临床耳鸣治疗中咨询问题和模式的建立

耳鸣是一种极为常见的症状,其病因和影响因素复杂多样,人群中耳鸣的患病率高达10-15%,而其中80%的人可不需要进行临床上的治疗或干预,但患者对耳鸣的容忍性却与患者的心理状态和社会方面的因素密切相关。有效的咨询又可使很多患者的耳鸣症状得到缓解,因此,系统全面的耳鸣咨询被认为是耳鸣治疗和康复中极其重要且不可缺少的组成部分,当然,咨询的方式在临床医生之间由于医生的治疗方案的选择和理念等不同而差异很大。为此,本文从耳鸣咨询的目的和作用、内容、方法和手段以及注意事项等方面进行阐述,最后就建立临床耳鸣咨询的模式提出一套方案。

The model for counseling tinnitus patients during clinical management of tinnitus

Tinnitus is an internally generated neural signal that is perceived as sound. Fortunately, of the approximately 10% to 15% of the population who experience tinnitus, about 80% do not require clinical intervention. The intolerance caused by tinnitus is enhanced by psychological and social aspects. For every type of tinnitus treatment, counseling plays an important role. Some methods used counseling only, while others combine counseling with a different modality of treatment, especially for tinnitus retraining therapy(TRT) and tinnitus masking. Regardless of the treatment form, certain counseling topics would be considered universal for tinnitus patients. The type of counseling will vary greatly between clinicians, depending on their treatment approach and level of expertise. This article propose a basic model for efficiently counseling tinnitus patients, especially most individuals who experience tinnitus do not require intervention, and two type of tinnitus counseling, which are the generic counseling for tinnitus and individualized counseling for tinnitus management, are presented. Finally, we suggest that audiologists should generally possess good counseling skills, which are essential form of tinnitus management.