臺灣博碩士論文加值系統

本研究旨在瞭解六種選配法在兩種施測音量的實耳塞入式增益值之差異情形，同時探討20名助聽器使用者搭配不同選配法，在噪音背景辨識語音測驗和語音閾信噪比的客觀語音聽取表現情形，對各選配法在音質、自然程度、清楚程度、舒適程度和雜音等層面的主觀喜好程度，以及主客觀成效的相關情形。研究結果如下所示：一、助聽器調整的符合情形如下：1.施測音量為65 dB SPL時，三種通用選配法調整後在嚴謹尺標的符合率為24至25%，寬鬆尺標的符合率為100%；各頻率的目標實耳差距值大小為500 Hz、250 Hz、1K Hz＞2K Hz＞4K Hz。 2.施測音量為80 dB SPL時，三種通用選配法調整後在嚴謹尺標的符合率為30至34%，寬鬆尺標的符合率為100%。Oticon通用各頻率的目標實耳差距值表現情形為250 Hz、500 Hz、2K Hz、1K Hz＞4K Hz；Phonak通用為500 Hz＞250 Hz、1K Hz＞2K Hz、4K Hz；Widex通用為500 Hz、250 Hz、1K Hz＞2K Hz＞4K Hz。 二、各選配法之實耳塞入式增益值的測量結果如下： 1.不論施測音量為65或80 dB SPL，各選配法的整體實耳塞入式增益值均表現出通用選配法和Widex專屬顯著大於Oticon專屬和Phonak專屬(p<.001)，且65 dB SPL的數值均顯著高於80 dB SPL(p<.001, p<.01)。 2.不同選配法在各頻率的實耳塞入式增益值之表現情形為500至2K Hz，以Widex專屬和通用選配法增益值較大，Oticon專屬和Phonak專屬最小(p<.001, p<.01, p<.05)；250和4K Hz，以Oticon專屬與通用選配法較大，Phonak專屬最小(p<.001, p<.01, p<.05)。且各選配法在65 dB SPL的數值均顯著高於80 dB SPL(p<.001, p<.01, p<.05)。 三、噪音背景辨識語音測驗和語音閾信噪比均未達顯著差異(p>.05)。 四、受試者對六個選配法在音質、自然程度、清楚程度、舒適程度和雜音等的主觀喜好程度得分皆未達顯著差異(p>.05)。 五、無論哪個選配法，受試者的主觀喜好程度與語音聽取的表現皆未 達顯著相關(p>.05)。

The purposes of the study were to investigate the effect of prescriptive methods upon subjective and objective outcome measurements in twenty hearing aid wearers. NAL-NL1 was chosen as the generic prescription. Three models of hearing aids, Oticon Sumo DM, Phonak Supero 412, and Widex SV38, were selected as proprietary prescriptions. Objective measurements included Rear-Ear Insertion gain (REIG), Speech Perception in Noise (SPIN) and Speech Reception Threshold in noise (SRT-Ns). Subjective measurements were performed on subjects‘ subjective preference rating in quality of sound, natural degree, clearness of sound, comfort level, and static sounds. The correlation between users’ subjective and objective outcomes were also studied. The results were listed as follows: 1.The agreement of data between targeted and measured REIG in NAL-NL1 a.At the input level of 65 dB SPL, it was 24 to 25% in strict standard and 100% in lax standard. Significant differences were observed among different frequencies. Scheffe post hoc analysis showed the differences were significant and the following order was indicated: 500 Hz、250 Hz、1K Hz＞2K Hz＞4K Hz. b.At the input level of 80 dB SPL, it was 30 to 34% in strict standard and 100% in lax standard. Significant differences were observed among different frequencies. Scheffe post hoc analysis indicated the following. (1) Oticon-generic prescription: 250 Hz、500 Hz、2K Hz、1K Hz＞4K Hz, (2) Phonak- generic prescription: 500 Hz＞250 Hz、1K Hz＞2K Hz、4K Hz, (3) Widex- generic prescription: 500 Hz、250 Hz、1K Hz＞2K Hz＞4K Hz. 2.The measured REIG in different prescriptive methods a.The measured REIG was observed to be significant higher in NAL-NL1 and Widex- proprietary than in Oticon- proprietary and Phonak-proprietary at both input levels (p<.001). The REIG at 65 dB SPL was significantly higher than that at 80 dB SPL (p<.001, p<.01). b.The measured REIG at each frequency showed the following trend. Widex-proprietary and generic prescription were the largest at 500 Hz to 2K Hz, whereas Oticon-proprietary and Phonak-proprietary were the smallest (p<.001, p<.01, p<.05). Oticon-proprietary and generic prescription were the largest at 250 Hz and 4K Hz, and Phonak-proprietary was the smallest (p<.001, p<.01, p<.05). The REIG at 65 dB SPL was significantly higher than that at 80 dB SPL (p<.001, p<.01). 3.The difference was insignificant between scores of SPINs and SRT-Ns (p>.05). 4.No significant difference was observed among the subjective preference rating on quality of sound, natural degree, clearness of sound, comfort level, and static sounds (p>.05). 5.No statistically significant correlation was indicated between users’ subjective preference rating and objective speech perception (p>.05).

目 錄 第一章 緒論...............................................1 第一節 研究背景與動機......................................1 第二節 研究目的與待答問題...................................8 第三節 名詞釋義...........................................12 第二章 文獻探討...........................................16 第一節 助聽器選配法比較之相關研究...........................16 第二節 測量變項的探討.....................................30 第三節 適應期的文獻探討....................................40 第四節 助聽器的特性與功能..................................45 第三章 研究方法...........................................52 第一節 研究架構...........................................52 第二節 研究對象...........................................54 第三節 研究工具...........................................56 第四節 研究流程...........................................60 第五節 資料分析...........................................71 第四章 結果與討論.........................................73 第一節 研究對象的基本描述..................................73 第二節 助聽器調整設定後與目標值之接近程度....................76 第三節 實耳塞入式增益值在不同選配法之比較....................93 第四節 語音聽取表現在不同選配法之比較......................111 第五節 助聽器喜好程度在不同選配法之比較.....................121 第六節 語音聽取與喜好程度量表的相關探討.....................131 第五章 結論與建議........................................135 第一節 結論.............................................136 第二節 建議.............................................142 參考文獻..................................................148 附錄.....................................................158

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