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ํ•œ๊ตญ์–ดํŒ Abbreviated Profile of Hearing Aid Benefit์˜ ํƒ€๋‹น๋„ ๋ฐ ์‹ ๋ขฐ๋„ ๊ฒ€์ฆ

Abstract

Background and Objectives

The quantification of hearing aid benefit is important in hearing aid fitting. The abbreviated profile of hearing aid benefit (APHAB) is a useful tool for measuring the benefit of using hearing aids. In this study, we developed a Korean version of APHAB (K-APHAB) and determined its validity and reliability.

Subjects and Method

An expert panel translated the original version of APHAB into Korean language. Two bilingual translators back-translated the first translated version into English and it was compared with the original version. After cognitive debriefing, the translation of APHAB into the Korean version was completed. One hundred ninety-seven subjects using hearing aids participated in this study and completed K-APHAB. Reliability was assessed using Cronbachโ€™s alpha coefficient, and validity was evaluated by factor analysis and criterion validity.

Results

K-APHAB had a good internal consistency (ฮฑ=0.80). Confirmatory factor analysis showed that K-APHAB is comprised of four subsections, namely โ€˜communication in daily lifeโ€™, โ€˜aversivenessโ€™, communication in โ€˜background noiseโ€™ or โ€˜reverberationโ€™.

Conclusion

The K-APHAB is a useful tool for evaluating the benefit of hearing aids in Korean hearing-impaired individuals.

์„œ ๋ก 

์ˆ˜์ˆ ์  ์น˜๋ฃŒ๊ฐ€ ์ ํ•ฉํ•˜์ง€ ์•Š์€ ๋‚œ์ฒญํ™˜์ž๋“ค์—๊ฒŒ ๋ณด์ฒญ๊ธฐ๋Š” ํšจ๊ณผ์ ์ธ ์žฌํ™œ๋ฐฉ๋ฒ•์ด๋ฉฐ, ์ ์ ˆํ•œ ๋ณด์ฒญ๊ธฐ ์ฒ˜๋ฐฉ ๋ฐ ์กฐ์ ˆ์„ ์œ„ํ•ด ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ „ํ›„์˜ ์ด๋“์„ ํ‰๊ฐ€ํ•˜๋Š” ๊ณผ์ •์€ ํ•„์ˆ˜์ ์ด๋‹ค. ์ฒญ๊ฐ ๊ฒ€์‚ฌ๋Š” ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ์œผ๋กœ ์ธํ•œ ์ฒญ๊ฐํ•™์  ์ด๋“์„ ํ‰๊ฐ€ํ•˜์ง€๋งŒ, ํ™˜์ž ๋ณธ์ธ์ด ์‹ค์ œ์ ์œผ๋กœ ๋Š๋ผ๋Š” ๋งŒ์กฑ๋„๋ฅผ ์ถฉ๋ถ„ํžˆ ๋ฐ˜์˜ํ•˜์ง€๋Š” ๋ชปํ•œ๋‹ค. ์ด์— ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ด๋“์— ๋Œ€ํ•œ ์ฃผ๊ด€์ ์ธ ์ฆ์ƒ์„ ๊ฐ๊ด€ํ™”ํ•˜๊ณ  ์ •๋Ÿ‰ํ™”ํ•  ์ˆ˜ ์žˆ๋Š” ๋„๊ตฌ์˜ ๊ฐœ๋ฐœ์€ ์„ฑ๊ณต์  ๋ณด์ฒญ๊ธฐ ์‚ฌ์šฉ์„ ์œ„ํ•ด ๋งค์šฐ ์ค‘์š”ํ•˜๋‹ค.
์ด๋Ÿฌํ•œ ๋ฐฐ๊ฒฝํ•˜์—์„œ ์™ธ๊ตญ์—์„œ๋Š” ๋งŽ์€ ๋ณด์ฒญ๊ธฐ ์ด๋“ ์ธก์ • ๋„๊ตฌ๋“ค์ด ๊ฐœ๋ฐœ๋˜์–ด ํ™œ์šฉ๋˜๊ณ  ์žˆ๋‹ค. ๊ตญ๋‚ด์—์„œ๋„ Yun ๋“ฑ[1]์ด abbreviated profile of hearing aid benefit(APHAB)๋ฅผ ์ด์šฉํ•˜์—ฌ ๋ณด์ฒญ๊ธฐ ์‚ฌ์šฉ ์ „ํ›„์˜ ์ด๋“์„ ๋น„๊ตํ•˜์˜€๊ณ , Lee ๋“ฑ[2]์€ satisfaction with amplification in daily life(SADL) ์„ค๋ฌธ์ง€๋ฅผ ์ด์šฉํ•˜์—ฌ ์ฃผ๊ด€์  ๋งŒ์กฑ๋„๋ฅผ ํ‰๊ฐ€ํ•˜์˜€๋‹ค. ํ•˜์ง€๋งŒ ์ด๋Ÿฌํ•œ ๋„๊ตฌ๋“ค์€ ๋Œ€๋ถ€๋ถ„ ์˜์–ด๊ถŒ ๊ตญ๊ฐ€์—์„œ ๋งŒ๋“ค์–ด์กŒ๊ธฐ ๋•Œ๋ฌธ์— ์šฐ๋ฆฌ๋‚˜๋ผ์—์„œ ์ด๋ฅผ ๋‹จ์ˆœ ๋ฒˆ์—ญํ•˜์—ฌ ํ™œ์šฉํ•˜๋Š” ๋ฐ์—๋Š” ์–ธ์–ด ๋ฐ ๋ฌธํ™”์  ์ œํ•œ์ด ์žˆ๋‹ค. Chu ๋“ฑ[3]์€ ํƒ€๋‹น๋„์™€ ์‹ ๋ขฐ๋„ ๊ฒ€์ •์„ ํ†ตํ•œ International Outcome Inventory for Hearing Aids(IOI-HA)์˜ ํ•œ๊ตญ์–ดํŒ ์„ค๋ฌธ์ง€๋ฅผ ์ œ์‹œํ•˜์˜€์ง€๋งŒ, ๊ทธ ์™ธ ๋Œ€๋ถ€๋ถ„์˜ ์„ค๋ฌธ์ง€์˜ ๊ฒฝ์šฐ ๊ฐ ์—ฐ๊ตฌ์ž๋“ค์ด ๊ฐœ๋ณ„๋กœ ๋ฒˆ์—ญํ•˜์—ฌ ๋ณ„๋„์˜ ๊ฒ€์ฆ ์ ˆ์ฐจ ์—†์ด ์‚ฌ์šฉํ•˜๊ณ  ์žˆ๋‹ค.
๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ๊ตญ๋‚ด ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ํ™˜์ž๋“ค์˜ ์ž„์ƒ ์ง„๋ฃŒ ๋ฐ ์—ฐ๊ตฌ์— ํ‘œ์ค€ํ™”๋œ ๋ณด์ฒญ๊ธฐ ์ด๋“ ํ‰๊ฐ€๋„๊ตฌ๋ฅผ ์ œ๊ณตํ•˜๊ธฐ ์œ„ํ•˜์—ฌ, ์‹ ๋ขฐ๋„๊ฐ€ ๋†’์•„ ๊ตญ์ œ์ ์œผ๋กœ ๋„๋ฆฌ ์‚ฌ์šฉ๋˜๊ณ  ์žˆ๋Š” APHAB๋ฅผ ๊ตญ๋‚ด ์‚ฌ์ •์— ๋งž๊ฒŒ๋” ํ•œ๊ตญ์–ด๋กœ ๋ฒˆ์—ญํ•˜๊ณ  ์ด ํ•œ๊ตญ์–ดํŒ์˜ ํƒ€๋‹น๋„ ๋ฐ ์‹ ๋ขฐ๋„๋ฅผ ํ‰๊ฐ€ํ•˜์˜€๋‹ค.

๋Œ€์ƒ ๋ฐ ๋ฐฉ๋ฒ•

๋ฐฉ ๋ฒ•

๋Œ€์ƒ ์„ค๋ฌธ์ง€

APHAB๋Š” ์ด 4๊ฐœ์˜ ์„ธ๋ถ€ ํ•ญ๋ชฉ, 24๊ฐœ ๋ฌธํ•ญ์œผ๋กœ ๊ตฌ์„ฑ๋˜์–ด ์žˆ์œผ๋ฉฐ ๊ฐ ๋ฌธํ•ญ์€ 7๊ฐœ์˜ ์ ์ˆ˜ ์ฒ™๋„๋กœ ํ‰๊ฐ€ํ•œ๋‹ค. ์ด 4๊ฐœ์˜ ํ•ญ๋ชฉ์€ ease of communication(EC), reverberation(RV), background noise(BN), aversiveness(AV)์ด๋ฉฐ, ๊ฐ ์„ธ๋ถ€ ํ•ญ๋ชฉ์€ 6๊ฐœ์˜ ๋ฌธํ•ญ์œผ๋กœ ์ด๋ฃจ์–ด์ ธ ์žˆ๋‹ค(EC=๋ฌธํ•ญ 4, 10, 12, 14, 15, 23; RV=๋ฌธํ•ญ 1, 6, 7, 16, 19, 24; BN=๋ฌธํ•ญ 2, 5, 9, 11, 18, 21; AV=๋ฌธํ•ญ 3, 8, 13, 17, 20, 22). ๊ฐ ๋ฌธํ•ญ์— ๋Œ€ํ•ด์„œ๋Š” ํ•ญ์ƒ(99%), ๊ฑฐ์˜ ํ•ญ์ƒ(87%), ๋Œ€์ฒด๋กœ(75%), ์ ˆ๋ฐ˜ ์ •๋„(50%), ๊ฐ€๋”(25%), ๋“œ๋ฌผ๊ฒŒ(12%), ์ „ํ˜€ ์•„๋‹ˆ๋‹ค(1%)์˜ 7๊ฐœ ์ ์ˆ˜ ์ฒ™๋„ ์ค‘ ํ•˜๋‚˜๋กœ ํ‰๊ฐ€ํ•˜์—ฌ %๋กœ ํ‘œ์‹œํ•˜๋ฉฐ, ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ „๊ณผ ํ›„์— ๋Œ€ํ•ด ๊ฐ๊ฐ ๋‹ต๋ณ€ํ•˜๋„๋ก ๋˜์–ด ์žˆ๋‹ค.

