人工電子耳對成人植入者的心理社會效益及其影響因素之研究

人工電子耳能回復植入者部分聽知覺能力，但在心理社會層面的效益則有待評估。本研究以61位使用人工電子耳的成人為對象，採問卷調查法探究人工電子耳對使用者心理與社會兩方面的效益，並分析相關變項的預測力與重要性。本研究工具「人工電子耳對成人植入者心理社會效益量表」，分為情緒與社會情境兩個分量表，經過試題分析、內部一致性分析、以及因素分析等方式檢定，為具有鑑別度、信度與效度的評估工具。調查結果顯示人工電子耳確實能夠改善多數使用者的心理社會問題，但使用者仍然自覺有障礙感，且在噪音環境的效益相對較差。此外，平均而言，人工電子耳雖然有明顯效益，但個別差異懸殊，少數個案並未獲益。在預測變項方面，本研究共計檢驗植入耳、植入時間、溝通方式、以及復健時間等15個變項。這些變項當中，能有效預測人工電子耳在心理層面的效益者，依重要性排序分別是植入人工電子耳的決定正確性、使用時的聽覺困難程度、以及每日使用人工電子耳的時間量；社會情境效益的預測變項，依重要性排序分別為植入人工電子耳的決定正確性、使用時的聽覺困難程度、以及人工電子耳的使用頻率、使用者的實足年齡；能有效預測全量表效益的變項依序為植入人工電子耳的決定正確性、使用時的聽覺困難程度。綜合言之，植入人工電子耳的決定正確性、使用時的聽覺困難程度是最具預測力的變項。

關鍵字

人工電子耳；成人；心理社會效益；相關因素

並列摘要

Background: Cochlear implantation has demonstrated to improve the auditory performance of the recipients to a great extent; however, psychosocial benefits of adult recipients after implantation remained further investigated. Objective: The objective of this questionnaire survey was to investigate social and emotional benefits of 61 adults after cochlear implantation and also to analyze important factors to predict these outcomes. Methods: ”The psychosocial scale of adult recipients with CIs” was developed to measure the social/situation and emotional performance of adult recipients. With several statistical models, item analysis, internal consistency reliability, and factor analysis had been performed, this scale was verified to be a discriminative, reliable and valid instrument. Results: The results demonstrated that the majority of adults with CIs responded favorably to cochlear implantation in regard to these psychosocial benefits. However, the feeling of handicap continued to exist among recipients, specifically, under noisy environments. In addition, the individual variability of psychosocial performance was also demonstrated, and few recipients were not benefited from implantation. The predictive factors of these outcomes included fifteen variables to be analyzed, such as the implanted ear, duration of implant use, communication mode, rehabilitation training, and others. Among these variables, the importance of predictive valid factors regarding to the emotion domain were the assertiveness of implantation decision, the degree of auditory difficulty when using CIs, and the daily amount of time using CIs. In contrast, those of the predictive variables of the social/situation domain were the assertiveness of CI decision, the degree of auditory difficulty when using CIs, and the frequency of CI use. Overall, the predictive valid factors of the whole scale demonstrated the assertiveness of CI decision and the degree of auditory difficulty when using CIs. Conclusion: Above all, the assertiveness of CI decision and the degree of auditory difficulty when using CIs were two most valid factors to predict psychosocial benefits of those adult recipients with CIs in this survey.