言语、空间与听觉质量量表在老年听力损失者助听器验配中的应用

Application of Speech,Spatial and Qualities of Hearing Scale in Hearing Aid Fitting for the Elderly

目的探讨言语、空间与听觉质量量表(speech,spatial and qualities of hearing scale,SSQ)用于老年听力损失患者佩戴助听器的效果评估作用。方法以100例老年感音神经性听力损失者(60~90岁)为研究对象,采用横断面研究和前瞻性研究,其中,无助听器使用经验者44例(75.8±8.1岁,气导纯音平均听阈59.8±13.3 dB HL)、有助听器使用经验者34例(77.5±6.3岁,气导纯音平均听阈64.5±17.8 dB HL,助听器佩戴时间大于三个月)进行横断面研究;22例(74.3±8.6岁,气导纯音平均听阈58.1±12.6 dB HL)首次配戴助听器者进行前瞻性研究;二组参与横断面研究者进行一次SSQ评估,前瞻性研究组分别在助听前和佩戴助听器1个月后进行二次SSQ评估,均采用面对面问答方式用SSQ量表评估三组受试者在言语理解能力、空间定位能力和声音聆听质量方面的变化。结果横断面研究结果显示,有助听经验组SSQ问卷言语理解(97.29±23.43分)、空间听觉(131.94±19.27分)、声音质量(143.53±20.31分)和总分(372.76±51.92分)均显著高于无助听经验组(分别为58.66±30.13、99.41±37.09、108.09±43.28、266.16±78.18分)。前瞻性研究结果显示,受试者初次佩戴助听器一个月后的SSQ问卷言语理解(106.27±13.86分)、空间听觉(136.00±14.09分)、声音质量(151.73±13.91分)和总分(394.00±34.70分)均显著高于佩戴助听器前(分别为65.64±21.89、115.09±17.17、111.91±25.41、292.64±45.58分),横断面研究和前瞻性研究结果均显示,老年听力损失患者佩戴助听器后在言语理解能力、空间声源定位能力和声音聆听质量方面均有显著改善(P<0.05)。结论SSQ量表可以有效评估老年听力损失患者助听器使用效果;老年听力损失患者佩戴助听器后在言语理解能力、空间定位能力和声音聆听质量方面均有显著提高。

Objective To evaluate the outcome of hearing aids in the hearing impaired elderlys using speech,spatial and quality of hearing scale(SSQ).Methods A total of 106 sensorineural hearing impaired patients(aged 60~90 years)were studied by means of a cross-sectional study and a prospective study.In the cross-sectional study,SSQ questionnaire was used to evaluate the differences in speech comprehension,spatial positioning and sound listening quality between the elderly hearing loss patients without hearing aids(44 cases,75.8±8.1 years old,0.5~4 kHz PTA 59.8±13.3 dB HL)and those with hearing aid experience(34 cases,77.5±6.3 years old,PTA 64.5±17.8 dB HL,the use time of hearing aid was more than three months).In a prospective study,22 patients(74.3±8.6 years old,PTA 58.1±12.6 dB HL)with hearing loss were followed up in terms of speech comprehension ability,spatial positioning ability and sound listening quality after using hearing aids for one month.The score of SSQ scale was then statistically analyzed by SPSS.Results The results of the cross-sectional study showed that the scores of SSQ questionnaire(speech-hearing items 97.29±23.43 points,spatial hearing items 131.94±19.27 points,qualities of hearing items 143.53±20.31 points,total score 372.76±51.92 points)in the group with history of hearing aids were significantly higher than those in the group without history of hearing aids(speech-hearing items 58.66±30.13 points,spatial hearing items 99.41±37.09 points,qualities of hearing items 108.09±43.28 points,total score 266.16±78.18 points).The prospective results showed that the scores of SSQ questionnaire(speech-hearing items 106.27±13.86 points,spatial hearing items 136.00±14.09 points,qualities of hearing items 151.73±13.91 points,total score 394.00±34.70 points)were significantly higher one month after the initial wearing of hearing aids(speech-hearing items 65.64±21.89 points,spatial hearing items 115.09±17.17 points,qualities of hearing items 111.91±25.41 points,total score 292.64±45.58 points).The results of cross-sectional study and prospective study both showed that with the hearing aids experiences,the elderly hearing-impaired patients had a significant improvement in speech comprehension,spatial sound source localization and sound listening quality.Conclusion The SSQ scale can be used to evaluate the outcomes of hearing aid fitting in the ability of spatial sound source locatization and sound listening quality for the elderly.The SSQ scale can be used as a useful supplement to other hearing aid effect evaluation questionnaires in clinical applications.