老年失聰的聽覺復健模式

An Aural Rehabilitation Model for Older People with Hearing-impaired

劉俊榮(Chun-Jung Liu) ； 林鴻清(Hung-Ching Lin)

《台灣耳鼻喉頭頸外科雜誌》 41卷3期 (2006/06) Pp. 89-94

https://doi.org/10.6286/2006.41.3.89

摘要

本文首先說明台灣應建立具體可行的聽覺復健模式以因應老年失聰人口成長的挑戰，其次分析聽覺復健在「損傷」「失能」「障礙」等3種不同層次的工作要項，接著說明老年聽覺復健模式的實施，最後則展望聽覺復健的未來趨勢。
在老年失聰的議題方面，根據國內外現有資料推估，到民國140年時，每5名國民當中，就有1名是遭受聽力問題困擾的老人。聽力問題不僅是個人生理的問題，更重要的心理與行為、家庭與社會等多方面的影響，亟待聽覺復健工作來解決。聽覺「損傷」可以藉由外科手術、醫藥、助聽器以及人工電子耳等方式處理。聽覺「失能」的復健工作包括助聽器、聽覺輔助裝置、聽覺技巧、以及視聽覺溝通技巧等，而訓練、諮詢、心理輔導、環境調整、教育、政策與行政等方法則用以解決聽覺「障礙」的問題。一般性的聽覺復健模式包括準備、介入、追蹤等3個階段；準備階段的主要工作在統整個案資料，介入階段則是設計復健成份以因應個案的需求，追蹤階段觀察聽覺復健的成效。
展望未來聽覺復健有幾個趨勢：服務導向、問題解決導向、專業合作取向、團體復健取向、實證取向、以及績效導向等。

關鍵字

聽力損失 ； 老年 ； 聽覺復健

並列摘要

The first aim of this paper is to describe the establishment of an aural rehabilitation model for older hearing-impaired people in Taiwan and to describe how important this is. The second aim is to describe the different tasks associated with the different level of hearing loss, namely hearing impairment, hearing disability and hearing handicap. The third aim is to describe how aural rehabilitation can be implemented among older hearing-impaired people. Finally, we prospectively examine the future of aural rehabilitation. It is estimated that about 20% of the Taiwan population will suffer from age related hearing difficulties by 2051. There are many negative impacts the result from hearing difficulties and these include physiological, psychological, behavioral, family and social aspects. These must be solved by efficient aural rehabilitation. Hearing impairment can also be corrected by medical approaches, surgery, or hearing aids/cochlear implantation. Hearing disability should to be rehabilitated by the use of a personal hearing aid, by environmental hearing amplification, by skillful auditory perception and through total communication skills. A hearing handicap must be rehabilitated by psychological counseling, by the promotion of the family/home environment and, by enhancement of correct policies in education, regulation and administration. Generally, preparation, intervention and follow-up are the three essential stages of aural rehabilitation. Integration of the client's data forms the preparation stage. The designing of an individual aural rehabilitation strategy makes up the intervention stage. Finally, an analysis of the efficacy of the aural rehabilitation forms the follow-up stage. There are several prospective directions that aural rehabilitation may move towards in the future, including a service orientation, a problem solving-orientation, an integrated cooperation orientation, the use of group therapy, the use of evidence based therapy, and an outcome measure orientated approach.

並列關鍵字

hearing loss ； elderly ； aural rehabilitation