臺灣博碩士論文加值系統

本研究旨在探討助聽器使用者不再使用助聽器的原因及助聽器使用與否和背景變項之相關，並且探討不再使用者與持續使用者的助聽器滿意度之差異，及助聽器滿意度問卷中不滿意評比與不使用助聽器原因的符合程度，最後並根據研究結果提出具體建議，以供聽力學專業人員及助聽器公司參考。
本研究採以自編問卷「不再使用助聽器的原因」及羅意琪(民94)所編製的「助聽器滿意度量表」為研究工具，針對不再使用助聽器及持續使用助聽器各30人，進行調查，研究結果摘述如下：
一.助聽器是否會繼續使用有關聯的三個背景變項是「是否初次使用」、「是否得到補助」與「優耳聽損程度」，不再使用組初次使用助聽器的比例較高、得到補助的比例較低及優耳聽損程度較輕，其餘基本變項包括性別、教育程度、個人月收入、助聽器樣式與類型皆沒有關聯，而不再使用組與持續使用組的年齡和自我感知聽覺障礙程度也沒有差異。
二.不再使用助聽器的原因，有6.6%的個案圈選單項，90%的個案則是綜合多項原因 (2至19個不等)，並且不使用的原因圈選越多，滿意度越低(p < .001)。就類別因素排序依次是「效益因素」、「選配人員因素」、「操作因素」、「個人因素」與「費用因素」。就單項原因排序，前10項依序是「因為助聽器放大背景噪音很不舒服」、「因為助聽器在吵雜環境下溝通沒幫助」、「因為助聽器時常有吱吱聲」、「因為無法聽清楚電視聲音」、「因為戴助聽器突然聽到很大的聲音很不舒服」、「因為助聽器會放大環境噪音對聽語音干擾很大」、「因為助聽器在安靜環境下溝通沒幫助」、「因為聽自己說話聲音很像在山洞裡」、「因為助聽器音質不自然」及「因為使用助聽器覺得很麻煩」。
三.因為回饋音、閉塞感或音質不自然而放棄使用助聽器者，有75%的人主訴有尋求選配人員調整，但問題沒有改善，其餘25%的人未主動尋求解決問題就放棄使用。
四.不再使用組的助聽器滿意度得分(單一滿意度平均分數36.0，標準差27.52；全量表百分比平均分數42.74，標準差15.63；各題平均得分；各分量表平均得分；全量表平均得分)皆顯著低於持續使用組(單一滿意度平均分數73.83，標準差14.42；全量表百分比平均分數62.84，標準差12.18) (p < .025)，不再使用組的全量表百分比平均分數也顯著低於羅意琪的調查(p < .05)，但持續使用組的全量表百分比平均分數與羅意琪的調查則沒有顯著差異(p > .05)，表示助聽器的繼續使用與否會造成助聽器滿意度得分的不同。
五.不再使用組與持續使用組的助聽器滿意度各分量表平均得分的差異皆達顯著水準(p < .001)，並且「售後服務」的平均得分顯著高於「助聽器所提供的效益」、「助聽器的舒適及操作」、「自我形象與助聽器外觀」與「助聽器的價格」(p < .05)。
六.「不再使用助聽器的原因」與「助聽器滿意度量表」兩份問卷相對的題項共14題，在前者作答為「非常符合」不使用的原因，若在後者評比也是「非常不滿意」，被視為作答具有一致性，其比率為58%。

關鍵字：不再使用助聽器、助聽器、助聽器滿意度

The purposes of the study were to investigate the reasons why hearing aid users stop wearing them, the correlation between the continuance use of hearing aids and their background variables, differences in hearing aid satisfaction between two groups of hearing-aid using (HA using) and hearing-aid stop-using (HA stop-using), and the consistency between answers of dissatisfaction in the questionnaire and the reasons for stopping wearing hearing aids. According to the findings, suggestions were proposed to audiologists and hearing aid companies.
The study was conducted with a self-designed questionnaire, “Reasons for stopping the use of hearing aids”, and Lo’s “Hearing aid satisfaction inventory” (Lo Yi-Chi, 2005). The questionnaires were answered by two groups of HA using and HA stop-using subjects, 30 each. The results were summarized as follows:

