妇科肿瘤患者PICC知情同意移动医疗决策辅助程序的设计与实施

目的设计并实施PICC知情同意移动医疗决策辅助程序,增强患者决策参与意愿。方法将妇科肿瘤科行PICC化疗的86例患者随机分为观察组和对照组各43例,对照组采用常规PICC知情同意,观察组在对照组基础上,利用移动护理信息系统,构建并实施妇科肿瘤患者PICC知情同意移动医疗决策辅助程序。结果观察组焦虑抑郁状态评分显著低于对照组,患者的决策实际参与程度显著高于对照组,患者决策参与满意度总分及各维度得分显著高于对照组(P<0.05,P<0.01)。结论PICC知情同意移动医疗决策辅助程序为妇科肿瘤患者提供精准化的决策辅助,缓解了患者置管时的焦虑抑郁情绪,提高了患者决策实际参与程度及满意度。     

Treatment feasibility of a digital tool for brief self-help behavioural therapy for insomnia (FastAsleep)

Cognitive behavioural therapy for insomnia is efficacious and recommended for insomnia, but availability is scarce. Cognitive behavioural therapy for insomnia self-help interventions could increase availability, especially if unguided. Optimizing cognitive behavioural therapy for insomnia methods and system user-friendliness, we developed a short, digital, self-help programme—FastAsleep—based on the behavioural components of sleep restriction and stimulus control. This study investigated its feasibility and preliminary effects. Thirty media-recruited participants with moderate to severe insomnia were assessed via telephone before using FastAsleep for 4 weeks, and were interviewed afterwards. Self-ratings with web questionnaires were conducted at screening, pre-, mid- and post-treatment, and at 3-month follow-up. Primary outcomes were feasibility (credibility, adherence, system user-friendliness and adverse effects), and secondary outcomes were changes in symptom severity (insomnia, depression and anxiety). Adherence was generally high, participants' feasibility ratings were favourable, and adverse effects matched previously reported levels for cognitive behavioural therapy for insomnia. Symptoms of insomnia decreased after the treatment period (Hedge's g = 1.79, 95% confidence interval = 1.20–2.39), as did symptoms of depression and anxiety. FastAsleep can be considered feasible and promising for alleviating insomnia symptoms among patients fit for self-care. Future controlled trials are needed to establish the efficacy of FastAsleep and its suitability in a stepped care model.     

便携式单筒望远镜助视器的临床应用

目的 :评价便携式单筒望远镜助视器的临床价值。方法 :对 6 6例 (12 2眼 )盲及低视力患者使用我国自行研制的新型 2 .5倍便携式单筒望远镜助视器 ,使他们的视功能有了极大的改善 ,视力提高明显。结果 :2 5眼盲使用单筒望远镜助视器后 2 4眼视力≥ 0 .0 5 ,脱盲率 96 % ,91眼低视力使用单筒望远镜后 75眼视力≥0 .3,脱残率 82 .4%。结论 :远用望远镜是低视力门诊必备的装置 ,亦是对低视力患者看远而唯一有实用价值的助视器。我国研制成功的便携式 2 .5倍单筒望远镜助视器不仅性能可靠、质量上乘 ,工艺造型精美 ,使用方便 ,而且价格便宜     

聋儿配戴助听器后使用无线调频语训系统的效果评估

目的：研究和比较全数字助听器与无线调频语训（FM）系统不同结合方式对重度听力损失儿童的助听效果，方法：聋儿双耳分别配戴全数字助听器，双耳全数字助听器结合单耳FM系统，双耳全数字助听器结合双耳FM系统，在安静和噪声环境中，以不同强度的言语声测试言语可懂度，比较在安静环境和噪声环境中使用与不同使用FM系统及单耳使用与双耳同时使用的助听效果。结果：在安静和噪声环境下，使用FM系统的言语可懂度优于不使用该系统（P＜0．05），单耳使用该系统和双耳使用该系统无明显差异（P＞0．05）。结论：聋儿配戴助听器使用无线调频语训系统在安静和噪声环境下言语可懂度高于不使用该系统者。     

Performance of Hearing Aids with an Induction Loop Amplification System: Laboratory Versus Classroom Setting

This study was designed to investigate the acoustic response of ten body-type hearing aids when used with an induction loop amplification (ILA) system in the laboratory and in the actual classroom setting. Undesirable frequency response characteristics were discovered in the classroom ILA system used in this study. These consist of a slightly poorer low-frequency response and a deep notch at about 2 500 Hz. Had the frequency response of the classroom ILA system been flat, differences between laboratory and classroom measures would have been minimized. Findings of this study support the practicality of measurement in the classroom of the operating characteristics of ILA systems     

Effects of Room Reverberation upon Hearing Aid Quality Judgments

Hearing-aid-processed speech recorded in reverberant and nonreverberant environments was ranked utilizing quality judgment and speech discrimination tasks. 21 normally hearing and 20 hearing-impaired listeners ranked the hearing-aid-processed speech. Quality judgments in reverberant environments may yield important information with respect to hearing aid selection. In contrast, speech discrimination rankings in a non-reverberant environment appeared to be similar to the speech discrimination rankings obtained in the reverberant condition.

