听力残疾人佩戴助听器前后照顾质量、残疾态度和生存质量的调查研究

发布时间：2018-08-15 13:31

【摘要】：背景:听力障碍不仅影响听力残疾人的身心健康,同时也造成家庭和社会负担加重等社会问题。而佩戴助听器能帮助他们改善听力,提高言语交往能力,减少他们参与社会生活的障碍,从而改善他们的生活。本文针对助听器佩戴前后听力残疾人生存质量、照顾质量和残疾态度的变化来开展相应的研究。目的:了解听力残疾人照顾质量、残疾态度和生存质量现状,通过照顾质量、残疾态度与生存质量这三方面评价助听器佩戴对听力残疾人的影响,分析助听器佩戴前后照顾质量、残疾态度和生存质量的关联性,以期为听力残疾人照顾的提供,残疾态度的改善和生存质量的提高提出有针对性的建议。方法:采用世界卫生组织照顾质量量表、残疾态度量表和生存质量量表调查杭州市4个区198名听力残疾人,通过单因素和多因素分析方法分析听力残疾人照顾质量、残疾态度和生存质量的现状并探索三者之间的相关性;通过回访调查比较助听器佩戴前后听力残疾人照顾质量、残疾态度和生存质量的变化。结果:(1)杭州市听力残疾发生的原因主要包括药物性、中耳炎、神经性、鼓膜穿孔、突发性和遗传性等;(2)66.2%的听力残疾人认为自身的生存质量一般,生存质量的平均得分为64.17±9.30分,生理维度的得分最低,生存质量与心理维度的相关性最大(r=0.895);(3)照顾质量总分的平均分为54.07±8.68分,残疾态度总分的平均分为50.46±7.48分;(4)照顾质量、残疾态度与生存质量呈正相关(r=0.491,r=0.439),通径分析结果显示听力残疾人生存质量的主要影响因素为照顾环境、包容、照顾可及性和照顾给予;(5)共回访195名听力残疾人,回访率为98.5%,在过去1年中有44名未佩戴助听器,151名佩戴助听器,其中偶尔佩戴的有59人,经常佩戴的有92人;(6)听力残疾人佩戴助听器后生存质量有所改善(t=2.041,P=0.043),主要是生理和心理维度得分较佩戴前高,残疾态度也有改善(t=5.237,P0.001)且各维度得分较佩戴前高,听力残疾人照顾质量得分在助听器佩戴前后没有统计学差异(t=1.832,P=0.072);经常佩戴助听器的人其生存质量和残疾态度的改善比偶尔佩戴的好;(7)残疾态度对佩戴助听器后生存质量的影响较大(标准化偏回归系数=0.357)。结论:(1)杭州市听力残疾人的照顾质量、残疾态度和生存质量不高,生存质量与国外研究相比差距不大而与国内其他研究相比较低,照顾质量和残疾态度相比于国内其他研究较低。(2)听力残疾人照顾质量、残疾态度和生存质量存在正相关。为改善听力残疾人的生存质量,需要加强他们的健康管理,尤其是康复服务,并给予生活、工作或学习上的支持和照顾;同时也要关注其心理健康,帮助他们树立积极的人生态度,用乐观的心态面对残疾带来的困难。(3)助听器佩戴后听力残疾人的生存质量和残疾态度有所改善,说明助听器的佩戴对两者产生正性影响并且经常佩戴的人生存质量改善的效果更明显。因此,对于未佩戴助听器的残疾人来说需要满足他们对健康的需求,尽可能佩戴助听器,并且需要提供完善的助听器后续服务,帮助听力残疾人适应助听器,发挥助听器的作用,从而改善他们的生理健康,提高其生存质量。
[Abstract]:BACKGROUND: Hearing impairment not only affects the physical and mental health of hearing-impaired people, but also causes social problems such as family and social burdens. Wearing hearing aids can help them improve their hearing, improve their verbal communication ability, reduce their barriers to participating in social life, and thus improve their lives. Objective: To understand the status quo of care quality, disability attitude and quality of life of hearing-impaired people, and to evaluate the impact of hearing aids on hearing-impaired people from three aspects: care quality, disability attitude and quality of life. Methods: 198 hearing-impaired people in four districts of Hangzhou were investigated with the World Health Organization Care Quality Scale, Disability Attitude Scale and Quality of Life Scale. Results: (1) The main causes of hearing disability were found in Hangzhou city. Including medication, otitis media, nervousness, tympanic membrane perforation, sudden and hereditary; (2) 66.2% of hearing-impaired people thought their own quality of life was average, the average score of quality of life was 64.17 [9.30], physiological dimension was the lowest, and the correlation between quality of life and psychological dimension was the greatest (r = 0.895); (3) the average score of total quality of care was 5. The average score of disability attitude was 50.46+7.48; (4) Care quality, disability attitude and quality of life were positively correlated (r = 0.491, r = 0.439). Path analysis showed that the main influencing factors of the quality of life of hearing disabilities were care environment, tolerance, accessibility and care giving; (5) 195 hearing disabilities were interviewed and returned. The interview rate was 98.5%. In the past year, 44 of them did not wear hearing aids, 151 of them were wearing hearing aids, of which 59 were occasionally worn and 92 were frequently worn. (6) The quality of life of hearing-impaired people with hearing aids improved (t = 2.041, P = 0.043), mainly because the scores of physical and psychological dimensions were higher than those before wearing hearing aids, and their attitudes towards disability improved (t = 5.237, P 0.043). There was no significant difference in the scores of care quality of hearing-impaired people before and after wearing hearing aids (t = 1.832, P = 0.072); the improvement of quality of life and disability attitudes of people who often wear hearing aids were better than those who occasionally wear them; (7) disability attitudes had a greater impact on the quality of life after wearing hearing aids (standardized bias). The regression coefficient was 0.357. Conclusion: (1) The quality of care, disability attitudes and quality of life of hearing-impaired people in Hangzhou were not high. The quality of life of hearing-impaired people in Hangzhou was not much different from that of foreign studies, but lower than that of other domestic studies. The quality of care and disability attitudes were lower than those of other domestic studies. (2) The quality of care, disability attitudes and survival of hearing-impaired people in Hang In order to improve the quality of life of hearing-impaired people, it is necessary to strengthen their health management, especially rehabilitation services, and give them support and care in life, work or study. At the same time, it is also necessary to pay attention to their mental health, help them establish a positive attitude towards life and face the difficulties caused by disability with an optimistic attitude. The quality of life and disability attitudes of hearing-impaired people have improved after wearing hearing aids, indicating that wearing hearing aids has a positive effect on both of them and the effect of improving the quality of life of people who often wear hearing aids is more obvious. And it is necessary to provide perfect follow-up service of hearing aids to help hearing disabled people adapt to hearing aids and play the role of hearing aids, so as to improve their physical health and improve their quality of life.
【学位授予单位】：杭州师范大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R764

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