Escuela de Fonoaudiología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Santiago, Chile.
Escuela de Fonoaudiología, Facultad de Salud, Universidad Santo Tomás -, Viña del Mar, Chile.
BMC Geriatr. 2024 Oct 12;24(1):828. doi: 10.1186/s12877-024-05424-0.
Hearing loss in older adults affects general, generic health-related and disease-specific quality of life (QoL). The conventional strategy to address it is through hearing aids, which have been shown to improve disease-specific QoL. However, the long-term results regarding general quality of life are unknown, and communication problems and stigma associated with hearing loss may persist. An effective intervention strategy to address these problems is group communication programs, most notably Active Communication Education (ACE). This program has been shown to increase communication strategies and reduce communication activity limitations and participation restrictions. These precedents allow us to hypothesize that this program could improve general QoL.
A randomized clinical trial was conducted on 114 older adult hearing aid users. Fifty-four subjects composed the intervention group that received the ACE program, while 60 subjects composed the control group that received an informational-lectures type intervention. The WHOQOL-BREF questionnaire was used to measure general QoL. Measurements were taken before and right after the intervention, with follow-ups at 6 and 12 months. Multilevel linear mixed models were estimated, considering the WHOQOL-BREF dimension scores and total score as the outcomes, and an interaction term between time since intervention and group as the predictor. Within- and between-group comparisons were made.
Compared to the baseline time-point, the ACE group showed significant improvements right after the intervention, and at the 6-month and 12-month follow-ups for the dimensions of psychological health, social relationships, environment, and total score. Compared to the control group, the ACE group exhibited significantly greater improvements in the social dimension at all postintervention assessments, as well as in the environment dimension and total score at the 12-month follow-up.
The ACE program improved general QoL in terms of social relationships and environment dimensions, which lasted up to 12 months after the intervention. Therefore, ACE is positioned as an effective complement for HA users, enhancing and delivering new benefits related to broader aspects of QoL not necessarily tied to health.
ISRCTN54021189 (retrospectively registered on 18/07/2023).
老年人听力损失会影响一般、通用的健康相关和疾病特异性生活质量（QoL）。解决这个问题的传统策略是通过助听器，助听器已被证明可以提高疾病特异性 QoL。然而，关于一般生活质量的长期结果尚不清楚，与听力损失相关的沟通问题和耻辱感可能仍然存在。解决这些问题的有效干预策略是群体沟通计划，尤其是积极沟通教育（ACE）。该计划已被证明可以增加沟通策略，减少沟通活动限制和参与限制。这些先例使我们假设该计划可以改善一般 QoL。
对 114 名老年助听器使用者进行了随机临床试验。54 名受试者组成干预组，接受 ACE 计划，60 名受试者组成对照组，接受信息讲座型干预。使用 WHOQOL-BREF 问卷来衡量一般 QoL。在干预前和干预后立即进行测量，并在 6 个月和 12 个月时进行随访。使用多级线性混合模型进行估计，将 WHOQOL-BREF 维度得分和总分作为结果，将干预后时间和组之间的交互项作为预测因子。进行了组内和组间比较。
与基线时间点相比，ACE 组在干预后立即、6 个月和 12 个月随访时，在心理健康、社会关系、环境和总分维度上均显示出显著改善。与对照组相比，ACE 组在所有干预后评估中，社会维度的改善更为显著，在环境维度和总分方面，在 12 个月随访时也有显著改善。
ACE 计划改善了社会关系和环境维度的一般 QoL，这种改善持续到干预后 12 个月。因此，ACE 是 HA 用户的有效补充，增强和提供与 QoL 的更广泛方面相关的新益处，这些益处不一定与健康有关。
ISRCTN54021189（于 2023 年 7 月 18 日回顾性注册）。
