Preference for one or two hearing AIDS among adult patients.
Preference for one or two hearing AIDS among adult patients.
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DOI：
10.1097/aud.0b013e3181f8bf6c
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发表时间：
2011-03
期刊：
影响因子：
3.7
通讯作者：
Alexander GC
中科院分区：
文献类型：
--
作者：
Cox RM;Schwartz KS;Noe CM;Alexander GC
大多数从业者认为，使用双助听器是理想的适合成人双侧对称性听力损失。然而，先前的研究一致表明，这些患者中有很大一部分实际上更喜欢只使用一种助听器。目前的研究探讨了这种偏好模式是否会在技术先进的助听器上出现。此外，选择的变量，可用的预拟被用来试图预测哪些患者会更喜欢一个助听器而不是两个。该研究设计为为期12周的现场试验，包括结构化和非结构化使用一种和两种助听器。94例轻度至中度双侧对称性听力损失的受试者双侧配戴2005-2007年时代的助听器。潜在的预测因素包括人口统计学、听力测量、听觉生活方式、个性和双耳处理变量。现场试验结束后，每位受试者陈述自己对一种或两种助听器的偏好，并完成三份自我报告结果问卷。先前的研究证实了现代技术助听器：在现场试验后，46%的受试者更喜欢使用一种助听器而不是两种。偏爱两种助听器的受试者往往比偏爱一种助听器的受试者报告更好的实际结果。日常生活中听力问题较多、双耳响度总和较多、双耳听力相近的受试者更倾向于使用两种助听器。与传统观点（通常被认为是正确的观点）相反，听力损失和听觉生活方式并不能预测助听器偏好。然而，从这些数据中得出的最佳预测方法只能对三分之二的受试者做出准确的预测。循证实践要求对现有证据、临床判断和患者偏好进行认真的融合。这项研究的结果挑战从业者认识到，许多患者似乎是理想的候选人双侧助听器实际上更喜欢只戴一个助听器。此外，目前还没有一种准确的方法来预测哪些患者更喜欢一种助听器而不是两种助听器。目前，对从业人员开放的最有效的方法是进行公正、无偏见的系统现场试验，允许每个患者在日常生活中比较单侧和双侧安装。这可能需要更多的合适的会议，可能会增加从业者的负担。这种不利因素应该与额外的患者满意度相权衡，这是由于合适方案的透明度、在治疗决策中与患者的合作以及选择最具成本效益的以患者为中心的解决方案的知识所带来的。
Most practitioners believe that use of two hearing aids is the ideal fitting for adults with bilateral symmetrical hearing loss. However, previous research has consistently shown that a substantial proportion of these patients actually prefer to use only one hearing aid. The current study explored whether this pattern of preferences is seen with technologically advanced hearing aids. In addition, a selection of variables that were available pre-fitting were used to attempt to predict which patients will prefer one hearing aid rather than two. The study was designed as a 12-week field trial including structured and unstructured use of one and two hearing aids. Ninety-four subjects with mild to moderate bilaterally symmetrical hearing loss were bilaterally fit with 2005-2007 era hearing aids. Potential predictors included demographic, audiometric, auditory lifestyle, personality, and binaural processing variables. After the field trial, each subject stated his/her preference for one or two hearing aids and completed three self-report outcome questionnaires for their preferred fitting. Previous research was confirmed with modern technology hearing aids: after the field trial 46% of the subjects preferred to use one hearing aid rather than two. Subjects who preferred two hearing aids tended to report better real-world outcomes than those who preferred one. Subjects who reported more hearing problems in daily life, who experienced more binaural loudness summation, and whose ears were more equivalent in dichotic listening were more likely to prefer to use two hearing aids. Contrary to conventional wisdom (ideas that are generally accepted as true), audiometric hearing loss and auditory lifestyle were not predictive of aiding preference. However, the best predictive approach from these data yielded accurate predictions for only two-thirds of subjects. Evidence-based practice calls for a conscientious melding of current evidence, clinical judgment, and patient preferences. The results of this research challenge practitioners to recognize that many patients who appear to be ideal candidates for bilateral aiding will actually prefer to wear only one hearing aid. Further, at this time there is not an accurate method that will predict which patients will prefer one hearing aid rather than two. Currently, the most effective approach open to practitioners would be to conduct a candid unbiased systematic field trial allowing each patient to compare unilateral and bilateral fittings in daily life. This might necessitate more fitting sessions and could perhaps add to the practitioner's burden. This downside should be weighed against the additional patient satisfaction that can be anticipated as a result of transparency in the fitting protocol, collaboration with the patient in the treatment decisions, and the knowledge of selecting the most cost-effective patient-centered solution.