突发性耳聋学龄前患儿治疗性游戏的设计与实践

Design and application of therapeutic games for preschool children with sudden sensorineural hearing loss

目的探讨突发性耳聋学龄前患儿治疗性游戏方案的设计方法及实践效果。方法评估突发性耳聋学龄前患儿心理特点及护理需求,查阅相关研究,设计包括声音感知及听觉原理的健康宣教、心理诱导及信念树立、听觉刺激及听觉唤醒、听力训练及音感培养等要素的治疗性游戏方案,并在83例患儿中实施。用问卷调查家长、患儿及护士对治疗性游戏的认可度,并收集反馈意见。结果 83例突发性耳聋患儿均按计划完成游戏。家长、患儿及护士对治疗性游戏综合认可度分别为95%(79/83)、98%(81/83)和80%(4/5);90%(37/41)的反馈家长希望增加突发性耳聋的预防知识;5名护士均反馈双侧耳聋及重度耳聋患儿游戏中反应明显较其他患儿滞后,建议单独组织游戏或者佩戴助听器。结论治疗性游戏具有较高的科学性和可行性,得到家长、患儿及护士的认可。但在不同耳聋程度患儿分层干预、游戏延续性效应、持续发展方面仍需完善。

Objective To explore the effects of the therapeutic games for preschool children with sudden sensorineural hearing loss(SSNHL). Methods We completely assessed the psychological characteristics and care needs of the preschool children with SSNHL. We designed the multi-dimensional therapeutic games based on the assessment we conducted and literature review. Those therapeutic games included health education of the voice perception and auditory principles,psychological induction and confidence building,auditory stimulation and auditory arousal,and hearing and phonological training. Totally 83 preschool children took part in the therapeutic games.The game acceptance by preschool children,their parents,and research nurses were investigated. Results All 83 children with SSNHL completed the game as planned. The game acceptance rate by parents,children and research nurses was 95%(79/83),98%(81/83)and 80%(4/5)respectively. It was showed that 90% of the parents wanted the prevention knowledge of SSNHL. Five research nurses reported that the response of children with bilateral deafness and severe deafness in games was obviously slower than other children. Hearing aids and individual game were suggested. Conclusion Therapeutic games are scientific and feasible. Preschool children,parents,and research nurses highly accept the games. However,the games still need to be improved regarding the stratified intervention,games continuing effects and games sustainable development.