心理因素对成人耳蜗植入者舒适阈的影响

The Effects of Psychological Factors on Comfortable Levels for Adult Cochlear Implants

目的探讨心理因素对成人耳蜗植入者舒适阈的影响,为成人耳蜗植入者舒适阈的设定提供参考。方法采用症状自评量表(SCL-90)对61例成人耳蜗植入者心理健康状态进行评分,并与国内常模进行比较,得分越高,症状越重,则心理健康状况不佳。按评分结果将耳蜗植入者分为心理健康状况良好组(45例)和心理健康状况不佳组(16例),观察两组开机后1、3和6个月时舒适阈的变化。结果成人耳蜗植入者焦虑、恐怖、偏执和精神病性四个因子得分均高于国内常模组(P<0.05)。心理健康状况良好组在开机后1、3和6个月时舒适阈比值分别为1.39±0.43、1.62±0.49、1.79±0.60,差异有统计学意义(P<0.05)。心理健康状况不佳组在开机后1、3和6个月时舒适阈比值分别为1.14±0.35、1.36±0.51、1.39±0.43,差异无统计学意义(P>0.05)。结论随开机时间延长,心理健康状况良好的成人耳蜗植入者的舒适阈显著增高,心理健康状况不佳者舒适阈缓慢增高。心理因素对舒适阈有影响,调试时要尽可能减少心理因素对测试的影响,以得到较为准确的舒适阈值。

Objective To explore the effects of psychological factors on comfortable levels for adult cochlear im- plants and to provide the basic mapping data for them. Methods The self--report symptom inventory（SCL--90） was used to evaluate the mental health status of 61 adult cochlear implants, and the resucts were compared with the domestic norms. The patients were divided into two groups according to the assessment results： the good mental health group and the poor mental health group. To observe the changes of comfortable levels at the time of 1 month, 3 months, 6 months after switch --on. Results There were significant differences between adult cochlear implants and domestic norms in four factors of SCL-90 （P〈0.05）, including anxiety, terror, crankiness and psychosis. The comfortable levels ratio of good mental health group at the time of 1 month,3 months,6 months after switch--on were= 1.39±0.43,1.62±0.49,1.79±0.60. There were significantly difference（P〈0.05）. The comfortable levels ratio of poor mental health group at the time of 1 month,3 months,6 months after switch--on were.. 1.14±0.35,1.36±0.51,1.39±0.43,with no significantly difference （P〉0. 05）. Conclusion The comfortable levels of good mental health group significantly increased with the time after switch--on. The comfortable levels of poor mental health group gradually increased with the time after switch--on. The psychological factors could affect the changes of comfortable levels, so that there was need to minimize the effect of psycho- logical factors on the test in mapping to obtain more accurate comfortable levels.