听力学家决策：助听器技术等级与听觉生态

文献信息

中文摘要

背景： 听力学家被期望采用循证实践来指导其决策实践以及针对每位患者特定助听器技术的推荐。然而，关于如何做出这些决策的指导有限，有时甚至相互矛盾。助听器制造商提倡这样一种观点，即个体的听觉生态——指其聆听需求和环境——可能导致特定技术结局和获益在患者间存在差异。围绕技术等级和听觉生态的有限且相互矛盾的证据如何影响听力学家的决策尚不清楚。
目的： 我们试图了解听力学家的决策实践，包括他们如何评估患者的听觉生态，并将此类评估结果应用于其决策。
研究设计： 向美国各地的听力学家发送了一份在线调查。该调查的21个问题涵盖受访者人口学特征、助听器选择过程、听觉生态的使用以及患者使用助听器的成功情况。
研究样本： 调查受访者为临床听力学家。共有185份完整调查纳入分析。
数据收集与分析： 对每个主题领域的结果进行描述性总结，并进行推断性研究。
结果： 大多数参与者报告，在选择技术等级时，患者的聆听需求和环境是最重要的考虑因素。评估患者听觉生态最常用的方法是临床访谈。大多数听力学家报告，对于生活方式更活跃的患者推荐更高等级的技术，对于生活方式更平静的患者推荐较低等级的技术。
结论： 听力学家报告，在选择技术等级时优先考虑听觉生态，并使用许多不同的方法，有时联合使用，来评估其患者的听觉生态。临床医生因素未影响听觉生态的使用或其推荐技术等级的方式。听觉生态的使用未影响退货/换货率。
临床相关性声明： 大多数听力学家已采用一种推荐模式，即对报告聆听环境和需求更严苛的患者鼓励使用更高等级的技术。需要更多研究，以更好地理解临床访谈的细微差别以及评估听觉生态的独特实践方法。

英文摘要

BACKGROUND: Audiologists are expected to use evidence-based practices to guide their decision-making practices and recommendations regarding specific hearing aid technology for each patient. However, guidance regarding how to make these decisions is limited and sometimes conflicting. Hearing aid manufacturers have promoted the idea that an individual's auditory ecology, which refers to their listening demands and environments, may contribute to interpatient differences in outcomes and benefits of specific technology. How the limited and conflicting evidence surrounding technology levels and auditory ecology impacts audiologists' decision-making is unknown.
PURPOSE: We sought to understand audiologists' decision-making practices, including how they assess patients' auditory ecologies and apply the results of such assessments to their decisions.
RESEARCH DESIGN: An online survey was sent to audiologists across the United States. The 21 survey questions covered respondent demographics, the hearing aid selection process, use of auditory ecology, and patients' success with hearing aids.
STUDY SAMPLE: Survey respondents were clinical audiologists. A total of 185 completed surveys were included in the analysis.
DATA COLLECTION AND ANALYSIS: The results of each topic area were summarized descriptively and investigated inferentially.
RESULTS: Most participants reported that a patient's listening demands and environments were the most important considerations when selecting the technology level. The most popular method of evaluating a patient's auditory ecology was a clinical interview. Most audiologists reported recommending higher-level technology for patients with more active lifestyles and lower-level technology for patients with calmer lifestyles.
CONCLUSIONS: Audiologists reported prioritizing auditory ecology when selecting a technology level and using many different methods, sometimes in combination, to evaluate the auditory ecology of their patients. Clinician factors did not impact the use of auditory ecology or how they recommended technology levels. The use of auditory ecology did not impact return/exchange rates.
CLINICAL RELEVANCE STATEMENT: Most audiologists have adopted a recommendation pattern of encouraging higher technology levels for patients who report more demanding listening environments and needs. More research is needed to gain a better understanding of the nuances of clinical interviews and unique practice approaches to evaluate auditory ecology.