Daily-Life Fatigue in Mild to Moderate Hearing Impairment: An Ecological Momentary Assessment Study.
Daily-Life Fatigue in Mild to Moderate Hearing Impairment: An Ecological Momentary Assessment Study.
复制标题
DOI：
10.1097/aud.0000000000000888
复制
发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
Naylor G
中科院分区：
文献类型：
--
作者：
Burke LA;Naylor G
先前的研究表明听力障碍（HI）和日常生活疲劳之间存在关联。然而，这种疲劳的时间和上下文相关性在很大程度上是未开发的。本研究使用生态瞬时评估（EMA）来检查（1）HI患者是否比听力正常的人更疲劳，（2）HI和听力正常（NH）的个体是否表现出相似的昼夜疲劳模式，（3）HI患者是否比NH对照组在具有挑战性的听力环境中花费更少的时间，以及（4）更具挑战性的听力情况是否与更疲劳相关，以及听力能力是否影响任何观察到的关联。在从分析中排除了22名自报疲劳健康状况的参与者后，参与者样本包括24名HI成人和20名NH成人，年龄为44至77岁（M = 65.4，SD = 7.5）。使用智能手机和市售EMA应用程序收集数据，该应用程序运行本研究指定的EMA方案。参与者每天回答六个智能手机调查，持续两周。“即时”问题要求参与者报告他们的听力情况，并在一天中的准随机时间点评估他们当前的疲劳程度（“瞬时疲劳”）。采用多水平模型对数据进行分析。听力组（HI与NH）与特质、日常和瞬间疲劳无关; HI和NH参与者全天都以相似的速度变得越来越疲劳。听力障碍的情况很少发生在HI和NH组。NH的参与者更有可能报告说，他们试图忽略的背景中有人在说话，但HI的参与者更有可能报告更多的背景发言者。人内听力情况和短暂疲劳之间没有发现任何关联，但人的平均听力活动和会话状态与短暂疲劳有关。值得注意的是，在控制了其他协变量后，耳鸣与短暂的疲劳呈正相关。最后，有一个疲劳的健康状况是一个强有力的预测特质和短暂的疲劳。这是第一项使用EMA探索和比较HI和NH组疲劳的研究。与预期相反，这些小组表现出相似的疲劳水平和昼夜模式，疲劳大多与听力环境无关。人与人之间的差异，虽然具有统计学意义，但产生的效应量很小，因此必须谨慎接受。与组匹配，疲劳的测量和感知听力相关的困难与NH的参与者之间的问题是显着的局限性。然而，这项研究为EMA和听力研究做出了新的贡献，并证明了筛查疲劳健康状况的重要性。进一步的研究是必要的，特别是与更严重的HI的个人。
Previous research has indicated an association between hearing impairment (HI) and daily-life fatigue. However, the temporal and contextual correlates of such fatigue are largely unexplored. The present study used ecological momentary assessment (EMA) to examine (1) whether people with HI are more fatigued than people with normal hearing, (2) whether individuals with HI and normal hearing (NH) show similar diurnal patterns of fatigue, (3) whether people with HI spend less time in challenging listening situations compared with NH controls, and (4) whether more challenging listening situations are associated with more fatigue and whether hearing ability influences any observed association. After excluding 22 participants with self-reported fatiguing health conditions from analyses, the participant sample consisted of 24 adults with HI and 20 adults with NH, aged 44 to 77 years (M = 65.4, SD = 7.5). Data were collected using smartphones and a commercially available EMA app, which ran the specified EMA protocol for this study. Participants responded to six smartphone surveys per day for two weeks. “In-the-moment” questions asked participants to report on their listening situation and to rate their current level of fatigue (“momentary fatigue”) at quasi-random time points throughout the day. Data were analyzed using multilevel modeling. Hearing group (HI versus NH) was unrelated to trait, daily, and momentary fatigue; both participants with HI and NH became increasingly fatigued throughout the day and at a similar rate. Challenging listening situations occurred infrequently both for HI and NH groups. Participants with NH were more likely to report that there were people speaking in the background whom they were trying to ignore, but participants with HI were more likely to report a greater number of background speakers. No associations were found between within-person listening situations and momentary fatigue, but person-mean listening activity and conversational status were related to momentary fatigue. Notably, having tinnitus was positively related to momentary fatigue, after controlling for other covariates. Finally, having a fatiguing health condition was a strong predictor of both trait and momentary fatigue. This is the first study to explore and compare fatigue across HI and NH groups using EMA. Contrary to expectations, the groups showed similar levels and diurnal patterns of fatigue, and fatigue was mostly unrelated to aspects of the listening environment. Between-person differences, although statistically significant, produced small effect sizes and therefore must be accepted cautiously. Issues with group matching, the measurement of fatigue, and perceived hearing-related difficulties among participants with NH are notable limitations. However, this study makes a novel contribution to both EMA and hearing research and demonstrates the importance of screening for fatiguing health conditions. Further research is warranted, particularly with individuals with more severe HI.