๋ฒˆ์—ญ ๋ฐ ์„ค๋ฌธ์ง€ ์™„์„ฑ

APHAB ์„ค๋ฌธ์ง€ ์›๋ณธ ํš๋“

๊ต์‹ ์ €์ž๊ฐ€ ์ „์ž์šฐํŽธ์œผ๋กœ ์›์ €์ž์ธ Dr. Cox๋ฅผ ์ ‘์ด‰ํ•˜์—ฌ ํ•œ๊ตญ์–ดํŒ ๋ฒˆ์—ญ์— ๋Œ€ํ•œ ํ—ˆ๊ฐ€๋ฅผ ์–ป๊ณ  APHAB์˜ ์›๋ณธ์„ ์ œ๊ณต ๋ฐ›์•˜๋‹ค.

์ˆœ ๋ฒˆ์—ญ(Forward translation)

๋Œ€ํ•œ์ฒญ๊ฐํ•™ํšŒ ์„ค๋ฌธ์ง€ ๋ฒˆ์—ญ์œ„์›ํšŒ์—์„œ ์˜์–ดํŒ APHAB์˜ ์ˆœ ๋ฒˆ์—ญ ์ง€์นจ์„ ๋งˆ๋ จํ•œ ํ›„, 2์ธ์˜ ๊ธฐํš์œ„์›์ด ํ•œ๊ธ€๋กœ ๊ฐ์ž ๋ฒˆ์—ญํ•˜์˜€๋‹ค.

์ ˆ์ถฉ(Reconciliation)

๋ฒˆ์—ญ์œ„์›ํšŒ์—์„œ ๋‘ ๋ฒˆ์—ญ๋ณธ์„ ๊ฒ€ํ† ํ•˜์—ฌ ํ•œ๊ตญ์–ด ์ ˆ์ถฉ ๋ฒˆ์—ญ๋ณธ์„ ๋งŒ๋“ค์—ˆ๋‹ค.

์—ญ ๋ฒˆ์—ญ(Backward translation)

ํ•œ๊ตญ์–ด ์ ˆ์ถฉ ๋ฒˆ์—ญ๋ณธ์„ ์–‘๊ตญ ์–ธ์–ด์— ๋Šฅํ†ตํ•œ ์ œ3์˜ ๋ฒˆ์—ญ์ž๊ฐ€ ์—ญ ๋ฒˆ์—ญํ•˜์˜€๋‹ค. ๊ทธ ํ›„ ์œ„์›ํšŒ์—์„œ ์„ค๋ฌธ์ง€ ์›๋ณธ๊ณผ ์—ญ ๋ฒˆ์—ญ๋ณธ์„ ๋น„๊ต ๊ฒ€ํ† ํ•˜์˜€๊ณ , ์›๋ณธ์˜ ํ•ญ๋ชฉ ๊ฐœ๋…๊ณผ ์—ญ ๋ฒˆ์—ญํ•œ ๋ฌธ์žฅ์˜ ํ•ญ๋ชฉ ๊ฐœ๋…์ด ํฌํ•จ๋˜์—ˆ์„ ๊ฒฝ์šฐ ๋ฒˆ์—ญ์ด ์ œ๋Œ€๋กœ ๋œ ๊ฒƒ์œผ๋กœ ํ‰๊ฐ€ํ•˜์˜€์œผ๋ฉฐ, ํฌํ•จ๋˜์ง€ ์•Š์€ ๊ฒฝ์šฐ์—๋Š” ์žฌ๊ฒ€ํ† ๋ฅผ ์‹œํ–‰ํ•˜์˜€๋‹ค. ์ƒˆ๋กœ ๋งŒ๋“ค์–ด์ง„ ๋ฌธ์žฅ์ด ์ˆ˜์šฉ๋˜๋ฉด ์ด ๊ณผ์ •์€ ์™„์„ฑ๋˜๋Š” ๊ฒƒ์œผ๋กœ ๊ฒฐ์ •ํ•˜์˜€๋‹ค.

์ธ์ง€์  ํ™•์ธ(Cognitive debriefing)

์„œ์šธ๋Œ€๋ณ‘์› ์ด๋น„์ธํ›„๊ณผ ์™ธ๋ž˜์—์„œ ๋ณด์ฒญ๊ธฐ๋ฅผ ์ฐฉ์šฉํ•˜๋Š” ํ™˜์ž 10๋ช…์—๊ฒŒ ๋…๋ฆฝ์ ์œผ๋กœ ์—ญ ๋ฒˆ์—ญ๊นŒ์ง€ ์™„์„ฑ๋œ ์„ค๋ฌธ์ง€๋ฅผ ์ œ๊ณตํ•˜์—ฌ ์„ค๋ฌธ ์‘๋‹ต์˜ ์†Œ์š”์‹œ๊ฐ„์„ ์ธก์ •ํ•˜๊ณ , ์ดํ›„ ์›๋ž˜ ์งˆ๋ฌธ์˜ ๊ฐœ๋…์„ ์ž˜๋ชป ์ดํ•ดํ•˜๊ณ  ์žˆ๊ฑฐ๋‚˜ ์ดํ•ด๊ฐ€ ํž˜๋“  ๋ถ€๋ถ„, ์งˆ๋ฌธ ๋‚ด์šฉ์ด ์• ๋งคํ•˜๊ฑฐ๋‚˜ ๋งค๋„๋Ÿฝ์ง€ ์•Š์€ ๋ถ€๋ถ„์— ๋Œ€ํ•œ ์˜๊ฒฌ์„ ๋ฐ›๊ณ  ์ด๋ฅผ ์ •๋ฆฌํ•˜์˜€๋‹ค.

๊ฐ ์ˆ˜

์™„์„ฑ๋œ ์—ญ ๋ฒˆ์—ญ๋ณธ์˜ ๊ตญ์–ด ์˜ค๋ฅ˜์˜ ์—ฌ๋ถ€๋ฅผ ํ™•์ธํ•˜๊ธฐ ์œ„ํ•ด ๊ตญ์–ด๊ต์œกํ‰๊ฐ€์›์— ๊ฐ์ˆ˜๋ฅผ ์˜๋ขฐํ•˜์˜€๋‹ค.

์ตœ์ข… ๊ต์ •

๊ตญ์–ด๊ต์œกํ‰๊ฐ€์›์˜ ๊ฐ์ˆ˜ ๋‚ด์šฉ์„ ๋ฐ”ํƒ•์œผ๋กœ ์ตœ์ข… ๊ฒ€์ฆ์„ ๊ฑฐ์ณ ํ•œ๊ตญ์–ดํŒ์„ ์™„์„ฑํ•˜์˜€๋‹ค.

ํƒ€๋‹น๋„ ๋ฐ ์‹ ๋ขฐ๋„ ๊ฒ€์‚ฌ

๋Œ€์ƒ์ž ์„ ์ •

๊ฐ€์ฒœ์˜๋Œ€ ๊ธธ๋ณ‘์›, ๊ฐ€ํ†จ๋ฆญ์˜๋Œ€ ์„œ์šธ์„ฑ๋ชจ๋ณ‘์›, ๊ณ ๋ ค๋Œ€ํ•™๊ต ๋ถ€์† ๊ตฌ๋กœ๋ณ‘์›, ๋‹จ๊ตญ๋Œ€ํ•™๊ต๋ณ‘์›, ๋™์•„๋Œ€ํ•™๊ต๋ณ‘์›, ์„œ์šธ๋Œ€ํ•™๊ต๋ณ‘์›, ์„œ์šธ๋Œ€ํ•™๊ต ๋ถ€์† ๋ถ„๋‹น๋ณ‘์›, ์„ฑ๊ท ๊ด€์˜๋Œ€ ์‚ผ์„ฑ์„œ์šธ๋ณ‘์›, ์—ฐ์„ธ๋Œ€ํ•™๊ต ์„ธ๋ธŒ๋ž€์Šค๋ณ‘์›, ์šธ์‚ฐ๋Œ€ํ•™๊ต ์„œ์šธ์•„์‚ฐ๋ณ‘์›, ์„์ง€๋Œ€ํ•™๊ต ๋ถ€์† ๋…ธ์›๋ณ‘์›, ์ „๋‚จ๋Œ€ํ•™๊ต๋ณ‘์›, ์ถฉ๋‚จ๋Œ€ํ•™๊ต๋ณ‘์› ๋ฐ ํ•œ์–‘๋Œ€ํ•™๊ต ๋ถ€์† ๊ตฌ๋ฆฌ๋ณ‘์› ์ด 14๊ฐœ ๋ณ‘์›(๊ฐ€๋‚˜๋‹ค ์ˆœ)์—์„œ ๋‚œ์ฒญ์œผ๋กœ ๋ณด์ฒญ๊ธฐ๋ฅผ ์ฐฉ์šฉํ•˜๊ณ  ์žˆ๋Š” ํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ํ•˜์˜€์œผ๋ฉฐ, ์—ฐ๊ตฌ์— ์ฐธ์—ฌํ•œ ๋ณ‘์›์€ ๋ชจ๋‘ ์—ฐ๊ตฌ ์ „ ๊ฐ ๋ณ‘์›์˜ ์ž„์ƒ์—ฐ๊ตฌ์œค๋ฆฌ์œ„์›ํšŒ(IRB No. 1409-092-610)์˜ ์‹ฌ์˜๋ฅผ ๋ฐ›์•˜๋‹ค.

