Personality, hearing problems, and amplification characteristics: Contributions to self-report hearing aid outcomes
Personality, hearing problems, and amplification characteristics: Contributions to self-report hearing aid outcomes
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DOI：
10.1097/aud.0b013e31803126a4
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发表时间：
2007-04-01
期刊：
影响因子：
3.7
通讯作者：
Gray, Ginger A.
中科院分区：
文献类型：
--
作者：
Cox, Robyn M.;Alexander, Genevieve C.;Gray, Ginger A.
目的：当我们评估助听器试戴的成功或新放大技术的有效性时，自我报告数据占据着至关重要的地位。除非患者报告说我们的努力是有帮助的，否则很难得出干预成功的结论。尽管一般认为主观报告主要反映了患者日常环境中配戴的助听器(S)的卓越之处，但评估这一假设有效性的研究相对较少。在以前的工作中，我们已经报告了服务交付环境(私人执业与公共卫生)对自我报告结果的一些贡献。本次调查的目的是评估患者变量(如个性和听力问题)和放大变量(如柔音可听度、增益和最大输出)对助听器配戴结果自我报告的相对贡献。设计：与11家听力学诊所合作，对205名患者进行横断面调查。所有受试者都是在寻找新助听器时被招募的。在佩戴助听器之前，进行了个性和反应偏差的测量，以及听力问题和对放大的期望的测量。在拟合时，测量了传统的验证数据，包括声场阈值、交谈的首选增益和最大输出。6个月后，完成了一套12个标准化的自我报告结果。分析涉及：(1)配戴助听器前的个性、反应偏差和听力问题自我报告之间的关系；(2)这些前兆变量和配戴验证数据与评估配戴助听器结果的自我报告数据之间的关联。结果：配戴前获得的听力问题、声音厌恶和助听器期望的自我报告与某些个性特征的强度的关系比听力损失更密切。回答偏差也与人格变量有关。对收集的结果衡量标准的分析产生了一套三个组成部分，它们被解释为设备组成部分、成功组成部分和验收组成部分。该装置部件被解释为反映助听器的特征，而另外两个部件被解释为反映佩戴者的属性。成功和接纳的每一个组成部分都与几个人格特质显著相关，但设备成分与人格无关。匹配前的变量占每个结果分量的20%到30%，而测量以验证匹配的放大变量只占一个分量的10%。结论：正如先前研究所报道的那样，个性与自我报告的结果数据有关。然而，如果从业者在预配阶段利用现有的听力问题测量方法，单独的个性数据将不会在预测长期配对结果方面产生额外的杠杆作用。在这项研究中测量的传统拟合验证数据，在预测拟合的长期结果方面被证明是最不有用的。自我报告拟合结果中的很大一部分差异尚未得到解释。最后，某些类型的问卷似乎更适合于评估新放大设备的研究，而不同的问卷方法可能更适合于评估临床背景下的干预效果。
Objective: When we evaluate the success of a hearing aid fitting, or the effectiveness of new amplification technology, self-report data occupy a position of critical importance. Unless patients report that our efforts are helpful, it is difficult to justify a conclusion that the intervention has been successful. Although it is generally assumed that subjective reports primarily reflect the excellence of the fitted hearing aid(s) within the context of the patient's everyday circumstances, there is relatively little research that assesses the validity of this assumption. In previous work, we have reported some contributions of the service delivery setting (private practice versus public health) to self-report outcomes. The purpose of the present investigation was to assess the relative contributions of patient variables (such as personality and hearing problems) and amplification variables (such as soft sound audibility, gain and maximum output) to self-reports of hearing aid fitting outcomes.Design: A cross-sectional survey of 205 patients was conducted with cooperation of eleven Audiology clinics. All subjects were recruited when they were seeking new hearing aids. Before the hearing aid fitting, measurements of personality and response bias were made, as well as measures of hearing problems and expectations about amplification. At the fitting, traditional verification data were measured including sound field thresholds, preferred gain for conversation, and maximum output. Six months after the fitting, a set of 12 standardized self-report outcomes was completed. Analyses concerned: (1) the associations among personality, response bias, and self-reports about hearing problems that are available before the hearing aid fitting, and (2) the associations of these precursor variables, and fitting verification data, with self-report data assessing the outcome of hearing aid provision.Results: Self-reports of hearing problems, sound aversiveness, and hearing aid expectations obtained before the fitting were found to be more closely related to the strength of certain personality traits than to audiometric hearing loss. Response bias also was associated with personality variables. Analyses of the collection of outcome measures produced a set of three components that were interpreted as a Device component, a Success component, and an Acceptance component. The Device component was construed as reflecting characteristics of the hearing aid whereas the two other components were construed as reflecting attributes of the wearer. The Success and Acceptance components were each significantly associated with several personality traits, but the Device component was not associated with personality. Variables available before the fitting accounted for 20 to 30% of each outcome component whereas amplification variables measured to verify the fitting accounted for only 10% on only one component.Conclusions: As reported in previous research, personality is associated with self-report outcome data. However, if practitioners utilize existing measures of hearing problems at the prefitting stage, separate personality data will not yield additional leverage in prediction of long-term fitting outcomes. Traditional fitting verification data as measured in this study, proved minimally useful in prediction of long-term outcomes of the fitting. A large proportion of variance in self-report fitting outcomes has yet to be accounted for. Finally, it appears that certain types of questionnaires might be more appropriate for research evaluating new amplification devices, whereas a different questionnaire approach might be optimal for evaluating intervention effectiveness in a clinical context.