【摘要】：背景:聽力障礙不僅影響聽力殘疾人的身心健康,同時也造成家庭和社會負擔加重等社會問題。而佩戴助聽器能幫助他們改善聽力,提高言語交往能力,減少他們參與社會生活的障礙,從而改善他們的生活。本文針對助聽器佩戴前后聽力殘疾人生存質量、照顧質量和殘疾態(tài)度的變化來開展相應的研究。目的:了解聽力殘疾人照顧質量、殘疾態(tài)度和生存質量現狀,通過照顧質量、殘疾態(tài)度與生存質量這三方面評價助聽器佩戴對聽力殘疾人的影響,分析助聽器佩戴前后照顧質量、殘疾態(tài)度和生存質量的關聯性,以期為聽力殘疾人照顧的提供,殘疾態(tài)度的改善和生存質量的提高提出有針對性的建議。方法:采用世界衛(wèi)生組織照顧質量量表、殘疾態(tài)度量表和生存質量量表調查杭州市4個區(qū)198名聽力殘疾人,通過單因素和多因素分析方法分析聽力殘疾人照顧質量、殘疾態(tài)度和生存質量的現狀并探索三者之間的相關性;通過回訪調查比較助聽器佩戴前后聽力殘疾人照顧質量、殘疾態(tài)度和生存質量的變化。結果:(1)杭州市聽力殘疾發(fā)生的原因主要包括藥物性、中耳炎、神經性、鼓膜穿孔、突發(fā)性和遺傳性等;(2)66.2%的聽力殘疾人認為自身的生存質量一般,生存質量的平均得分為64.17±9.30分,生理維度的得分最低,生存質量與心理維度的相關性最大(r=0.895);(3)照顧質量總分的平均分為54.07±8.68分,殘疾態(tài)度總分的平均分為50.46±7.48分;(4)照顧質量、殘疾態(tài)度與生存質量呈正相關(r=0.491,r=0.439),通徑分析結果顯示聽力殘疾人生存質量的主要影響因素為照顧環(huán)境、包容、照顧可及性和照顧給予;(5)共回訪195名聽力殘疾人,回訪率為98.5%,在過去1年中有44名未佩戴助聽器,151名佩戴助聽器,其中偶爾佩戴的有59人,經常佩戴的有92人;(6)聽力殘疾人佩戴助聽器后生存質量有所改善(t=2.041,P=0.043),主要是生理和心理維度得分較佩戴前高,殘疾態(tài)度也有改善(t=5.237,P0.001)且各維度得分較佩戴前高,聽力殘疾人照顧質量得分在助聽器佩戴前后沒有統計學差異(t=1.832,P=0.072);經常佩戴助聽器的人其生存質量和殘疾態(tài)度的改善比偶爾佩戴的好;(7)殘疾態(tài)度對佩戴助聽器后生存質量的影響較大(標準化偏回歸系數=0.357)。結論:(1)杭州市聽力殘疾人的照顧質量、殘疾態(tài)度和生存質量不高,生存質量與國外研究相比差距不大而與國內其他研究相比較低,照顧質量和殘疾態(tài)度相比于國內其他研究較低。(2)聽力殘疾人照顧質量、殘疾態(tài)度和生存質量存在正相關。為改善聽力殘疾人的生存質量,需要加強他們的健康管理,尤其是康復服務,并給予生活、工作或學習上的支持和照顧;同時也要關注其心理健康,幫助他們樹立積極的人生態(tài)度,用樂觀的心態(tài)面對殘疾帶來的困難。(3)助聽器佩戴后聽力殘疾人的生存質量和殘疾態(tài)度有所改善,說明助聽器的佩戴對兩者產生正性影響并且經常佩戴的人生存質量改善的效果更明顯。因此,對于未佩戴助聽器的殘疾人來說需要滿足他們對健康的需求,盡可能佩戴助聽器,并且需要提供完善的助聽器后續(xù)服務,幫助聽力殘疾人適應助聽器,發(fā)揮助聽器的作用,從而改善他們的生理健康,提高其生存質量。
[Abstract]:BACKGROUND: Hearing impairment not only affects the physical and mental health of hearing-impaired people, but also causes social problems such as family and social burdens. Wearing hearing aids can help them improve their hearing, improve their verbal communication ability, reduce their barriers to participating in social life, and thus improve their lives. Objective: To understand the status quo of care quality, disability attitude and quality of life of hearing-impaired people, and to evaluate the impact of hearing aids on hearing-impaired people from three aspects: care quality, disability attitude and quality of life. Methods: 198 hearing-impaired people in four districts of Hangzhou were investigated with the World Health Organization Care Quality Scale, Disability Attitude Scale and Quality of Life Scale. Results: (1) The main causes of hearing disability were found in Hangzhou city. Including medication, otitis media, nervousness, tympanic membrane perforation, sudden and hereditary; (2) 66.2% of hearing-impaired people thought their own quality of life was average, the average score of quality of life was 64.17 [9.30], physiological dimension was the lowest, and the correlation between quality of life and psychological dimension was the greatest (r = 0.895); (3) the average score of total quality of care was 5. The average score of disability attitude was 50.46+7.48; (4) Care quality, disability attitude and quality of life were positively correlated (r = 0.491, r = 0.439). Path analysis showed that the main influencing factors of the quality of life of hearing disabilities were care environment, tolerance, accessibility and care giving; (5) 195 hearing disabilities were interviewed and returned. The interview rate was 98.5%. In the past year, 44 of them did not wear hearing aids, 151 of them were wearing hearing aids, of which 59 were occasionally worn and 92 were frequently worn. (6) The quality of life of hearing-impaired people with hearing aids improved (t = 2.041, P = 0.043), mainly because the scores of physical and psychological dimensions were higher than those before wearing hearing aids, and their attitudes towards disability improved (t = 5.237, P 0.043). There was no significant difference in the scores of care quality of hearing-impaired people before and after wearing hearing aids (t = 1.832, P = 0.072); the improvement of quality of life and disability attitudes of people who often wear hearing aids were better than those who occasionally wear them; (7) disability attitudes had a greater impact on the quality of life after wearing hearing aids (standardized bias). The regression coefficient was 0.357. Conclusion: (1) The quality of care, disability attitudes and quality of life of hearing-impaired people in Hangzhou were not high. The quality of life of hearing-impaired people in Hangzhou was not much different from that of foreign studies, but lower than that of other domestic studies. The quality of care and disability attitudes were lower than those of other domestic studies. (2) The quality of care, disability attitudes and survival of hearing-impaired people in Hang In order to improve the quality of life of hearing-impaired people, it is necessary to strengthen their health management, especially rehabilitation services, and give them support and care in life, work or study. At the same time, it is also necessary to pay attention to their mental health, help them establish a positive attitude towards life and face the difficulties caused by disability with an optimistic attitude. The quality of life and disability attitudes of hearing-impaired people have improved after wearing hearing aids, indicating that wearing hearing aids has a positive effect on both of them and the effect of improving the quality of life of people who often wear hearing aids is more obvious. And it is necessary to provide perfect follow-up service of hearing aids to help hearing disabled people adapt to hearing aids and play the role of hearing aids, so as to improve their physical health and improve their quality of life.
【學位授予單位】：杭州師范大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R764

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