์‹ ๋ขฐ๋„ ๋ฐ ํƒ€๋‹น๋„ ์กฐ์‚ฌ

์—ฐ๊ตฌ์— ์ฐธ์—ฌํ•œ ๋ณ‘์›์œผ๋กœ APHAB ์ตœ์ข… ํ•œ๊ตญ์–ดํŒ ์ธ์‡„๋ฌผ๊ณผ ์„ค๋ฌธ์ž‘์„ฑ์„ ์œ„ํ•œ ํ•ด์„ค์„œ๋ฅผ ์šฐํŽธ์œผ๋กœ ๋ฐฐํฌํ•˜์˜€๋‹ค. ํ™˜์ž๋“ค์—๊ฒŒ ์—ฐ๊ตฌ ์ฐธ์—ฌ์— ๋Œ€ํ•œ ๋™์˜๋ฅผ ๊ตฌํ•œ ํ›„ ์„ค๋ฌธ์ง€ ์ž‘์„ฑ ์ž‘์—…์„ ์‹œํ–‰ํ•˜์˜€๊ณ , ํ™˜์ž ๋ณธ์ธ์ด ์„ค๋ฌธ์ง€ ์ž‘์„ฑํ•˜๋Š” ๊ฒƒ์„ ์›์น™์œผ๋กœ ํ•˜๋˜ ์ดํ•ด๊ฐ€ ๋˜์ง€ ์•Š๋Š” ๋ฌธํ•ญ์— ๋Œ€ํ•ด์„œ๋Š” ๋ณดํ˜ธ์ž์™€ ๊ฐ™์ด ์ƒ์˜ํ•˜์—ฌ ์ž‘์„ฑํ•˜๋„๋ก ํ•˜์˜€๋‹ค.

K-APHAB score ๋ฐ ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ด๋“

Korean version of APHAB(K-APHAB)์˜ ๊ฐ ๋ฌธํ•ญ์€ ํ•ญ์ƒ(99%), ๊ฑฐ์˜ ํ•ญ์ƒ(87%), ๋Œ€์ฒด๋กœ(75%), ์ ˆ๋ฐ˜ ์ •๋„(50%), ๊ฐ€๋”(25%), ๋“œ๋ฌผ๊ฒŒ(12%), ์ „ํ˜€ ์•„๋‹ˆ๋‹ค(1%)์˜ 7๊ฐœ Point Scale์„ ์ด์šฉํ•˜์—ฌ ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ „๊ณผ ์ฐฉ์šฉ ํ›„์˜ ์žฅํ•ด ์ •๋„๋ฅผ ๊ฐ๊ฐ ์ ์ˆ˜ํ™”ํ•˜์˜€๋‹ค. ๋ณธ ์„ค๋ฌธ์ง€๋Š” ๊ธ์ •ํ˜• ์งˆ๋ฌธ๊ณผ ์ผ๋ถ€ ๋ถ€์ •ํ˜• ์งˆ๋ฌธ(ํ•ญ๋ชฉ 1, 9, 11, 16, 19, 21)์ด ์„ž์—ฌ ์žˆ๋Š” ์„ค๋ฌธ์ง€๋กœ, ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ด๋“์„ ๊ตฌํ•  ๋•Œ ๊ธ์ •ํ˜• ์งˆ๋ฌธ์˜ ๊ฒฝ์šฐ ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ „ ์ ์ˆ˜์—์„œ ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ํ›„ ์ ์ˆ˜๋ฅผ ๋บ€ ๊ฐ’์œผ๋กœ ๊ณ„์‚ฐํ•˜์˜€๊ณ , ๋ถ€์ •ํ˜• ์งˆ๋ฌธ์˜ ๊ฒฝ์šฐ ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ํ›„ ์ ์ˆ˜์—์„œ ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ „ ์ ์ˆ˜๋ฅผ ๋บ€ ๊ฐ’์œผ๋กœ ๊ตฌํ•˜์˜€๋‹ค. ๊ฐ ๋ฌธํ•ญ์˜ ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ด๋“์„ ๊ตฌํ•œ ์ดํ›„, 4๊ฐ€์ง€ ์„ธ๋ถ€ ํ•ญ๋ชฉ EC, RV, BN, AV์— ํ•ด๋‹นํ•˜๋Š” ๊ฐ 6๋ฌธํ•ญ๋“ค์˜ ํ‰๊ท ์„ ๊ตฌํ•˜์˜€๋‹ค.

๊ฒฐ ๊ณผ

์ธ์ง€์  ํ™•์ธ(Cognitive debriefing)

์ˆœ ๋ฒˆ์—ญ ๋ฐ ์—ญ ๋ฒˆ์—ญ๊นŒ์ง€ ๋งˆ์นœ K-APHAB์˜ ํ‰๊ท  ์†Œ์š”์‹œ๊ฐ„์€ 11๋ถ„(10~13๋ถ„)์œผ๋กœ, APHAB ์›์ € ์†Œ์š”์‹œ๊ฐ„ 10๋ถ„๊ณผ ํฐ ์ฐจ์ด๋ฅผ ๋ณด์ด์ง€ ์•Š์•˜์ง€๋งŒ, 1, 2, 3, 8, 9, 10, 14, 21, 23๋ฒˆ ๋ฌธํ•ญ๋“ค์˜ ์งˆ๋ฌธ์ด ๋‹ค์†Œ ์ดํ•ดํ•˜๊ธฐ ํž˜๋“ค์—ˆ๋‹ค๋Š” ์˜๊ฒฌ์ด ์žˆ์—ˆ๋‹ค. ์ด์— ์ข€ ๋” ๋งค๋„๋Ÿฌ์šด ๋ฌธ์žฅ์œผ๋กœ ์ˆ˜์ •ํ•˜๋Š” ๊ณผ์ •์„ ๊ฑฐ์ณค๊ณ , ๊ทธ์ค‘ 3๋ฒˆ ๋ฌธํ•ญ์„ ์˜ˆ๋กœ ๋“ค๋ฉด โ€˜ํ™”์žฌ ๊ฒฝ๋ณด ๋˜๋Š” ๋น„์ƒ๋ฒจ๊ณผ ๊ฐ™์€ ์˜ˆ๊ธฐ์น˜ ๋ชปํ•œ ์†Œ๋ฆฌ๊ฐ€ ๋ถˆํŽธํ•ฉ๋‹ˆ๋‹คโ€™์—์„œ โ€˜ํ™”์žฌ ๊ฒฝ๋ณด๊ธฐ๋‚˜ ๋˜๋Š” ์ž๋ช…์ข…๊ณผ ๊ฐ™์€ ๊ฐ‘์ž‘์Šค๋Ÿฐ ์†Œ๋ฆฌ๊ฐ€ ๋ถˆ์พŒํ•ฉ๋‹ˆ๋‹คโ€™๋กœ ์ˆ˜์ •๋˜์—ˆ๋‹ค.

์—ฐ๊ตฌ ๋Œ€์ƒ์ž์˜ ์ž„์ƒ์  ํŠน์ง•

์ตœ์ข… ํ•œ๊ตญ์–ดํŒ APHAB(K-APHAB)๋ฅผ ์ œ์ž‘ํ•˜์˜€๊ณ (Appendix 1), 14๊ฐœ ๊ธฐ๊ด€์—์„œ ์ด 197๋ช…์˜ ํ™˜์ž๊ฐ€ ์„ค๋ฌธ์— ๋‹ตํ•˜์˜€์œผ๋ฉฐ, ์ด ์ค‘ ๋‚จ์ž๋Š” 92๋ช…, ์—ฌ์ž๋Š” 105๋ช…์ด์—ˆ์œผ๋ฉฐ, ์ด๋“ค์˜ ํ‰๊ท  ์—ฐ๋ น์€ ๋‚จ๋…€ ๊ฐ๊ฐ 62(ยฑ19)์„ธ, 68(ยฑ15)์„ธ์˜€๋‹ค. ์ฒญ๋ ฅ์€ 40 dB์ดํ•˜์˜ ๊ฒฝ๋„ ๋‚œ์ฒญ 14๋ช…, ์ค‘๋„ ๋‚œ์ฒญ 24๋ช…, ์ค‘๊ณ ๋„ ๋‚œ์ฒญ 37๋ช…, ๊ณ ๋„ ๋‚œ์ฒญ 96๋ช… ๊ทธ๋ฆฌ๊ณ  ์‹ฌ๋„ ๋‚œ์ฒญ 26๋ช…์ด์—ˆ๋‹ค. ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ๊ฒฝ๋ ฅ์€ 6์ฃผ ๋ฏธ๋งŒ 42๋ช…, 6์ฃผ์—์„œ 1๋…„ ๋ฏธ๋งŒ 55๋ช…, 1๋…„ ์ด์ƒ 10๋…„ ๋ฏธ๋งŒ 78๋ช…, 10๋…„ ์ด์ƒ 18๋ช…์ด์—ˆ๋‹ค(๋ฌด์‘๋‹ต 4๋ช…). ํ•˜๋ฃจ ๋™์•ˆ ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ์„ ์ „ํ˜€ ํ•˜์ง€ ์•Š๋Š” ์‚ฌ๋žŒ์ด 7๋ช…, 1์‹œ๊ฐ„ ๋ฏธ๋งŒ 5๋ช…, 1์‹œ๊ฐ„ ์ด์ƒ 4์‹œ๊ฐ„ ๋ฏธ๋งŒ 24๋ช…, 4์‹œ๊ฐ„ ์ด์ƒ 8์‹œ๊ฐ„ ๋ฏธ๋งŒ 73๋ช…, 8์‹œ๊ฐ„ ์ด์ƒ 16์‹œ๊ฐ„ ๋ฏธ๋งŒ์ด 83๋ช…์ด์—ˆ๋‹ค(๋ฌด์‘๋‹ต 5๋ช…)(Table 1).

๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ด๋“

๋ฌธํ•ญ๋ณ„ K-APHAB score, ๋ณด์ฒญ๊ธฐ ์ด๋“ ํ‰๊ท , ํ‘œ์ค€ํŽธ์ฐจ ๊ทธ๋ฆฌ๊ณ  ๊ฐ ๋ฌธํ•ญ์˜ ์‘๋‹ต๋ฅ ์„ ๊ตฌํ•˜์˜€๊ณ (Appendix 2), K-APHAB ์„ธ๋ถ€ ํ•ญ๋ชฉ EC, BN, RV, AV์˜ ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ด๋“ ํ‰๊ท ์€ ๊ฐ๊ฐ 24.8(ยฑ30.7), 22.5(ยฑ22.3), 23.5(ยฑ24.4), -18.7(ยฑ28.2)์ด์—ˆ์œผ๋ฉฐ, ๋ณด์ฒญ๊ธฐ ์‚ฌ์šฉ ์ „ํ›„ ์ˆœ์Œ์ฒญ๋ ฅ๊ฒ€์‚ฌ์ƒ ์ด๋“์˜ ํ‰๊ท ์€ 18.6(ยฑ9.3)dB์ด์—ˆ๋‹ค(Table 2).

์‹ ๋ขฐ๋„

K-APHAB์˜ ๋‚ด์  ์ผ์น˜๋„๋Š” Cronbachโ€™s alpha coefficient๋กœ ํ‰๊ฐ€ํ•˜์˜€์œผ๋ฉฐ, 24๋ฌธํ•ญ์— ๋Œ€ํ•œ Cronbachโ€™s alpha ๊ฐ’์€ 0.8๋กœ ๋†’์€ ๋‚ด์  ์ผ์น˜๋„๋ฅผ ๋ณด์˜€๋‹ค. 4๊ฐ€์ง€ ์„ธ๋ถ€ ํ•ญ๋ชฉ์— ๋Œ€ํ•œ Cronbachโ€™s alpha ๊ฐ’์€ EC๋Š” 0.86, AV๋Š” 0.85๋กœ ๋†’์•˜์œผ๋‚˜, BN์€ 0.58, RV๋Š” 0.65๋กœ ๋‹ค์†Œ ๋‚ฎ์€ ๊ฐ’์„ ๋ณด์˜€๋‹ค.

ํƒ€๋‹น๋„

๊ตฌ์„ฑ๊ฐœ๋… ํƒ€๋‹น๋„

์š”์ธ ๋ถ„์„

K-APHAB์˜ Kaiser-Meyer-Olkin ratio๋Š” 0.82๋กœ ๋†’๊ฒŒ ๋‚˜ํƒ€๋‚˜, ๋ณธ ์—ฐ๊ตฌ์— ์‚ฌ์šฉ๋œ 24๊ฐœ์˜ ๋ฌธํ•ญ์ด ์š”์ธ ๋ถ„์„์— ์ ์ ˆํ•œ ํ‘œ๋ณธ์ž„์„ ์•Œ ์ˆ˜ ์žˆ์—ˆ๋‹ค. Varimax rotation์„ ์ด์šฉํ•˜์—ฌ ์ฃผ์„ฑ๋ถ„ ๋ถ„์„์„ ์‹œํ–‰ํ•˜์˜€์œผ๋ฉฐ, 1 ์ด์ƒ์˜ eigenvalue๋ฅผ ๊ฐ–๋Š” 5๊ฐœ์˜ ์š”์ธ์ด ์ถ”์ถœ๋˜์—ˆ์œผ๋‚˜, scree plot์—์„œ 3๋ฒˆ์งธ ์š”์ธ ์ดํ›„๋กœ ๊ทธ๋ž˜ํ”„์˜ ๊ธฐ์šธ๊ธฐ๊ฐ€ ๊ธ‰๊ฒฉํžˆ ๊ฐ์†Œ๋˜์–ด(Fig. 1), ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” K-APHAB๋ฅผ ์„ค๋ช…ํ•  ์š”์ธ์„ 3๊ฐœ๋กœ ๊ฒฐ์ •ํ•˜์˜€๋‹ค. ์š”์ธ ์ˆ˜๋ฅผ 3๊ฐœ๋กœ ์„ค์ •ํ•˜์—ฌ ๋ถ„์„ํ•œ ๊ฒฐ๊ณผ, 3๊ฐœ์˜ ์š”์ธ์— ์˜ํ•ด ์„ค๋ช…๋˜๋Š” ๋น„์œจ์€ ์ด 58%์˜€์œผ๋ฉฐ, ๊ฐ ์š”์ธ์˜ ์„ค๋ช…๋ ฅ์€ ์ œ1์š”์ธ 30%, ์ œ2์š”์ธ 21%, ์ œ3์š”์ธ 7%์˜€๊ณ , 24๋ฌธํ•ญ ๋ชจ๋‘ ๊ฐ ๋ฌธํ•ญ๊ณผ ์š”์ธ ๊ฐ„์˜ ์ƒ๊ด€๊ด€๊ณ„๋ฅผ ๋‚˜ํƒ€๋‚ด๋Š” ์ ์žฌ๋Ÿ‰์ด 0.40 ์ด์ƒ์œผ๋กœ ์œ ์˜์„ฑ์ด ์žˆ์—ˆ๋‹ค(Appendix 3).

์š”์ธ ๋ช…๋ช…

3๊ฐ€์ง€ ์š”์ธ๋“ค์˜ ๋ช…๋ช…์„ ์œ„ํ•ด ๊ฐ ์š”์ธ์— ํ•ด๋‹นํ•˜๋Š” ๋ฌธํ•ญ์„ ๋ถ„์„ํ•œ ๊ฒฐ๊ณผ, ์ œ1์š”์ธ์— ํ•ด๋‹นํ•˜๋Š” ๋ฌธํ•ญ์€ โ€˜๊ฐ•์˜๋‚˜ ์ˆ˜์—… ๋“ฃ๊ธฐโ€™, โ€˜์ง‘์—์„œ ๊ฐ€์กฑ๊ณผ์˜ ๋Œ€ํ™”โ€™, โ€˜์˜ํ™” ๋˜๋Š” ๊ณต์—ฐ์˜ ๋Œ€์‚ฌ ์ฒญ์ทจโ€™, โ€˜์ฐจ ์•ˆ์—์„œ ๋‹ค๋ฅธ ์‚ฌ๋žŒ๋“ค ๊ฐ„์˜ ๋Œ€ํ™” ์ค‘ ๋ผ๋””์˜ค ์ฒญ์ทจโ€™, โ€˜์—ฌ๋Ÿฌ ์‚ฌ๋žŒ๊ณผ ์ €๋… ์‹์‚ฌ ์ค‘ ํ•œ ์‚ฌ๋žŒ๊ณผ์˜ ๋Œ€ํ™”โ€™, โ€˜์‚ฌ๋ฌด์‹ค์—์„œ ์งˆ๋ฌธ์„ ๋ฐ›๊ณ  ๋Œ€๋‹ตํ•˜๊ธฐโ€™, โ€˜์นœ๊ตฌ ํ•œ ์‚ฌ๋žŒ๊ณผ ์กฐ์šฉํžˆ ๋Œ€ํ™”โ€™, โ€˜๋ชจ์ž„์—์„œ์˜ ๋Œ€ํ™”โ€™, โ€˜์ง„์ฐฐ์‹ค์—์„œ ์˜์‚ฌ์™€์˜ ๋Œ€ํ™”โ€™, โ€˜๊ตํšŒ ์˜ˆ๋ฐฐ ๋‚ด์šฉ ๋“ฃ๊ธฐโ€™, โ€˜์กฐ์šฉํ•œ ๋ฐฉ์—์„œ ์ผ๋Œ€์ผ๋กœ ๋Œ€ํ™”โ€™, โ€˜๊ธฐ๊ณ„์†Œ์Œ ์†์—์„œ์˜ ๋Œ€ํ™”โ€™์˜ 12๋ฌธํ•ญ์œผ๋กœ, ์ผ์ƒ ์ƒํ™œ ์ „๋ฐ˜์— ๊ฑธ์นœ ๋‚ด์šฉ๋“ค์ด ํฌํ•จ๋˜์–ด ์žˆ์–ด ์ œ1์š”์ธ์„ โ€˜์ผ์ƒ ์ƒํ™œ์—์„œ์˜ ์˜์‚ฌ ์†Œํ†ตโ€™์ด๋ผ ๋ช…๋ช…ํ•˜์˜€๋‹ค. ์ œ2์š”์ธ์—๋Š” โ€˜ํ™”์žฌ ๊ฒฝ๋ณด ๋˜๋Š” ์ž๋ช…์ข… ๊ฐ™์€ ๊ฐ‘์ž‘์Šค๋Ÿฌ์šด ์†Œ๋ฆฌ์˜ ๋ถˆ์พŒ๊ฐโ€™, โ€˜๊ตํ†ต ์†Œ์Œ์˜ ์‹œ๋„๋Ÿฌ์›€โ€™, โ€˜์ƒค์›Œ๊ธฐ ๋˜๋Š” ๋ณ€๊ธฐ ๋ฌผ ๋‚ด๋ฆฌ๋Š” ์†Œ๋ฆฌ์˜ ๋ถˆ์พŒ๊ฐโ€™, โ€˜๊ณต์‚ฌ์žฅ ์†Œ์Œ์˜ ์‹œ๋„๋Ÿฌ์›€โ€™, โ€˜์†Œ๋ฐฉ์ฐจ ์‚ฌ์ด๋ Œ ์†Œ๋ฆฌ์˜ ์‹œ๋„๋Ÿฌ์›€โ€™, โ€˜๊ธ‰์ •๊ฑฐ ์‹œ ํƒ€์ด์–ด ์†Œ๋ฆฌ์˜ ๋ถˆ์พŒ๊ฐโ€™์˜ 6๋ฌธํ•ญ์ด ์†ํ•ด ์žˆ์œผ๋ฉฐ, ๋ชจ๋‘ ํฐ ์†Œ๋ฆฌ์— ๋Œ€ํ•œ ๋ถˆ์พŒ๊ฐ์— ๊ด€ํ•œ ๋‚ด์šฉ์ด๋ฏ€๋กœ ์ œ2์š”์ธ์„ โ€˜ํฐ ์†Œ๋ฆฌ์— ๋Œ€ํ•œ ๋ถˆ์พŒ๊ฐโ€™์ด๋ผ ๋ช…๋ช…ํ•˜์˜€๋‹ค. ์ œ3์š”์ธ์—๋Š” โ€˜ํ˜ผ์žกํ•œ ์‹ํ’ˆ ๋งค์žฅ ๊ณ„์‚ฐ ์‹œ ๋Œ€ํ™”โ€™, โ€˜ํฐ ๋ฐฉ์•ˆ์—์„œ ๊ฑด๋„ˆํŽธ ์‚ฌ๋žŒ๊ณผ์˜ ๋Œ€ํ™”โ€™, โ€˜๊ทน์žฅ ๋˜๋Š” ๊ณต์—ฐ์žฅ์—์„œ ์ฃผ๋ณ€์˜ ์†์‚ญ์ด๋Š” ์†Œ๋ฆฌ ๋˜๋Š” ๋ฐ”์Šค๋ฝ๊ฑฐ๋ฆฌ๋Š” ์†Œ์Œ์ด ์žˆ๋Š” ์ƒํ™ฉ์—์„œ ๋Œ€์‚ฌ ์ฒญ์ทจโ€™, โ€˜์—ฌ๋Ÿฌ ์‚ฌ๋žŒ๋“ค๊ณผ์˜ ๋Œ€ํ™”โ€™, โ€˜ํ˜ผ์žกํ•œ ๊ตฐ์ค‘ ์†์—์„œ์˜ ๋Œ€ํ™”โ€™, โ€˜์ข…๊ต์˜์‹์—์„œ ์„ค๊ต๋‚˜ ๊ฐ•์˜ ์ฒญ์ทจโ€™์˜ 6๋ฌธํ•ญ์ด ํฌํ•จ๋˜์–ด ์žˆ์œผ๋ฉฐ, ๋ชจ๋‘ ์†Œ์Œ ํ™˜๊ฒฝ ๋˜๋Š” ๋ฐ˜ํ–ฅ์Œ์—์„œ์˜ ์˜์‚ฌ ์†Œํ†ต์— ๊ด€๋ จ๋œ ๋‚ด์šฉ์ด๋ฏ€๋กœ ์ œ3์š”์ธ์„ โ€˜์†Œ์Œ/๋ฐ˜ํ–ฅ์Œ์—์„œ์˜ ์˜์‚ฌ ์†Œํ†ตโ€™์ด๋ผ ๋ช…๋ช…ํ•˜์˜€๋‹ค.

