Expectations, prefitting counseling, and hearing aid outcome.
Expectations, prefitting counseling, and hearing aid outcome.
复制标题
期望、预验咨询和助听器结果。
DOI：
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发表时间：
2009
期刊：
影响因子：
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通讯作者：
Anna Forsline
中科院分区：
文献类型：
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作者：
Gabrielle H. Saunders;M Samantha Lewis;Anna Forsline
背景
数据表明，对助听器抱有较高期望会带来更好的总体效果。然而，一些人推测过高的期望会导致失望，从而产生不良结果。有人提出，在佩戴助听器之前对抱有不切实际期望的患者进行咨询可能是有益的。然而，就期望的改变和最终结果而言，关于这种咨询的有效性，数据是复杂的。
目的
本研究的主要目的是确定在佩戴前咨询中增加现实生活听力演示是否能够（1）改变新助听器使用者的期望，以及（2）提高相较于仅口头咨询的满意度。研究的次要目标是检验（1）佩戴前期望与佩戴后结果之间的关系，以及（2）助听器微调对助听器效果的影响。
研究设计
60名新的助听器使用者双耳佩戴了贝尔通奥里亚耳背式数字助听器。40名参与者接受了佩戴前咨询以及使用贝尔通音频验证环境（AVE）系统进行的听力情况演示；20名参与者接受了佩戴前咨询但没有听力情况演示。在初次接触时以及佩戴前咨询之后测量助听器期望。在使用助听器8到10周后测量所报告的助听器效果。
研究样本
60名年龄在55到81岁之间、患有对称性感音神经性听力损失的新助听器使用者。
干预措施
参与者被随机分配到三个实验组中的一个，不同组的佩戴前咨询和后续措施有所不同：第1组接受佩戴前咨询以及听力情况演示。此外，如果参与者在后续随访时对音质有抱怨，使用贝尔通AVE系统对助听器进行微调。第2组接受佩戴前咨询以及使用贝尔通AVE系统进行的听力情况演示，但在后续随访时不进行微调。第3组接受不包括听力演示的佩戴前助听器咨询，并且在后续随访预约时不对助听器进行微调。
结果
结果表明，佩戴前助听器咨询对期望有微小但显著的影响。两种咨询形式在改变期望的有效性方面没有差异；然而，从许多参与者的反馈中我们了解到，他们喜欢听听力演示，并且觉得这是一种有趣的听力练习。数据还表明，积极的期望会带来更积极的结果，并且助听器微调对使用者有益。
结论
我们得出结论，佩戴前咨询对助听器效果可能是有利的，并建议增加佩戴前咨询以解决与生活质量和自我形象相关的期望问题。数据强调在谨慎佩戴助听器之前解决不切实际期望的必要性，以免将期望降低到使患者气馁和失去动力的程度。数据还表明，对助听器将对心理社会健康产生的影响抱有积极期望对于成功的助听器效果是重要的。
BACKGROUND
Data suggest that having high expectations about hearing aids results in better overall outcome. However, some have postulated that excessively high expectations will result in disappointment and thus poor outcome. It has been suggested that counseling patients with unrealistic expectations about hearing aids prior to fitting may be beneficial. Data, however, are mixed as to the effectiveness of such counseling, in terms of both changes in expectations and final outcome.
PURPOSE
The primary purpose of this study was to determine whether supplementing prefitting counseling with demonstration of real-world listening can (1) alter expectations of new hearing aid users and (2) increase satisfaction over verbal-only counseling. Secondary goals of the study were to examine (1) the relationship between prefitting expectations and postfitting outcome, and (2) the effect of hearing aid fine-tuning on hearing aid outcome.
RESEARCH DESIGN
Sixty new hearing aid users were fitted binaurally with Beltone Oria behind-the-ear digital hearing aids. Forty participants received prefitting counseling and demonstration of listening situations with the Beltone AVE (Audio Verification Environment) system; 20 received prefitting counseling without a demonstration of listening situations. Hearing aid expectations were measured at initial contact and following prefitting counseling. Reported hearing aid outcome was measured after eight to ten weeks of hearing aid use.
STUDY SAMPLE
Sixty new hearing aid users aged between 55 and 81 years with symmetrical sensorineural hearing loss.
INTERVENTION
Participants were randomly assigned to one of three experimental groups, between which the prefitting counseling and follow-up differed: Group 1 received prefitting counseling in combination with demonstration of listening situations. Additionally, if the participant had complaints about sound quality at the follow-up visit, the hearing aids were fine-tuned using the Beltone AVE system. Group 2 received prefitting counseling in combination with demonstration of listening situations with the Beltone AVE system, but no fine-tuning was provided at follow-up. Group 3 received prefitting hearing aid counseling that did not include demonstration of listening, and the hearing aids were not fine-tuned at the follow-up appointment.
RESULTS
The results showed that prefitting hearing aid counseling had small but significant effects on expectations. The two forms of counseling did not differ in their effectiveness at changing expectations; however, anecdotally, we learned from many participants that that they enjoyed listening to the auditory demonstrations and that they found them to be an interesting listening exercise. The data also show that positive expectations result in more positive outcome and that hearing aid fine-tuning is beneficial to the user.
CONCLUSIONS
We conclude that prefitting counseling can be advantageous to hearing aid outcome and recommend the addition of prefitting counseling to address expectations associated with quality of life and self-image. The data emphasize the need to address unrealistic expectations prior to fitting hearing aids cautiously, so as not to decrease expectations to the extent of discouraging and demotivating the patient. Data also show that positive expectations regarding the impact hearing aids will have on psychosocial well-being are important for successful hearing aid outcome.