[[alternative]]Investigation of the factors associated with effectiveness resulting from the use of hearing aids by patients with hearing loss and tinnitus

[[abstract]]耳鳴意指沒有外來聲音的刺激下，感受到擾人的聲音。美國的耳鳴盛行率約3,000萬人或佔總人口數之10-15%。研究顯示在65-84歲年齡層約26.7%有耳鳴之經驗。聽力障礙者合併耳鳴症狀高達75至80%。為瞭解聽障者配戴助聽器對耳鳴的影響，本研究擬探討其改善成效知相關因子。本研究之對象為102年3月至11月之間，馬偕紀念醫院台北院區耳鼻喉科門診就醫，評估500、1000、2000及4000Hz之單側或雙側純音聽力閾值平均劣於40dBHL及優於91dBHL，聽力損失類型有傳導性、感音神經性和混合性，主訴有耳鳴症狀並且助聽器已配戴滿三個月。本研究之方法為採用問卷調查的方式，以瞭解各項因子與改善成效的相關性，使用助聽器對耳鳴改善成效調查問卷，耳鳴障礙量表 (Tinnitus Handicap Inventory)及中文版情境特質焦慮量表特質焦慮部分(State-Trait Anxiety Index-Trait)。以SPSS 19統計套裝軟體，進行資料建檔與描述性統計分析。所採用統計分析方法包括：卡方檢定、皮爾森相關係數、斯皮爾曼等級相關分析以及簡單線性迴歸分析做描述性與推論性統計法分析資料。本研究結果發現助聽器配戴時間長短和耳鳴改善狀況使用Pearson卡方檢定，顯著性值.027，斯皮爾曼積差相關係數.591 (p=.000)，達到中等程度正相關，以及線性迴歸顯示每天平均使用助聽器時間對於助聽器耳鳴改善狀況有27.2%的解釋力(p=.002)，該解釋力具有統計上顯著的意義；THI問卷與STAI-T問卷Pearson積差相關係數.633(p=.000)，達中等程度正相關。STAI-T問卷分數預測THI問卷分數具有43.9%的解釋力(F =25.065, p=.000)，該解釋力具有統計上顯著的意義。本研究結果顯示耳鳴合併聽力損失患者使用助聽器約有64.71%耳鳴症狀減緩，然而每日使用助聽器的時間越長改善成效越佳。透過STIA-T評估患者的焦慮程度，能夠有效預測THI程度，當STAI-T分數越高THI分數也越高。有助於未來研究使用THI和STAI-T篩選出高焦慮和耳鳴障礙程度嚴重的個案，是否需要合併進行其他耳鳴療法的參考。[[abstract]]Tinnitus can be described as the perception of sound in the absence of external acoustic stimulation. The size of the tinnitus population in the United States is nearly 30 million or about 10% of their entire population and the incidence of tinnitus are as high as 26.7% for people ages 65-84 years. Within that population, 75 to 80 percent of patients with hearing loss may experience tinnitus symptoms. In this study, patients with hearing loss and tinnitus are evaluated to distinguish factors associated with the effectiveness of hearing aid use. Thirty four subjects were recruited between March and November 2013, at Mackay Memorial Hospital ENT outpatient department. Pure tone thresholds were assessed at 500, 1000, 2000 and 4000 Hz. Subjects with pure tone loss between 40dBHL with less 91dBHL were included in the study. These subjects experienced tinnitus symptoms with the use of hearing aids for at least three months. The study utilized questionnaires to survey the factors associated with the effectiveness of hearing aids use by subjects with hearing loss and tinnitus. Subjects received both Tinnitus Handicap Inventory and the Chinese version of State-Trait Anxiety Index. The study also used the SPSS 19 statistical software packages for descriptive statistics. Statistical analysis methods used include Chi-square test, Pearson correlation coefficient, Spearman Rank Correlation and simple linear regression analysis.The Pearson chi-square test was used to determine correlation of the lengths of time in which the hearing aids were in use by subjects with tinnitus symptoms. The significance value of .027 and Spearman Rank Correlation of .591(p=.000) were observed. The moderately positive correlation and the linear regression analysis showed that the average daily time of use for tinnitus hearing aids improve the symptoms have an explanatory power of 27.2%(p=.002), an explanatory power of statistical significance; THI and STAI-T Pearson correlation coefficient analysis of .633(p=.000) were also observed, reaching a moderate positive correlation. STAI-T predict THI with 43.9% of the explanatory power, F=25.065, p=.000, the explanatory power of statistical significance.The results of this study suggested that among patients with hearing loss, with the use of hearing aids, about 65% may exhibit improvements of tinnitus. In addition, it was observed that a prolonged period of hearing aid use produces higher improvements. Through the use of STIA-T, patient anxiety levels are assessed to predict the validity extent of THI. It was found that the patients with higher STAI-T scores also consumed higher THI scores