์ค€๊ฑฐ ํƒ€๋‹น๋„

K-APHAB์˜ ์ค€๊ฑฐ ํƒ€๋‹น๋„๋Š” ๋ณด์ฒญ๊ธฐ ์‚ฌ์šฉ ์‹œ ์–ป๋Š” ์ฒญ๊ฐํ•™์  ์ด๋“๊ณผ K-APHAB ์„ค๋ฌธ์„ ํ†ตํ•ด ์–ป์€ ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ด๋“์˜ ์ƒ๊ด€๊ด€๊ณ„๋ฅผ Spearmanโ€™s correlation coefficient๋ฅผ ๊ตฌํ•˜์—ฌ ๋ถ„์„ํ•˜์˜€๋‹ค. ์„ธ๋ถ€ ํ•ญ๋ชฉ EC, BN, RV, AV์™€ ์ฒญ๊ฐํ•™์  ์ด๋“ ์‚ฌ์ด์˜ Spearmanโ€™s correlation coefficient๋Š” ๊ฐ๊ฐ 0.11, 0.08, 0.11, -0.07์ด์—ˆ์œผ๋ฉฐ, ๋ชจ๋‘ ์˜๋ฏธ ์žˆ๋Š” ์ƒ๊ด€๊ด€๊ณ„๋Š” ๋ณด์ด์ง€ ์•Š์•˜๋‹ค(p๏ผž0.05). ํ•˜์ง€๋งŒ ๊ฐ ๋ฌธํ•ญ๋ณ„ ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ „๊ณผ ์ฐฉ์šฉ ํ›„์˜ K-APHAB score๋Š” ๋ชจ๋“  ๋ฌธํ•ญ์—์„œ ํ†ต๊ณ„์ ์œผ๋กœ ์œ ์˜ํ•œ ์ฐจ์ด๋ฅผ ๋ณด์˜€๋‹ค(p๏ผœ0.000)(Appendix 2).

