医生向他们解释了就诊问题，而对照组为 36%。3%的干预组在 3 天内再次到 ED 就诊，而对照组为 9.0%。
听力困难的退伍军人使用个人放大器报告 ED 就诊体验得到改善，并且在 3 天内返回 ED 的可能性较低。PA 可能是老年患者 ED 护理的重要辅助手段，但需要在更大规模、更明确的随机对照试验中进行验证。
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