노인성 난청인의 적응과정 경험

Abstract

Age-related hearing loss (presbycusis) is a common disease caused by degenerative changes of the auditory system in the elderly. Patients complain of a mild or moderate hearing loss and inability to localize the sound. Communication difficulites depend on the degree of hearing loss and speech perception. The purpose of this study is to comprehend the hearing-related problems in prebycusis patients using the in-depth interviews about experiences in everyday life and the phenomenological method in order to contribute to the basis for a future presbycusis management program. The focus of the present study is 'what is the experiences of adaptation process in prebycusis patients?'. The subjects for this study was 11 patients aged 65 years or older who were diagnosed as age-related hearing loss at a university hospital in Seoul. The data collected were analyzed with the van Kamm phenomenological method, inductive and descriptive. Five categories, 13 themes, and 34 subthemes were drawn from the 168 significant statements about the experiences of prebycusis adaptation. The themes that constitute each category were as follows: the category of [changes in personal relationships] was subdivided into <awareness of communication problems>, <challenging situations for communication>, and <conflicts with people around them>; the category of [pressure],<emotional burden due to communication difficulties>; the category of [discomfort], <negative adaptation to hearing aids>, <difficulties in tinnitus adaptation>; the category of [acceptance], <learning about the state of presbycusis> looking back the course of hearing loss, <positive adaptation to hearing aids>, <expectations for hearing aids>, <tinnitus adaptation>; the category of [wish], <a demand for social connection>, <a demand for treatment and psychological support>, <hope for welfare benefit>. It is hoped that this study can form the basic data in the nursing field of presbycusis, which makes the nurses recognize the experiences of the hearing-impaired elderly and perform a high-quality nursing care for them. At present, the development of a more systematic management program is needed. The contents should include an education course to relieve the subject's inner pressure, make them accept the hearing losses, and promote self efficacy, as well as the utilization of various communication media. It is also hoped that the program will establish the strategies to induce family support and a new understanding of the community members, and to simplify the dignostic tests for hearing disability considering the economic burden of the elderly patients. In addition, a progressive management program comprising the resources available for the tertiary prevention of rehabilitation and the social support systems are expected.