๊ณ  ์ฐฐ

๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ „ํ›„ ์ˆ˜ํ–‰๋Šฅ๋ ฅ๊ณผ ๋งŒ์กฑ๋„๋ฅผ ํ‰๊ฐ€ํ•˜๋Š” ์„ค๋ฌธ์ง€์—๋Š” ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ „ํ›„์˜ ์ด๋“์„ ์ธก์ •ํ•˜๋Š” Hearing Handicap Scale [4], Hearing Aid Profile Inventory [5], Hearing Handicap Inventory [6], APHAB [7] ๋“ฑ์ด ์žˆ์œผ๋ฉฐ, ๋ณด์ฒญ๊ธฐ์˜ ์ฃผ๊ด€์ ์ธ ๋งŒ์กฑ๋„๋ฅผ ์กฐ์‚ฌํ•˜๋Š” ์„ค๋ฌธ์ง€์ธ IOI-HA [8], SADL [9] ๊ทธ๋ฆฌ๊ณ  ์‚ฌ์šฉ์ž์˜ ๋‹ค์–‘ํ•œ ์ธ๊ตฌ์‚ฌํšŒํ•™์  ํ™˜๊ฒฝ์— ๋”ฐ๋ฅธ ๋งŒ์กฑ๋„๋ฅผ ์กฐ์‚ฌํ•˜๋Š” Marke Trak Survey [10]๊ฐ€ ์žˆ๋‹ค. Cox์™€ Gilmore [11]๋Š” ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ํ™˜์ž์˜ ๊ฒฝํ—˜์— ๋Œ€ํ•œ ์„ค๋ฌธ์ง€์ธ profile of hearing aid performance(PHAP)๋ฅผ ๊ฐœ๋ฐœํ•˜์˜€๊ณ , ๊ทธ ๋’ค ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉํ•œ ์ƒํƒœ์™€ ์ฐฉ์šฉํ•˜์ง€ ์•Š์€ ์ƒํƒœ๋ฅผ ๋ชจ๋‘ ํ‰๊ฐ€ํ•˜๋Š” profile of hearing aid benefit(PHAB) [12]๋ฅผ ๊ฐœ๋ฐœํ•˜์—ฌ ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ์œผ๋กœ ์ธํ•œ ์ด๋“์„ ์ธก์ •ํ•  ์ˆ˜ ์žˆ๊ฒŒ ๋˜์—ˆ๋‹ค. ํ•˜์ง€๋งŒ PHAP์™€ PHAB์˜ ๊ฒฝ์šฐ ์ž„์ƒ์—์„œ ์‚ฌ์šฉํ•˜๊ธฐ์—๋Š” ๋ฌธํ•ญ์ˆ˜๊ฐ€ ๋งŽ๊ณ  ๋ณต์žกํ•˜์—ฌ, ์ž„์ƒ์—์„œ ๋ณด๋‹ค ์‰ฝ๊ฒŒ ์‚ฌ์šฉํ•  ์ˆ˜ ์žˆ๋Š” ์„ค๋ฌธ์ง€์˜ ๊ฐœ๋ฐœ์ด ํ•„์š”ํ•˜์˜€๋‹ค. ์ด์— Cox์™€ Alexander [7,13]๋Š” PHAB์˜ 7๊ฐœ์˜ ํ•ญ๋ชฉ๊ณผ 66๊ฐœ์˜ ๋ฌธํ•ญ์—์„œ ์‹ ๋ขฐ๋„๊ฐ€ ๋†’์€ 4ํ•ญ๋ชฉ๊ณผ 24๋ฌธํ•ญ์„ ์„ ํƒํ•œ APHAB๋ฅผ ์ œ์‹œํ•˜๊ฒŒ ๋˜์—ˆ๋‹ค. ์ด๋กœ์จ APHAB๋Š” ๊ฒ€์‚ฌํ•˜๋Š”๋ฐ ์•ฝ 10๋ถ„ ์ •๋„์˜ ์งง์€ ์‹œ๊ฐ„์ด ์†Œ์š”๋˜๋ฉด์„œ, ํ™˜์ž๋“ค์ด ํŠน์ • ์ƒํ™ฉ์—์„œ์˜ ์˜์‚ฌ ์†Œํ†ต์— ์žˆ์–ด ๊ฐ ๋ณด์ฒญ๊ธฐ์˜ ์žฅ์ ๊ณผ ๋‹จ์ ์„ ๋”์šฑ ์ž˜ ํ‰๊ฐ€ํ•˜๊ฒŒ ๋˜์—ˆ์„ ๋ฟ๋งŒ ์•„๋‹ˆ๋ผ ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ด๋“์˜ ์ฃผ๊ด€์ ์ธ ์š”์†Œ๋ฅผ ๊ธฐ๋กํ•  ์ˆ˜๋„ ์žˆ๊ฒŒ ๋˜์—ˆ๋‹ค. APHAB๋Š” ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ด๋“ ํ‰๊ฐ€๊ฐ€ ํ•„์š”ํ•œ ์‹ค์ œ ์ž„์ƒ ํ™˜๊ฒฝ์—์„œ ํ™œ์šฉ๊ฐ€๋Šฅํ•˜๋ฉฐ, ์—ฌ๋Ÿฌ ๋‚œ์ฒญ ๊ทธ๋ฃน์—์„œ์˜ ๋ณด์ฒญ๊ธฐ๋“ค์˜ ๋น„๊ต ํ‰๊ฐ€ํ•˜๋Š” ์—ฐ๊ตฌ์—๋„ ์‚ฌ์šฉ๋  ์ˆ˜ ์žˆ๋‹ค.
K-APHAB์˜ ์ž‘์„ฑ ์†Œ์š”์‹œ๊ฐ„์€ ์•ฝ 11๋ถ„์œผ๋กœ ์›์ €์˜ ์†Œ์š”์‹œ๊ฐ„๊ณผ ํฐ ์ฐจ์ด๊ฐ€ ์—†์—ˆ์œผ๋ฉฐ, K-APHAB ์—ญ์‹œ ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ด๋“์„ ํ‰๊ฐ€ํ•˜๋Š” ๋ฐ ์ž„์ƒ์—์„œ ์‰ฝ๊ฒŒ ์ด์šฉํ•  ์ˆ˜ ์žˆ์„ ๊ฒƒ์œผ๋กœ ๊ธฐ๋Œ€๋œ๋‹ค. ๊ทธ๋ฆฌ๊ณ  ์„ธ๋ถ€ ํ•ญ๋ชฉ EC, BN, RV์˜ ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ด๋“ ํ‰๊ท ๊ฐ’์ด ๊ฐ๊ฐ 24.8, 22.5, 23.5๋กœ ๋‹ค์–‘ํ•œ ํ™˜๊ฒฝ(์กฐ์šฉํ•œ ํ™˜๊ฒฝ, ์†Œ์Œ ํ™˜๊ฒฝ, ๋ฐ˜ํ–ฅ์Œ ํ™˜๊ฒฝ)์˜ ๋Œ€ํ™”์—์„œ ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ด๋“์ด ์žˆ์Œ์„ ํ™•์ธํ•˜์˜€๊ณ , ์„ธ๋ถ€ ํ•ญ๋ชฉ AV์˜ ๊ฒฝ์šฐ ํ‰๊ท ๊ฐ’์ด -18.7๋กœ ํฐ์†Œ๋ฆฌ์— ๋Œ€ํ•œ ํ˜์˜ค๊ฐ์€ ์˜คํžˆ๋ ค ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์‹œ ๋” ์ปค์ง์„ ํ™•์ธํ•  ์ˆ˜ ์žˆ์—ˆ๋‹ค(Table 2). ์ด๋Š” ์ด์ „ APHAB ๊ด€๋ จ ๋‹ค๋ฅธ ์—ฐ๊ตฌ ๊ฒฐ๊ณผ์™€๋„ ๋ถ€ํ•ฉํ•œ๋‹ค[7,14,15].
์‘๋‹ต๋ฅ ์˜ ๊ฒฝ์šฐ ํ‰๊ท ์€ 90.8%(ยฑ4.4)๋กœ ๋น„๊ต์  ๋†’์€ ํŽธ์ด๋‚˜ ๊ฐ ๋ฌธํ•ญ๋ณ„๋กœ ์‚ดํŽด๋ดค์„ ๋•Œ ์‘๋‹ต๋ฅ ์ด 100%์ธ ๋ฌธํ•ญ์€ ์—†์—ˆ๋‹ค(Appendix 2). ์ด๋Š” ์„ค๋ฌธ์ง€์— ์ฐธ์—ฌํ•œ ํ™˜์ž๋“ค์˜ 62%๊ฐ€ ๊ณ ๋„ ๋˜๋Š” ์‹ฌ๋„ ๋‚œ์ฒญ์ด์—ˆ์„ ๋ฟ๋งŒ ์•„๋‹ˆ๋ผ 55%๊ฐ€ 70๋Œ€ ์ด์ƒ์˜ ๊ณ ๋ น์œผ๋กœ(Table 1) ๋Œ€์ƒ์ž ๊ตฐ์ด ์ง‘์ค‘๋ ฅ ๋ฐ ์ธ์ง€๊ธฐ๋Šฅ์ด ๋‹ค์†Œ ์ €ํ•˜๋œ ์ง‘๋‹จ์œผ๋กœ ํŽธํ–ฅ๋˜์—ˆ์Œ์„ ํ™•์ธํ•  ์ˆ˜ ์žˆ์—ˆ๊ณ , ์ด๋กœ ์ธํ•ด ์‘๋‹ต๋ฅ ์ด ์ €ํ•˜๋œ ๊ฒƒ์œผ๋กœ ํŒ๋‹จ๋œ๋‹ค.
