Watkin P M, Baldwin M, Dixon R, Beckman A
Audiology Services, Forest Healthcare, Whipps Cross Hospital, Leytonstone, London.
Br J Audiol. 1998 Feb;32(1):27-37. doi: 10.3109/03005364000000048.
Neonatal hearing screening of all babies within the maternity unit is now feasible using transient evoked otoacoustic emission (TEOAE) recording. However, in many maternity units in the United Kingdom, the majority of babies are discharged within the first 48 hours. During the first two days of life, there is a higher proportion of babies in whom emissions cannot be recorded. A universal TEOAE hearing screen has been implemented in Whipps Cross Hospital. As 70% of the babies are discharged from the maternity unit before they are 48 hours old, a two stage screen was implemented, with failure at the initial TEOAE test being followed by a retest after 4-6 weeks. The maternal anxiety caused by this model was investigated in 288 mothers enrolled for the initial TEOAE test. Generally, anxiety was low and attitudes towards the screen were positive. Ninety-seven per cent of mothers considered the screen to be worthwhile at the initial test with 15% feeling it had caused some anxiety but less than 1% being very worried. The mothers who had some anxieties were not dissatisfied with the screen, and within this group there was no increase in the proportion of babies who had failed the initial test. At the retest, two of 57 mothers (3.5%) considered they were very worried, but there was no significant deterioration in attitude towards the screen. Spielberger's State-Trait Anxiety Inventory revealed no significant difference in the anxiety state of the retest group when compared with a control group whose babies had not received a neonatal hearing test. The results of the initial test and the retest did not influence the anxiety state of the mothers. Ways of minimizing anxiety caused to a minority of mothers whilst maintaining positive attitudes to the screen are discussed.
现在，使用瞬态诱发耳声发射（TEOAE）记录对产科病房内的所有婴儿进行新生儿听力筛查是可行的。然而，在英国的许多产科病房，大多数婴儿在出生后的头48小时内就出院了。在出生后的前两天，有较高比例的婴儿无法记录到耳声发射。惠普斯十字医院实施了普遍的TEOAE听力筛查。由于70%的婴儿在48小时之前就从产科病房出院，因此实施了两阶段筛查，在初始TEOAE测试未通过后，在4 - 6周后进行重新测试。对288名参加初始TEOAE测试的母亲的这种模式所引起的母亲焦虑进行了调查。总体而言，焦虑程度较低，对筛查的态度是积极的。97%的母亲认为在初始测试时筛查是值得的，15%的母亲觉得筛查引起了一些焦虑，但不到1%的母亲非常担心。有一些焦虑的母亲对筛查并不不满意，在这个群体中，初始测试未通过的婴儿比例也没有增加。在重新测试时，57名母亲中有两名（3.5%）认为她们非常担心，但对筛查的态度没有明显恶化。斯皮尔伯格状态 - 特质焦虑量表显示，与未接受新生儿听力测试的婴儿的对照组相比，重新测试组的焦虑状态没有显著差异。初始测试和重新测试的结果并未影响母亲的焦虑状态。本文讨论了在保持对筛查的积极态度的同时，将少数母亲所产生的焦虑降至最低的方法。
