突发性耳聋并发耳鸣患者疾病不确定感影响因素及循证干预措施分析

Analysis of Factors Influencing Disease Uncertainty and Evidence-based Interventions in Patients with Sudden Deafness Complicated by Tinnitus

目的:探讨突发性耳聋并发耳鸣患者疾病不确定感影响因素及循证干预措施。方法:按照随机数表,选取天津医科大学第二医院2018年3月-2020年10月收治的130例突发性耳聋并发耳鸣患者作为研究对象,对所有对象发放健康状况问卷调查表,分析总结突发性耳聋并发耳鸣患者疾病不确定感影响因素,并对循证干预措施展开进一步研究。结果:婚姻状况、文化程度、听力损失程度、耳鸣等级主观分级是突发性耳聋并发耳鸣患者疾病不确定感主要影响因素,差异有统计学意义(t=1.966、1.711、10.080、2.760,P<0.05)。文化程度(初中以下)、听力受损程度(中度、中度、极重度)、耳鸣等级主观分级(3、4、5级)均为突发性耳聋并发耳鸣危险因素。循证干预后汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分均低于循证干预前,生活质量量表(SF-36)评分高于循证干预前,差异有统计学意义(t=1.447、4.351、1.872,P<0.05)。循证干预后,轻度、中度、重度及极重度听力损失程度均有所改善。结论:突发性耳聋并发耳鸣患者疾病不确定感受多因素影响,循证干预措施可提高患者治疗依从性。

Objective:To explore the influencing factors of disease uncertainty and evidence-based intervention measures in patients with sudden deafness and tinnitus.Methods:According to the random unmber table assignment method,130 patients with sudden deafness complicated by tinnitus admitted to the hospital from March 2018 to October 2020 were selected as study subjects.Health status questionnaires were administered to all subjects.The factors influencing the uncertainty of disease in patients with sudden deafness complicated by tinnitus were analyzed and summarized,and further research on evidence-based interventions was conducted.Results:Marital status,literacy,degree of hearing loss,and subjective grading of tinnitus grade were the main influencing factors of disease uncertainty in patients with sudden deafness complicated by tinnitus,with statistically significant differences(t=1.966,1.711,10.080,2.760,P<0.05).Education level(below junior high school),degree of hearing impairment(moderate,moderate,very severe),and subjective grading of tinnitus level(3,4,5)were all risk factors for sudden deafness complicated by tinnitus.After the evidence-based intervention,HAMA and HAMD scores were lower than before the evidence-based intervention,and SF-36 scores were higher than before the evidence-based intervention,with statistically significant differences(t=1.447,4.351,1.872,P<0.05).The degree of mild,moderate,severe and very severe hearing loss improved after the evidence-based intervention.Conclusion:The uncertainty of disease in patients with sudden deafness complicated by tinnitus is felt as a multifactorial influence,and evidence-based interventions may promote patient adherence to treatment.