K-APHAB์˜ Cronbachโ€™s alpha ๊ฐ’์€ 0.8๋กœ ๋†’์€ ๋‚ด์  ์ผ์น˜๋„ ๋ฐ ์‹ ๋ขฐ๋„๋ฅผ ๋ณด์—ฌ์ฃผ์—ˆ๋‹ค. ์„ธ๋ถ€ ํ•ญ๋ชฉ์˜ Cronbachโ€™s alpha ๊ฐ’์„ ์‚ดํŽด๋ณด๋ฉด EC์™€ AV์˜ ๊ฒฝ์šฐ ๊ฐ๊ฐ 0.86, 0.85๋กœ ๋†’์•˜์œผ๋‚˜, BN ๋ฐ RV์—์„œ๋Š” 0.58๊ณผ 0.65๋กœ ๋‹ค์†Œ ๋‚ฎ์€ ๊ฐ’์„ ๋ณด์˜€๋‹ค. Cox์™€ Alexander [7]๋Š” ์ด์ „ ๋…ผ๋ฌธ์—์„œ ํ•ด๋‹น ๋…ผ๋ฌธ์˜ ํ™˜์ž๊ตฐ๊ณผ ๋‹ค๋ฅธ ํ™˜์ž๊ตฐ์—์„œ๋Š” ๋‚ด์  ์‹ ๋ขฐ๋„๊ฐ€ ๊ฐ์†Œ๋  ์ˆ˜ ์žˆ๋‹ค๊ณ  ์˜ˆ์ƒํ•˜์˜€์œผ๋ฉฐ, APHAB์˜ ์ค‘๊ตญ์–ด ๋ฒˆ์—ญ๋ณธ์—์„œ๋„ AV์˜ ๊ฒฝ์šฐ Cronbachโ€™s alpha ๊ฐ’์ด 0.50์œผ๋กœ ๋‚ฎ๊ฒŒ ๋‚˜์˜จ ๋ฐ” ์žˆ๋‹ค[14].
K-APHAB์˜ ์š”์ธ ๋ถ„์„์—์„œ๋Š” 24๊ฐœ์˜ ํ•ญ๋ชฉ์„ Cox [7,13]๊ฐ€ ์ œ์‹œํ•œ 4๊ฐœ์˜ ์š”์ธ์œผ๋กœ ์ถ”์ถœํ•˜๋Š” ๋ฐ์—๋Š” ์‹คํŒจํ•˜์˜€๋‹ค. 1 ์ด์ƒ์˜ eigenvalue๋ฅผ ๊ฐ–๋Š” ์ด 5๊ฐœ์˜ ์š”์ธ์ด ์ถ”์ถœ๋˜์—ˆ์œผ๋‚˜, scree plot์—์„œ 3๋ฒˆ์งธ ์š”์ธ ์ดํ›„๋กœ ๊ธฐ์šธ๊ธฐ๊ฐ€ ๊ธ‰๊ฒฉํžˆ ์ค„์–ด๋“œ๋Š” ๊ฒƒ์„ ํ™•์ธํ•˜๊ณ  ์š”์ธ ์ˆ˜๋ฅผ 3๊ฐœ๋กœ ๊ฒฐ์ •ํ•˜์˜€๋‹ค. ๋น„๋ก ์›์ €์™€ ๊ฐ™์ด 4๊ฐœ์˜ ์š”์ธ์œผ๋กœ ์ถ”์ถœํ•˜๋Š” ๋ฐ์—๋Š” ์‹คํŒจํ•˜์˜€์ง€๋งŒ, APHAB์™€ K-APHAB์˜ ํ•˜๋ถ€์š”์ธ์— ๋”ฐ๋ฅธ ๋ฌธํ•ญ๋“ค์„ ๋น„๊ตํ•˜์˜€์„ ๋•Œ ์„œ๋กœ ์œ ์‚ฌํ•œ ํ˜•ํƒœ๋กœ ๋ฌถ์—ฌ์ง์„ ํ™•์ธํ•  ์ˆ˜ ์žˆ์—ˆ๋‹ค. 30%๋กœ ๊ฐ€์žฅ ์„ค๋ช…๋ ฅ์ด ๋†’์•˜๋˜ K-APHAB์˜ ์ œ1์š”์ธ์€ APHAB์˜ EC 6๋ฌธํ•ญ๊ณผ BN 3๋ฌธํ•ญ, RV 3๋ฌธํ•ญ์œผ๋กœ ์ด๋ฃจ์–ด์ ธ ์žˆ์—ˆ๊ณ , ์ด๋Š” ์กฐ์šฉํ•œ ํ™˜๊ฒฝ์—์„œ์˜ ๋Œ€ํ™”๋ฅผ ์œ„์ฃผ๋กœ ํ•˜๋˜ ์†Œ์Œ ๋ฐ ๋ฐ˜ํ–ฅ์Œ ํ™˜๊ฒฝ์˜ ๋Œ€ํ™”๊ฐ€ ์ผ๋ถ€ ์„ž์ธ ์ผ์ƒ ์ƒํ™œ ์ „๋ฐ˜์— ๊ด€๋ จ๋œ ๋‚ด์šฉ์„ ๋‹ค๋ฃจ๊ณ  ์žˆ์–ด โ€˜์ผ์ƒ ์ƒํ™œ์—์„œ์˜ ์˜์‚ฌ ์†Œํ†ตโ€™์ด๋ผ๊ณ  ๋ช…๋ช…ํ•˜์˜€๋‹ค. 21%์˜ ์„ค๋ช…๋ ฅ์„ ๊ฐ€์ง„ ์ œ2์š”์ธ์€ APHAB์˜ AV 6๋ฌธํ•ญ์œผ๋กœ๋งŒ ์ด๋ฃจ์–ด์ ธ ์žˆ์—ˆ๊ณ , ๋ชจ๋‘ ํฐ ์†Œ๋ฆฌ์— ๋Œ€ํ•œ ๋ถˆ์พŒ๊ฐ์— ๊ด€๋ จ๋˜์–ด ์žˆ์–ด โ€˜ํฐ ์†Œ๋ฆฌ์— ๋Œ€ํ•œ ๋ถˆ์พŒ๊ฐโ€™์ด๋ผ ๋ช…๋ช…ํ•˜์˜€๋‹ค. 7%์˜ ์„ค๋ช…๋ ฅ์„ ๊ฐ€์ง„ ์ œ 3์š”์ธ์€ APHAB์˜ BN 3๋ฌธํ•ญ, RV 3๋ฌธํ•ญ์œผ๋กœ ๊ตฌ์„ฑ๋˜์—ˆ๊ณ , ์ฃผ๋กœ ์†Œ์Œ ํ™˜๊ฒฝ ๋˜๋Š” ๋ฐ˜ํ–ฅ์Œ์—์„œ์˜ ์˜์‚ฌ ์†Œํ†ต์— ๊ด€๋ จ๋œ ๋‚ด์šฉ์ด๋ฏ€๋กœ โ€˜์†Œ์Œ/๋ฐ˜ํ–ฅ์Œ์—์„œ์˜ ์˜์‚ฌ ์†Œํ†ตโ€™์ด๋ผ ๋ช…๋ช…ํ•˜์˜€๋‹ค.
์ค€๊ฑฐ ํƒ€๋‹น๋„ ๊ฒ€์ฆ์„ ์œ„ํ•ด ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ „ํ›„ ์ˆœ์Œ์ฒญ๋ ฅ๊ฒ€์‚ฌ์˜ ์—ญ์น˜์™€ K-APHAB ์ ์ˆ˜ ์‚ฌ์ด์˜ ์ƒ๊ด€๊ด€๊ณ„๋ฅผ ํ‰๊ฐ€ํ•˜์˜€์ง€๋งŒ ํ†ต๊ณ„์ ์œผ๋กœ ์œ ์˜ํ•˜์ง€ ์•Š์•˜๋‹ค. ์ผ๋ฐ˜์ ์œผ๋กœ ๋ณด์ฒญ๊ธฐ์˜ ๋งŒ์กฑ๋„๋Š” ์ค‘๋„๋‚˜ ์ค‘๊ณ ๋„ ๋‚œ์ฒญ์—์„œ ๊ฐ€์žฅ ๋†’์œผ๋ฉฐ, ๊ฒฝ๋„๋‚˜ ๊ณ ๋„ ๋‚œ์ฒญ์—์„œ๋Š” ๋น„๊ต์  ๋‚ฎ๋‹ค๊ณ  ์•Œ๋ ค์ ธ ์žˆ์œผ๋‚˜, ์ด๋ฒˆ K-APHAB ์„ค๋ฌธ์— ์ฐธ์—ฌํ•œ ํ™˜์ž๋“ค์˜ ์•ฝ 62%๊ฐ€ ๊ณ ๋„ ๋‚œ์ฒญ ์ด์ƒ์˜ ํ™˜์ž๋“ค์ด์—ˆ์œผ๋ฉฐ, ์ด๋กœ ์ธํ•ด ์„ ํ˜•์  ์ƒ๊ด€๊ด€๊ณ„๋ฅผ ๋‚˜ํƒ€๋‚ด๊ธฐ ์–ด๋ ค์› ์„ ๊ฒƒ์œผ๋กœ ์ถ”์ •๋œ๋‹ค. ํ•˜์ง€๋งŒ ๊ฐ ๋ฌธํ•ญ๋ณ„ ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ „๊ณผ ์ฐฉ์šฉ ํ›„์˜ K-APHAB score๋Š” ๋ชจ๋“  ๋ฌธํ•ญ์—์„œ ํ†ต๊ณ„์ ์œผ๋กœ ์œ ์˜ํ•œ ์ฐจ์ด๋ฅผ ๋ณด์˜€๊ณ , ์ด๋ฅผ ํ†ตํ•ด K-APHAB์˜ ์ค€๊ฑฐ ํƒ€๋‹น๋„๊ฐ€ ๊ฒ€์ฆ๋˜์—ˆ๋‹ค๊ณ  ๋ณผ ์ˆ˜ ์žˆ๊ฒ ๋‹ค.
์ €์ž๋“ค์€ APHAB๋ฅผ ํ•œ๊ตญ์–ด๋กœ ๋ฒˆ์—ญํ•˜์˜€์œผ๋ฉฐ, ํ•œ๊ตญ์–ดํŒ APHAB์˜ ํƒ€๋‹น๋„ ๋ฐ ์‹ ๋ขฐ๋„๋ฅผ ์ฆ๋ช…ํ•˜์˜€๋‹ค. ์ด ๊ณผ์ •์„ ํ†ตํ•˜์—ฌ ๊ตญ๋‚ด ๋ณด์ฒญ๊ธฐ ์‚ฌ์šฉ ๋‚œ์ฒญํ™˜์ž๋“ค์˜ ๋ณด์ฒญ๊ธฐ ์ฐฉ์šฉ ์ด๋“ ํ‰๊ฐ€์— ํ‘œ์ค€ํ™”๋œ ํ•œ๊ตญ์–ดํŒ APHAB๋ฅผ ์ œ๊ณตํ•  ์ˆ˜ ์žˆ๊ฒŒ ๋˜์—ˆ๋‹ค. ๋˜ํ•œ ํ‘œ์ค€ํ™”๋œ ์„ค๋ฌธ์ง€๋ฅผ ์‚ฌ์šฉํ•จ์œผ๋กœ์จ APHAB๋ฅผ ์ด์šฉํ•œ ์—ฐ๊ตฌ๋“ค์˜ ๋น„๊ต ๋ถ„์„์ด ๊ฐ€๋Šฅํ•˜๊ฒŒ ๋  ๊ฒƒ์œผ๋กœ ๊ธฐ๋Œ€ํ•œ๋‹ค.