1.Variables significantly correlated with the continuance use of hearing aids were “first time hearing aid user”, “hearing aids being subsidized”, and “degree of hearing loss in the better ear”. For subjects in HA stop-using group, the proportion for “first time hearing aid user” was higher, for “being subsidized” was lower and the degree of loss in the better ear was lower than the HA stop wearing group. Other variables, including sex, education level, personal income and hearing aid types, were not correlated to the continuance use of hearing aids. There was no significant difference between these two groups in the age and self-perceived hearing handicap.
2.For subjects who stop wearing hearing aids, 6.6% of them attributed to one single reason, and 90% of them selected multiple reasons (2 to 19). The more the reasons selected, the lower the level of satisfaction showed (p < .001). The categorical factors in reasons for stop wearing hearing aids were ranked from high to low as “benefit”, “hearing aid specialists”, “manipulation”, “personal”, and “expense”. The reasons ranked for the top ten were (1) I feel uncomfortable about amplified background noise. (2) Hearing aids are of no help when I try to communicate with others in a noisy environment. (3) Hearing aids often whistle (a feedback sound). (4) I can’t hear TV clearly. (5) With hearing aids, hearing a sudden loud noise sound makes me feel uncomfortable. (6) The environment noise is amplified and greatly interferes with speech sounds. (7) Hearing aids are of no help in a quiet environment. (8) Listening to my own voice, I feel like being in a cave. (9) The sound quality through hearing aids is not good enough. (10) It is troublesome to use hearing aids.
3.For subjects who stopped wearing hearing aids due to sound feedback, occlusion effect or poor sound quality, 75% of them had asked specialists to adjust hearing aids but in vain. The remaining 25% gave up using hearing aids without looking for solutions.
4.The scores in hearing aid satisfaction inventory for subjects of the HA stop-wearing group were significantly lower than those of the other group (p < .025) and was also lower than the score reported in Lo’s study (p < .05). For the HA using group, there was no significant difference between scores reported in this study and in Lo’s study (p＞.05).
5.The scores for the five subscales in hearing aid satisfaction inventory were significantly different from each other for both groups (p＜.001). The average score in “service of hearing aids” was significantly higher than those in subscales of “benefit”, “comfort and manipulation”, “self-image issues and visibility”, and “expenses of hearing aids” (p < .05).
6.There were 14 comparable questions in questionnaires of “Reasons for stopping the use of hearing aids” and “Hearing aid satisfaction inventory”. Fifty-eight percent of consistency was observed between the results of these two questionnaires.

Key words: stop wearing hearing aids, hearing aids, hearing aid satisfaction

目 錄


第一章 緒論
第一節 研究背景與動機………………………………… 1
第二節 研究目的與待答問題…………………………… 6
第三節 名詞釋義………………………………………… 7
第二章 文獻探討
第一節 聽力損失者不再使用助聽器的原因…………… 8
第二節 與助聽器使用與否相關的因素………………… 16
第三節 助聽器滿意度調查的結果……………………… 22
第三章 研究方法
第一節 研究對象與取樣來源…………………………… 27
第二節 研究工具………………………………………… 28
第三節 實施方式與步驟………………………………… 32
第四節 資料分析………………………………………… 35
第五節 研究限制………………………………………… 37
第四章 結果與討論
第一節 研究對象的背景變項描述及助聽器使用與否和背景變項之關係/差異………………………… 38
第二節 聽力損失者不再使用助聽器的原因…………… 47
第三節 助聽器滿意度分析……………………………… 63



第五章 結論與建議
第一節 結論……………………………………………… 75
第二節 建議……………………………………………… 78

參考資料……………………………………………… 82
附錄…………………………………………………… 87
表 次

表2-1-1 聽力損失者不再使用助聽器的原因…………… 9
表3-2-1 自編問卷的類別名稱及題號、題數…………… 29
表3-2-2 助聽器滿意度與不使用原因呼應程度比較表… 31
表4-1-1 助聽器使用與否和背景變項之卡方考驗……… 42
表4-1-2 年齡與自我感知聽覺障礙程度之t考驗……… 43
表4-2-1 各題作答人次百分比(n = 30)…………………… 49
表4-2-2 「非常符合」的次數百分比排序……………… 50
表4-2-3 不使用助聽器的原因排序……………………… 51
表4-2-4 不再使用助聽器之五類因素排序……………… 52
表4-2-5 不再使用助聽器的五類因素平均得分之單因子變異素分析……………………………………… 53
表4-2-6 助聽器不再使用的單一原因與多個原因分佈情形(n = 30)………………………………………… 54
表4-2-7 最主要原因為單項與複項的人數分佈………… 55
表4-2-8 不使用助聽器的最主要原因排序……………… 56
表4-3-1 「助聽器滿意度量表」各題、各分量表及全量表平均得分與t考驗…………………………… 66
表4-3-2 兩組助聽器滿意度量表各分量表平均得分之差異比較…………………………………………… 67
表4-3-3 不再使用組與持續使用組「助聽器滿意度量表」百分比分數比較………………………………… 68
表4-3-4 以(平均數差異顯著性)考驗三組受試者得分差異………………………………………………… 69
表4-3-5 助聽器滿意度與不使用原因呼應程度之比較………………………………………………… 71
圖 次

圖3-3-1 研究流程圖……………………………………… 34
圖4-1-1 自我感知聽覺障礙程度之分佈………………… 43
圖4-2-1 五類因素平均得分長條圖……………………… 52
圖4-2-2 多個原因圈選項目的人數分佈………………… 54
圖4-3-1 單一滿意度得分分佈…………………………… 69

附 錄

附錄一 聽力損失者不再使用助聽器的原因(不再使用組正式版)及助聽器滿意度量表…………………… 87
附錄二 助聽器滿意度量表(持續使用組正式版)……… 93
附錄三 助聽器使用者不再使用助聽器的原因(預試版)………………………………………………… 96
附錄四 聽力損失者不再使用助聽器的原因(根據研究結果再修改版)……………………………………………… 99

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