臺灣博碩士論文加值系統

本研究旨在探討華語ANL測驗之信度、配戴助聽器/助聽器噪音處理特性設定（方向性麥克風、數位噪音抑制系統）對於華語ANL值之效應，以及依據助聽器使用頻繁度的不同測量方式（三區段分類、助聽器使用率）找出較適切的方式，以便能透過華語ANL值預測助聽器的使用頻繁度，以之提供聽語界在選配前預測個案未來對於助聽器的使用情形。研究方法係以自編華語ANL測驗及「助聽器使用現況調查表」為主要研究工具，以三個實驗探討各項目的，受試者皆為有配戴助聽器經驗的成人，實驗一至三分別有25、43及122人參與。研究結果如下：(1)自編華語ANL材料具信度，且15分鐘可完成測驗（含解說與施測）；(2)配戴助聽器並開啟噪音處理特性的華語ANL值，比未戴助聽器與雖戴助聽器但關閉噪音處理特性，都顯著低了1.72 dB（p<.05）；(3)華語ANL值無法如國外研究數據般將助聽器使用型態區分為經常使用、偶爾使用及不再使用；(4)以華語ANL值預測助聽器使用率，解釋變異量僅25.4 %（無功能組）及18.4 %（有功能組），優耳聽閾可增加無功能組13 %的解釋量，但有功能組則否；(5)以助聽器使用率作分組依據，無功能組與有功能組皆以67 %做切截點，切截點以上(含)是「高使用」組，以下是「低使用」。Logistic預測迴歸曲線指出無功能及有功能組，未助聽的華語ANL值< 5 dB，有85 %以上的機率成為助聽器高使用者，而無功能組之華語ANL值＞13 dB，以及有功能組華語ANL值＞17 dB，易成為低使用者（成為高使用者的機率≦20 %），整體預測正確率在無功能組為86.0 %，有功能組是81.9 %。本研究最重要的發現是：配戴有噪音處理特性之助聽器會改變並降低華語ANL值，因此建構ANL與助聽器使用頻繁度預測關係，應考量助聽器內建聲音處理功能之潛在效應，才能適切地建立二者之對應關係。

The aims of this study were to explore the reliability of Mandarin ANL test (M-ANL), the effects of wearing hearing aids and noise reduction features (NRF) (directional microphone and digital noise reduction system) in M-ANL test, and to find out which one, (three patterns of hearing-aid usage v.s. percentage of hearing-aid use) is more appropriate in predicting the frequency of hearing-aid use via ANL values. The established relationship between M-ANL and the frequency of hearing-aid use will provide clinicians a tool in predicting how often the hearing aids will be used even before hearing-aid evaluation. The M-ANL test and the questionnaire of hearing-aid use were the basic tools of the study. Participants were hearing-impaired adults and they all had experiences of wearing hearing aids. Three experiments were designed to achieve different purposes. Participants were 25, 43, and 122 for experiment I to III, respectively. Results showed that (1) The M-ANL test had good reliability, and it took 15 minutes to finish the test (including introduction and assessment); (2) The ANL values measured in aided condition with NRF on were significant lower than both in unaided condition and in aided condition with NRF off. The difference between them was about 1.72 dB (p<.05); (3) M-ANL values could not discriminate among the three patterns of hearing-aid usage: full-time users, part-time users, and non-users; (4) M-ANL values could explain the variation of the percentage of hearing-aid usage only about 25.4 % (for aided group with NRF off) and 18.4 % (for aided group with NRF on). Furthermore, better ear’s average hearing thresholds could provide additional 13 % variance for aided with NRF off, but not for the other group. (5) If subjects’ use of hearing aids were equal or higher than 67 %, they would be assigned to the high-use group; otherwise, they would be assigned to the low-use group. Logistic regression curves pointed out that if unaided ANL values＜5 dB, there would be more than 85% of the probability to become a hearing-aid user with high-frequency of usage, in addition, unaided ANL values＞13 dB for aided group with NRF off, and unaided ANL values＞17 dB for aided group with NRF on, they would easily become a hearing-aid user with low-frequency of usage (the odds of becoming a high-frequency user was less than 20 %). Regression analysis indicated that unaided ANL values could predict hearing-aid usage patterns with 86.0 % (aided group with NRF off) and 81.9 % (aided group with NRF on) of accuracy. The most important finding of this study is that wearing a hearing aid with NRF-on will change and reduce M-ANL values, therefore, establishing a corresponding relationship between ANL and frequency of hearing-aid use should consider the potential effects of hearing-aid features.

表 次 viii
圖 次 xi
第一章 緒論 1
第一節 研究動機與背景 1
第二節 研究目的與待答問題 12
第三節 名詞釋義 15
第二章 文獻探討 18
第一節 可接受噪音音量測驗（ANL）的發展歷史 18
第二節 不同變項對ANL之效應 20
第三節 ANL值與助聽器使用頻繁度之關係 32
第三章 研究方法 36
第一節 研究設計與架構 36
第二節 研究對象 38
第三節 研究工具 42
第四節 研究程序 48
第五節 統計分析 57

第四章 結果與討論 61
第一節 華語ANL測驗之信度分析 61
第二節 華語版ANL平均測驗時間 83
第三節 助聽器噪音處理特性與配戴助聽器之效應（實驗一與實驗二） 86
第四節 助聽器使用頻繁度之效應（實驗三） 115
第五章 結論與建議 149
第一節 研究結論 149
第二節 研究建議 155
參考資料 159
一、中文部分 159
二、西文部分 160
附錄一 原始ANL問卷 165
附錄二 助聽器使用現況調查表-A版 166
助聽器使用現況調查表-B版 168
附錄三 助聽器使用時間架構表 170
附錄四 簡單提問問題 173
附錄五 華語ANL語音施測材料 174
附錄六ANSI S3.1-1991之最大允許噪音標準值 180
附錄七ANSI S3.6-1996純音換能器校準值 181
附錄八ANSI S3.6-2004語音換能器校準值 182
附錄九 施測者訓練課程規劃 183
附錄十 參與研究同意書 186
附錄十一 個案基本資料表 187
附錄十二 聽力資料紀錄暨ANL測驗紀錄表 188
附錄十三 華語ANL測驗之口述指導語 189
附錄十四 華語ANL測驗之書面指導語 191
附錄十五 參與施測者間一致性考驗之受試者華語ANL值 194

一、中文部分
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吳明隆（2008）：SPSS操作與應用-多變量分析實務。台北：五南。
陳秋芬（2006）：使用者對助聽器之音效抱怨及其與助聽器不滿意度之關係。國立高雄師範大學聽力學與語言治療研究所碩士論文。
黃美睿（2008）：聽力正常者噪音可接受音量相關變項之探討。國立高雄師範大學聽力學與語言治療研究所碩士論文（未發表）。
鈕文英（2007）：教育研究方法與論文寫作。台北：雙葉書廊。
蔡志浩、陳小娟（2002）：噪音背景辨識語音測驗編製之研究。特殊教育研究學刊, 23, 121-140。
羅意琪（2004）：助聽器滿意度量表編製及相關因素之研究。國立高雄師範大學溝通障礙教育所碩士論文。


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