老年聽覺損傷者的復健需求及其參與限制

Understanding the Needs and Constraints on Participation in Aural Rehabilitation for the Elderly with Hearing Impairments

台灣人口老齡化、高齡化逐年加深，老年聽損的出現率隨著年齡層提高而增加，年長者的聽覺敏感度也隨著年齡增加而下降。聽損長者需要聽覺復健的介入，以協助其解決聽損對生命的廣泛衝擊。然而老年人對聽覺復健的需求並未得到重視，且其參與復健的限制因素也不明朗，因此本研究採用問卷調查法以探究此問題。本研究有效問卷170份，填答者均為聽閾超過55分貝(dB HL)而曾經向台中市政府申請助聽器補助者，年齡介於57到97歲之間，平均75.63歲。調查結果顯示：這些曾經選配助聽器的年長者，對於助聽器效益、溝通滿意度的評估都只在中等程度，每天使用助聽器的時間為6.24小時，顯示助聽器選配工程仍有進步的空間。此外，填答者的家人對於聽力損失的現象並不清楚，未來有需要將聽損者的重要他人納入聽覺復健方案當中，以協助彼此的瞭解與互動。在復健需求方面，有超過三分之二的聽損長者表達對於聽力保健、聽力知識的需要，而需要教導輔具使用、瞭解政府補助者也都各有二分之一；溝通技巧的需求較少，但方案設計者宜確認聽損長者對於溝通技巧是否真能掌握，以避免其對溝通技巧的後設認知不足。當有合適且免費的復健方案可以參加時，有43.53%的填答者願意參加，顯示除了助聽器外，聽損長者希望能得到更多的復健；需要更多資訊才能決定是否參加者有33.53%，而沒有意願參與復健方案者有22.94%。填答有參與限制者，其限制因素由多到少依序為個體內在因素、結構因素、以及人際因素，這些因素當中，健康、交通與時間問題是最多人反應的參與限制。

The number of elderly people is growing steadily. With increasing age， the prevalence of hearing impairment increases significantly and the hearing sensitivity decreases. The rehabilitation for the elderly with hearing impairments can decrease the negative impacts of hearing loss. Nevertheless， the rehabilitation needs of the elderly are not paid sufficient attention. Besides， the constraints for their participation in rehabilitation are not clear. Hence， the purposes of this study were to explore these issues by questionnaire. One hundred and seventy participates (age range 57-97years， mean age 75.63 years) with hearing impairments over 55 dB HL completed questionnaire. The participants had to be aged 55 years or older and ever applied for a hearing aids allowance. The results showed that the average using time of hearing aids was 6.24 hours and that the benefits hearing aids brought for the participants and their communication satisfactions were only rated as medium. Their significant others of were not clear for hearing loss. Two-thirds of the participants expressed their rehabilitation needs of hearing care and relevant knowledge. In addition， half of the participants needed instructions of using hearing devices and the allowances of government. Relatively， there was less need for communication skills. Of all the participants， 43.53% showed willingness to attend free and appropriate aural rehabilitation programs. The participants who had a hearing aid wanted more rehabilitation. Of all the participants， 33.53% needed more information to decide whether to participate in rehabilitation programs， and 22.94% were not willing to participate in rehabilitation programs. The constraint factors for participating in aural rehabilitation programs were intrapersonal， structural， and interpersonal in a descending order. The problems of poor health， lack of transportation and time were raised most frequently.