将心理教育、声音暴露和心理咨询相结合的全新听力障碍疗法

IF 1.4 4区 医学 Q3 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY American Journal of Audiology Pub Date : 2024-09-03 Epub Date: 2024-05-20 DOI:10.1044/2024_AJA-23-00210
Sandrien Thieren, Paula van Dommelen, Michel R Benard
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引用次数: 0

摘要

目的:本研究旨在探讨一种新的认知声音暴露疗法(CSET)对听力亢进患者的短期和长期影响:方法:研究人员开发了一种新疗法,利用声音暴露,结合接受与承诺疗法和认知行为疗法中的呼吸和放松策略,来减轻听力障碍。研究对象包括转诊至荷兰亨格洛(Hengelo)和兹沃勒(Zwolle)言语和听力中心的患者,年龄≥ 18 岁,主诉为听力过强,无听力损失或听力损失轻微。患者在 2020 年 6 月至 2022 年 8 月期间接受了 CSET 治疗。治疗每两周进行一次。当暴露水平达到最大 70-80 dB SPL 时,疗程结束。治疗开始和结束之间的短期效果基于可忍受的声音暴露水平(分贝声压级)、听力障碍的主观程度以及使用听力障碍问卷(HQ)对声音的敏感度。长期效果以治疗结束 6 个月后的 HQ 为依据。线性混合效应和回归模型用于研究随时间变化的结果:本研究共纳入了 30 名患者,其中男性 15 人,女性 15 人,年龄在 24 岁至 76 岁之间。治疗期间的平均治疗次数为 6 次,介于 4 至 8 次之间。结果显示,从治疗开始到治疗结束,暴露水平有所提高(平均变化为 +23.7 dB,标差为 7.9,p < .001),对日常声音的敏感度有所下降(平均[标差]变化为-1.6 [2.1],p < .001),HQ 有所下降(平均[标差]变化为-9.8 [4.9],p < .001)。治疗结束后 6 个月,HQ 没有明显变化;平均(标清)变化为 0.2 (4.3),P = .81:对 CSET 的评估表明,听力障碍患者对声音的短期和长期敏感度均有所下降。此外,CSET 还显示出积极的影响,不仅对治疗过程中使用的声音有影响,而且还能将益处转移到日常声音中。将心理教育、声音暴露和咨询结合起来的结果很有希望,值得进一步评估。
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New Hyperacusis Therapy Combines Psychoeducation, Sound Exposure, and Counseling.

Purpose: The aim of this study was to investigate the short- and long-term effects of a new cognitive sound exposure therapy (CSET) in patients with hyperacusis.

Method: A new therapy was developed to reduce hyperacusis using sound exposure combined with breathing and relaxation strategies from both acceptance and commitment therapy and cognitive behavioral therapy. Patients who were referred to the Speech and Hearing Centers located in Hengelo and Zwolle in the Netherlands and aged ≥ 18 years with hyperacusis as main complaint and no or mild hearing loss were included in this study. Patients were seen for CSET between June 2020 and August 2022. The sessions took place biweekly. Sessions ended when exposure reached a level with a maximum of 70-80 dB SPL. Short-term effects between the start and the end of therapy were based on tolerable level of sound exposure (dB SPL), subjective-level hinderance of hyperacusis, and sensitivity to sound using the Hyperacusis Questionnaire (HQ). The long-term effect was based on HQ 6 months after the end of therapy. Linear mixed-effects and regression models were applied to study outcomes over time.

Results: In total, 30 patients, 15 men and 15 women, aged between 24 and 76 years were included in this study. The mean number of sessions during therapy was 6 and ranged between 4 and 8. Results showed an increase of exposure level (mean change was +23.7 dB with an SD of 7.9, p < .001), a decrease in sensitivity to daily sounds (mean [SD] change was -1.6 [2.1], p < .001), and a decrease in HQ (mean [SD] change was -9.8 [4.9], p < .001), between the start and the end of therapy. There was no significant change in HQ after the end of therapy and 6 months later; mean (SD) change was 0.2 (4.3), p = .81.

Conclusions: The evaluation of CSET indicated a decrease in short- and long-term sensitivity to sound in patients with hyperacusis. Additionally, CSET has shown a positive impact, not only for the sounds used in the therapy sessions but also in transferring benefits to everyday sounds. The results of combining psychoeducation, sound exposure, and counseling are promising and warrant further evaluation.

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来源期刊
American Journal of Audiology
American Journal of Audiology AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-OTORHINOLARYNGOLOGY
CiteScore
3.00
自引率
16.70%
发文量
163
审稿时长
>12 weeks
期刊介绍: Mission: AJA publishes peer-reviewed research and other scholarly articles pertaining to clinical audiology methods and issues, and serves as an outlet for discussion of related professional and educational issues and ideas. The journal is an international outlet for research on clinical research pertaining to screening, diagnosis, management and outcomes of hearing and balance disorders as well as the etiologies and characteristics of these disorders. The clinical orientation of the journal allows for the publication of reports on audiology as implemented nationally and internationally, including novel clinical procedures, approaches, and cases. AJA seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work. Scope: The broad field of clinical audiology, including audiologic/aural rehabilitation; balance and balance disorders; cultural and linguistic diversity; detection, diagnosis, prevention, habilitation, rehabilitation, and monitoring of hearing loss; hearing aids, cochlear implants, and hearing-assistive technology; hearing disorders; lifespan perspectives on auditory function; speech perception; and tinnitus.
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