新生兒聽力缺損之篩檢與照護需求

Issues Related to Screening and Caring for Newborns With Hearing Impairments

劉美秀(Mei-Show Liou) ； 曹英(Ying Tsao)

《護理雜誌》 63卷6期 (2016/12) Pp. 120-126

https://doi.org/10.6224/JN.63.6.120

摘要

人類聽力自胎兒20週開始發展至孩童三歲前完成。造成聽力缺損的原因有：先天基因或後天感染等因素；孩童聽力若有缺損且延誤最佳治療時機，則影響範圍不僅包括個人的聽取能力，也對語言發展、智力及學習表現、社交及心理發展等有負面效應。目前聽力篩檢工具主要有兩種：短暫誘發耳聲傳射（transient evoked otoacousticemission）、自動聽性腦幹反應（automatedauditory brainstem response, aABR），其中aABR具有較高的敏感性、特異性以及較低的偽陽性和轉介率，為多數地區採用。在得知新生兒聽力缺損的當下，父母的情緒通常是倍感壓力與焦慮。病童在就醫與成長過程中，父母需外界醫療、經濟、社會或教育等多方面的資訊與協助，以渡過困難時刻。本文藉由文獻整理與報告，期能提供醫護人員於個案照護的參考。

關鍵字

新生兒聽力篩檢 ； 新生兒聽力缺損 ； 短暫誘發耳聲傳射 ； 自動聽性腦幹反應

並列摘要

The critical period for auditory development in humans begins at around the 20th gestational week and continues until 3 years of age. Both genetic and environmental factors are known to cause impaired hearing. Without early identification and intervention, hearing-impaired children face a high risk of experiencing significant difficulties with speech and language development, social behavior, and emotional functioning. Two types of commonly used hearing screening technologies include transient evoked otoacoustic emission (TEOAE) and automated auditory brainstem response (aABR). aABR is considered to have high sensitivity and specificity, to have a relatively low referral rate, and to generate a relatively low rate of false-positive results in identifying newborn hearing impairment. The present paper outlines the psychosocial issues that are commonly experienced by parents of hearing- impaired children. Parents and other family members may benefit from medical, financial, social, and education supports in order to facilitate their adjustment to this challenging situation. The relevant literature is reviewed and recommendations for improving care for this population are provided.

並列關鍵字

newborn hearing screening ； newborn with hearing impairment ； transient evoked otoacoustic emission (TEOAE) ； automated auditory brainstem response (aABR)

參考文獻

金幼婷、劉文琪（2009）．雙親對新生兒聽力篩檢偽陽性結果之心路歷程．身心障礙研究，7（1），33–44。[Jin, Y. T., & Liu, W. C. (2009). A discussion on psychosocial reaction of the parents for newborn hearing screening to a false positive result. Journal of Disability Research, 7(1), 33–44.]

吳振吉、許權振（2012）．基因醫學於耳科疾病之新進展．臺灣耳鼻喉頭頸外科雜誌，47（2），91–99。[Wu, C. C., & Hsu, C. J, (2012). New horizons of genetic medicine in otological diseases. The Journal of Taiwan Otolaryngology-

胡　蓉、林金定（2009）．特殊需求學生主要照顧者壓力與健康相關生活品質相關性之研究．身心障礙研究，7（2），132–143。[Hu, J., & Lin, J. D. (2009). The relationship between stress and health-related quality of life on primary caregivers of special needs students. Journal of Disability Research, 7(2), 132–143.]

陳瑞玲、王紀勳、吳俊良、范君揚、周昱甫、林鴻清（2015）．台灣實施公費新生兒聽力篩檢之過去、現況與未來．臺灣耳鼻喉頭頸外科雜誌，50（2），67–73。[Chen, J. L., Wang, C. H., Wu, J. L., Fan, J. Y., Chou, Y. F., & Lin, H. C. (2015). The past, present and future of newborn hearing screening program in Taiwan. The Journal of Taiwan Otolaryngology-Head and Neck Surgery, 50(2), 67–73.]

鄭芬蘭、蔡孟芬、蔡惠玲（2013）．罕見疾患的家庭壓力因應與需求―以高雄市為例．教育心理學報，44（S），433–458。[Cheng, F. L., Tsai, M. F., & Tsai, H. L. (2013). Stressors coping and needs of the families with rare disorders. Bulletin of Educational Psychology, 44(S), 433–458.] doi:10.6251/BEP.20110829