21 sujets à audition normale et 20 sujets souffrant d'une atteinte de l'audition participèrent à cette étude qui avait pour but de classer un certain nombre d'appareils de correction auditive, compte tenu des résultats d'un test de qualité et d'un test de discrimination de la parole en milieu réverbérant et en milieu non réverbérant. En milieu réverbérant, les jugements subjectifs de qualité sont susceptibles de fournir des renseignements importants pour le choix de l'appareil de correction auditive. Par contre, le classement de ces appareils par l'étude de la discrimination de la parole en milieu réverbérant est semblable à celui effectué en milieu non réverbérant.     

Disturbance caused by varying propagation delay in non-occluding hearing aid fittings

The disturbance caused by various short propagation delays to the perception of external sounds and own voice for a non-occluding hearing aid was investigated. Ten normal-hearing and 10 mildly hearing-impaired individuals listened to external sounds and their own voice while wearing non-occluding devices providing 10dB of linear gain. Participants rated the disturbance caused by delays of 2, 4 and 10ms to music, running speech, and their own voices. The results indicated greater disturbance for the longest delay for both subject groups when judging own voice, with the ratings of the hearing-impaired participants being lowest. Normal-hearing participants also judged the 10-ms delay as more disturbing for the external sounds. Owing to the listening conditions with constant gain from 800Hz and above, the results apply directly only to this experiment. Disturbance ratings for all delays were low, which suggests that any of those tested would be acceptable for this application.     

Hearing aids as an adjunct to counseling: Tinnitus patients who choose amplification do better than those that don't

Abstract

Hearing aids are commonly used for tinnitus management () but there is limited evidence to support their use. The purpose of this study was to quantify the effectiveness of hearing aids and counseling as a tinnitus treatment option. This study is a retrospective analysis of tinnitus handicap questionnaire (THQ, ) results from 58 tinnitus patients with hearing loss who received counseling, and (1) chose to follow recommendations of hearing aid fitting, or (2) chose not to have hearing aids. The groups (N = 29 each) had similar audiometric configuration, tinnitus duration, and age. It was hypothesized that the use of hearing aids would provide greater reduction in THQ scores than counseling alone. THQ scores were reduced 12 months following counseling but improvement in THQ only reached statistical significance for the group that received hearing aids (p < 0.0001). The hearing aid group had reduced; psychosocial handicap (p < 0.0002); and tinnitus-hearing handicap (p < 0.0005). It is concluded that patients with hearing loss and tinnitus should trial amplification.

Sumario

Los auxiliares auditivos son usados comúnmente para el manejo del acúfeno () pero existe evidencia limitada para apoyar su uso. El propósito de este estudio fue cuantificar la efectividad de los auxiliares auditivos y de la consejería como una opción de tratamiento del acúfeno. Este estudio es un análisis retrospectivo del los resultados del cuestionario de desventaja por acúfeno (TQH, Luky col, 1990) de 58 pacientes con acúfeno y con hipoacusia, que recibieron orientación, y (1) escogieron seguir la recomendación de adaptación de un auxiliar auditivo, o (2) escogieron no utilizar auxiliares auditivos. Los grupos (N = 29 cada uno) tenían configuraciones audiométricas, duración del acúfeno y edades similares. Se estableció la hipótesis de que el uso de auxiliares auditivos proporcionaría una mayor reducción en los puntajes THQ que la orientación sola. Los puntajes THQ se redujeron 12 meses después de recibir consejería, pero la mejoría en THQ sólo alcanzó significancia estadística para el grupo que utilizó auxiliares auditivos (p < 0.0001). El grupo con auxiliares auditivos tuvo un impedimento psico-social reducido (p < 0.0002) y un impedimento acúfeno-audición reducido (p < 0.0005). Se concluye que los pacientes con hipoacusia y acúfeno deberían intentar la amplificación.     

Participation in 12-Step-Based Fellowships Among Dually-Diagnosed Persons

Abstract

Twelve-step groups (12SG), a useful recovery resource, are underutilized by dually-diagnosed persons. There has been little empirical research in this area. This study followed members of a dual-focus 12-step-based fellowship (N = 277) over one year to gain a greater understanding of participation in both specialized dual focus and traditional 12SG among dually-diagnosed persons, including reasons for attending, perceived benefits of and obstacles to affiliation, and predictors of affiliation. Findings indicate that dually-diagnosed persons do engage in both types of fellowships; patterns of engagement differed across fellowships, suggesting different comfort levels. Both types of fellowships were used to deal with addiction. Greater difficulty with substance use at baseline was associated with greater likelihood of attending 12SG at follow-up; the reverse was true for self-reported substance use at baseline. Findings are discussed in light of existing literature and clinical implications are suggested.