數位式助聽器使用與中老年聽覺損傷族群之生活品質關係探討

The Relationship between Digital Hearing Aid Fitting and Quality of Life in the Middle-Aged and Older Adults with Hearing Impairment

李建賢(Jian-Sian Li)

指導教授 ： 陳雅美

國立臺灣大學/公共衛生學院/公共衛生碩士學位學程/碩士(2017年)

https://doi.org/10.6342/NTU201700185

摘要

背景：聽覺損傷是中老年族群中常見的感官障礙與生活品質及身心健康有負向關係，並會使中老年人容易產生社會隔離、憂鬱、焦慮甚至導致日常生活功能下降。台灣聽覺損傷的盛行率隨人口結構的老化而逐漸上升，約四成的老年人有足以影響溝通的聽力障礙。而本研究目的是希望由國內常見聽覺復健模式探討數位式助聽器使用與中老年聽覺損傷者生活品質間之關係。
方法：本研究是採橫斷式研究方式，在2016年4月29日至11月10日間，以北部區域教學醫院及其合作助聽器中心之聽覺損傷中老年患者為取樣對象，透過台灣簡明版世界衛生組織生活品質問卷與老年人聽覺表現(HHIE-S)量表來收集中老年聽覺損傷患者之資料。使用SPSS 18版統計軟體進行資料分析，對於社會人口學資料、聽力損傷狀況、HHIE-S量表與生活品質各範疇分數採描述性統計分析，進一步使用雙變項分析探討與生活品質相關之重要因子，最後採迴歸模式分析數位式助聽器使用在各生活品質範疇內之關係。
結果：總共有效問卷57份(佔回收問卷76.9%)，有配戴數位式助聽器者佔21位(36.8%)。有佩戴助聽器者其HHIE-S量表分數顯著低於無配戴助聽器之族群，且助聽器使用與環境及本土化環境範疇生活品質有正向相關。在數位式助聽器使用下，中老年聽覺損傷患者對於居住安全及家居品質有較佳的正向感受且自覺參與休閒活動機會較高，此外有配戴助聽器者亦較能獲得與享受個人所期待的飲食。在考量相關影響因子下，助聽器配戴變項對本土化環境範疇生活品質分數有顯著正向關係。
結論：數位式助聽器的使用有助於提升中老年聽覺損傷者之環境範疇生活品質有高度相關。特別重要的是老年人的環境範疇生活品質的增加有助於維持老年人生理活動及社會參與，進而提升活躍老化之機會。台灣面對快速人口老化，聽覺損傷相關問題將會增加。助聽器的使用對中老年聽覺損傷族群的環境親和力在健康老化過程中所扮演的角色應是未來重要探索的議題。另外，本研究亦建議未來使用台灣簡明版世界衛生組織生活品質問卷來評估中老年聽覺損傷者助聽器使用與生活品質之間的關係，透過此量表可作為未來聽覺損傷患者在比較跨疾病治療時成本效益的評估工具。

關鍵字

聽覺損傷 ； 中老年人 ； 數位式助聽器 ； 生活品質 ； 台灣簡明版世界衛生組織生活品質問卷

並列摘要

Background: Hearing impairment is common in the middle-aged and older adults. It has negative relationships with the quality of life (QOL) and physical-mental health, and makes older adults vulnerable to social isolation, depression, anxiety and even leads to decreased activities of daily living. The prevalence of hearing impairment in Taiwan is gradually increasing, about 40% of the elderly have hearing impairment affecting the communication. The aim of this study is to analyze the relationship between the digital hearing aid fitting and the QOL of the middle-aged and older hearing-impaired adults through the domestic common hearing rehabilitation model.
Methods: In this cross-sectional study, we sampled the middle-aged and older patients with hearing impairment in a regional hospital and cooperative auditory centers during April 29 to November 10, 2016. We use the World Health Organization Quality-of-Life Scale BREF Taiwan version (WHOQOL-BREF) and Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S) to collect data. Statistical analysis was performed with SPSS 18 software. Descriptive analysis was used for sociodemographic data, hearing status, HHIE-S scale, and quality of life. Further, bivariate analysis was used to explore the factors related with the QOL. Finally, the regression model was used to analyze the relationship between digital hearing aid fitting and QOL in each domain.
Results: A total of 57 valid questionnaires (76.9%) were collected and 21 (36.8%) wearing digital hearing aids. The HHIE-S scale was significantly lower in those who wearing hearing aids, and the hearing aids fitting has positive correlation with the environment and environment (TW) domains QOL. Under digital hearing aid fitting, middle-aged and older adults with hearing impairment perceive better residential safety, home environment quality and chance for participating in leisure activities. They also have better access to enjoy the desirable food. After controlling all the relevant factors, the hearing aid fitting has significant positive correlation with the QOL in environment (TW) domain.
Conclusions: The digital hearing aid fittig could improve the environment domain QOL among the middle-aged and older adults with hearing impairment. Environment domain QOL are especially important for promoting older adults’ maintaining physical activities, social participation, and the chance of active ageing. Thus, while facing the challenge of fast population ageing, which envision high level of hearing-related problems and associated disaiblities in Taiwan, exploratiing the role of hearing aids fitting for the environmental accecibilities in the process of healthy ageing is warrented . In addition, this study also proposed to use the WHOQOL-BREF Taiwan version to assess the QOL and hearing aids fitting effect in the middle-aged and older adults with hearing impairment. This scale could be used as future cross-disease cost-effective assessment tools.

並列關鍵字

Hearing Impairment ； Middle-aged and Older Adults ； Digital Hearing Aids ； Quality of Life ； the Taiwan Version of WHOQOL-BREF

參考文獻

16. 朱思盈. 聽覺缺損對台灣老年男性榮家住民生活品質的影響. 國立成功大學. 2011;老年學研究所(碩士).

15. 張維修. 老年人使用現代化數位助聽器的結果測量與其決定因素之研究. 國立臺灣大學. 2010;職業醫學與工業衛生研究所(碩士).

42. 劉殿楨. 數位式助聽器的最新進展. 健康世界. 2004;220:50-52.

52. 游曉微. 臺灣老人失能趨勢之回顧. 長期照護雜誌. 2015;19(2):157-186.

50. 姚開屏. 台灣簡明版世界衛生組織生活品質問卷之發展及使用手冊. 2005.