ACKNOWLEDGMENTS

This study received the approval (Research Grant No. 1409-092-610) from the Institutional Review Board of Seoul National University Hospital.

Appendices

Appendix 1.

Korean Version of Abbreviated Profile of Hearing Aid Benefit
์„ค๋ช…: ๊ท€ํ•˜์˜ ์ผ์ƒ ๊ฒฝํ—˜๊ณผ ๊ฐ€์žฅ ๊ฐ€๊นŒ์šด ๋Œ€๋‹ต์— ๋™๊ทธ๋ผ๋ฏธ๋ฅผ ํ•˜์‹ญ์‹œ์˜ค. ๊ฐ๊ฐ์˜ ๋ณด๊ธฐ๋Š” ๋นˆ๋„๋ฅผ ํ‘œ์‹œํ•ฉ๋‹ˆ๋‹ค. ๋นˆ๋„๋ฅผ ๋ณด๊ณ  ๋Œ€๋‹ต์„ ๊ฒฐ์ •ํ•˜์‹ญ์‹œ์˜ค. ์˜ˆ๋ฅผ ๋“ค์–ด, ๊ท€ํ•˜์˜ ๊ฒฝํ—˜์ด ์•ฝ 75% ๋ฌธํ•ญ์— ํ•ด๋‹นํ•˜๋ฉด โ€˜๋‹คโ€™์— ๋™๊ทธ๋ผ๋ฏธ๋ฅผ ํ•˜์‹ญ์‹œ์˜ค. ๋งŒ์•ฝ ๋ฌธํ•ญ์—์„œ ์„ค๋ช…ํ•œ ์ƒํ™ฉ์„ ๊ฒฝํ—˜ํ•œ ์ ์ด ์—†๋‹ค๋ฉด ๊ท€ํ•˜๊ฐ€ ๊ฒฝํ—˜ํ•ด ๋ณธ ์œ ์‚ฌํ•œ ์ƒํ™ฉ์„ ์ƒ๊ฐํ•ด ๋ณด๊ณ  ๊ทธ ์ƒํ™ฉ์— ๋งž๊ฒŒ ๋Œ€๋‹ตํ•˜์‹ญ์‹œ์˜ค. ๋ชจ๋ฅด๋Š” ๋‚ด์šฉ์€ ๋นˆ์นธ์œผ๋กœ ๋‚จ๊ฒจ๋‘์‹ญ์‹œ์˜ค.
๊ฐ€. ํ•ญ์ƒ(99%)
๋‚˜. ๊ฑฐ์˜ ํ•ญ์ƒ(87%)
๋‹ค. ๋Œ€์ฒด๋กœ(75%)
๋ผ. ์ ˆ๋ฐ˜ ์ •๋„(50%)
๋งˆ. ๊ฐ€๋”(25%)
๋ฐ”. ๋“œ๋ฌผ๊ฒŒ(12%)
์‚ฌ. ์ „ํ˜€ ์•„๋‹ˆ๋‹ค(1%)
๋ณด์ฒญ๊ธฐ ๋ฏธ์‚ฌ์šฉ ์‹œ ๋ณด์ฒญ๊ธฐ ์‚ฌ์šฉ ์‹œ
1. ๋‚˜๋Š” ํ˜ผ์žกํ•œ ์‹ํ’ˆ ๋งค์žฅ์—์„œ ๊ณ„์‚ฐ์„ ํ•  ๋•Œ ์ž˜ ์•Œ์•„๋“ค์„ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
2. ๋‚˜๋Š” ๊ฐ•์˜๋‚˜ ์ˆ˜์—…์„ ๋“ค์„ ๋•Œ ๋งŽ์€ ๋‚ด์šฉ์„ ๋†“์นฉ๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
3. ํ™”์žฌ ๊ฒฝ๋ณด๊ธฐ๋‚˜ ๋˜๋Š” ์ž๋ช…์ข…๊ณผ ๊ฐ™์€ ๊ฐ‘์ž‘์Šค๋Ÿฌ์šด ์†Œ๋ฆฌ๊ฐ€ ๋ถˆ์พŒํ•ฉ๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
4. ๋‚˜๋Š” ์ง‘์—์„œ ๊ฐ€์กฑ ์ค‘ ํ•œ ๋ช…๊ณผ ๋Œ€ํ™”ํ•  ๋•Œ ์–ด๋ ค์›€์ด ์žˆ์Šต๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
5. ๋‚˜๋Š” ์˜ํ™”๊ด€์ด๋‚˜ ๊ณต์—ฐ์žฅ์—์„œ ๋Œ€์‚ฌ๋ฅผ ์ดํ•ดํ•˜๋Š” ๋ฐ ์–ด๋ ค์›€์ด ์žˆ์Šต๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
6. ๋‚˜๋Š” ์ฐจ ์•ˆ์—์„œ ๋‰ด์Šค๋ฅผ ๋“ค์„ ๋•Œ ์‹๊ตฌ๋“ค์ด ๋ง์„ ํ•˜๋ฉด๏ผŒ๋ผ๋””์˜ค์˜ ๋‰ด์Šค๋ฅผ ๋“ฃ๊ธฐ๊ฐ€ ์–ด๋ ต์Šต๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
7. ๋‚˜๋Š” ์—ฌ๋Ÿฌ ์‚ฌ๋žŒ๊ณผ์˜ ์ €๋…์‹์‚ฌ ์ค‘ ํ•œ ์‚ฌ๋žŒ๊ณผ ์ด์•ผ๊ธฐ๋ฅผ ํ•  ๋•Œ ์–ด๋ ค์›€์ด ์žˆ์Šต๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
8. ๊ฑฐ๋ฆฌ์˜ ๊ตํ†ต ์†Œ์Œ์ด ๋„ˆ๋ฌด ์‹œ๋„๋Ÿฝ์Šต๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
9. ๋‚˜๋Š” ์ปค๋‹ค๋ž€ ๋นˆ ๋ฐฉ์•ˆ์—์„œ ๊ฑด๋„ˆํŽธ ๋ˆ„๊ตฐ๊ฐ€์™€ ์ด์•ผ๊ธฐ๋ฅผ ํ•  ๋•Œ ๊ทธ ๋ง์„ ์ดํ•ดํ•  ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
10. ๋‚˜๋Š” ์ž‘์€ ์‚ฌ๋ฌด์‹ค ์•ˆ์—์„œ ๋ฉด์ ‘์„ ๋ณด๊ฑฐ๋‚˜ ์งˆ๋ฌธ์— ๋Œ€๋‹ตํ•  ๋•Œ ๋Œ€ํ™”๋ฅผ ์ดํ•ดํ•˜๋Š” ๊ฒƒ์ด ์–ด๋ ต์Šต๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
11. ๋‚˜๋Š” ๊ทน์žฅ์—์„œ ์˜ํ™”๋‚˜ ์—ฐ๊ทน์„ ๋ณผ ๋•Œ ์ฃผ๋ณ€์—์„œ ์†์‚ญ์ด๊ฑฐ๋‚˜ ๋ฐ”์Šค๋ฝ๊ฑฐ๋ฆฌ๋Š” ์†Œ๋ฆฌ๊ฐ€ ๋‚˜๋„ ๋Œ€์‚ฌ๋ฅผ ์ดํ•ดํ•  ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
12. ๋‚˜๋Š” ์นœ๊ตฌ์™€ ์กฐ์šฉํžˆ ์ด์•ผ๊ธฐ๋ฅผ ํ•  ๋•Œ ์•Œ์•„๋“ฃ๊ธฐ๊ฐ€ ์–ด๋ ต์Šต๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
13. ์ƒค์›Œ๊ธฐ ๋˜๋Š” ๋ณ€๊ธฐ์˜ ๋ฌผ์„ ๋‚ด๋ฆด ๋•Œ ๋‚˜๋Š” ์†Œ๋ฆฌ๋Š” ๋ถˆ์พŒํ•˜๊ฒŒ ์‹œ๋„๋Ÿฝ์Šต๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
14. ๋ˆ„๊ตฐ๊ฐ€ ์ž‘์€ ๋ชจ์ž„์—์„œ ๋ง์„ ํ•˜๊ณ  ์ฒญ์ค‘์ด ์กฐ์šฉํžˆ ๋“ฃ๊ณ  ์žˆ์„ ๋•Œ์—๋„ ๋‚˜๋Š” ๋‚ด์šฉ์„ ์•Œ์•„๋“ค์œผ๋ ค๋ฉด ์• ์จ์•ผ ํ•ฉ๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
15. ๋‚˜๋Š” ์ง„์ฐฐ์‹ค์—์„œ ๋‹ด๋‹น ์˜์‚ฌ์™€ ์กฐ์šฉํžˆ ๋Œ€ํ™”ํ•  ๋•Œ ์•Œ์•„๋“ฃ๊ธฐ๊ฐ€ ์–ด๋ ต์Šต๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
16. ๋‚˜๋Š” ์—ฌ๋Ÿฌ ์‚ฌ๋žŒ์ด ์ด์•ผ๊ธฐ๋ฅผ ํ•˜๊ณ  ์žˆ์„ ๋•Œ์—๋„ ๊ทธ ๋Œ€ํ™”๋“ค์„ ์•Œ์•„๋“ค์„ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
17. ๊ณต์‚ฌ์žฅ์˜ ์†Œ์Œ์€ ๋ถˆ์พŒํ•˜๊ฒŒ ์‹œ๋„๋Ÿฝ์Šต๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
18. ๋‚˜๋Š” ๊ฐ•์˜ ๋˜๋Š” ์˜ˆ๋ฐฐ์—์„œ ํ•˜๋Š” ๋ง์„ ์•Œ์•„๋“ฃ๊ธฐ ์–ด๋ ต์Šต๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
19. ๋‚˜๋Š” ๊ตฐ์ค‘ ์†์— ์žˆ์„ ๋•Œ ๋‹ค๋ฅธ ์‚ฌ๋žŒ๋“ค๊ณผ ๋Œ€ํ™”๋ฅผ ๋‚˜๋ˆŒ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
20. ๊ฐ€๊นŒ์ด์—์„œ ์†Œ๋ฐฉ์ฐจ ์‚ฌ์ด๋ Œ ์†Œ๋ฆฌ๊ฐ€ ๋‚˜๋ฉด ๋„ˆ๋ฌด ์‹œ๋„๋Ÿฌ์›Œ์„œ ๊ท€๋ฅผ ๋ง‰์•„์•ผ ํ•ฉ๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
21. ๋‚˜๋Š” ์ข…๊ต์˜์‹์—์„œ ์„ค๊ต๋‚˜ ๊ฐ•์˜๋ฅผ ์ดํ•ดํ•  ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
22. ๊ธ‰์ •๊ฑฐํ•  ๋•Œ ๋‚˜๋Š” ํƒ€์ด์–ด ์†Œ๋ฆฌ๋Š” ๋ถˆ์พŒํ•˜๊ฒŒ ์‹œ๋„๋Ÿฝ์Šต๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
23. ๋‚˜๋Š” ์กฐ์šฉํ•œ ๋ฐฉ์—์„œ ์ผ๋Œ€์ผ๋กœ ๋Œ€ํ™”๋ฅผ ๋‚˜๋ˆŒ ๋•Œ ์‚ฌ๋žŒ๋“ค์—๊ฒŒ ๋‹ค์‹œ ๋งํ•ด๋‹ฌ๋ผ๊ณ  ๋ถ€ํƒํ•ด์•ผ ํ•ฉ๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ
24. ๋‚˜๋Š” ์—์–ด์ปจ์ด๋‚˜ ํ™˜ํ’๊ธฐ๊ฐ€ ์ผœ์ ธ ์žˆ์„ ๋•Œ ๋‹ค๋ฅธ ์‚ฌ๋žŒ๋“ค์˜ ๋Œ€ํ™”๋ฅผ ์•Œ์•„๋“ฃ๊ธฐ๊ฐ€ ์–ด๋ ต์Šต๋‹ˆ๋‹ค. ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ ๊ฐ€ ๋‚˜ ๋‹ค ๋ผ ๋งˆ ๋ฐ” ์‚ฌ

Appendix 2.

Response Rate, K-APHAB Score, Mean of Hearing Aid Benefit of Each Item of the K-APHAB
Subscale Item Response rate (%) K-APHAB score
p-value Mean of hearing aid benefit SD
Without hearing aid With hearing aid
BN 1* 92 40.5 62.8 < 0.000 22.3 42.0
RV 2 84 56.0 39.0 < 0.000 l7.0 42.6
AV 3 95 3l.0 47.9 <0.000 -l6.9 38.5
EC 4 95 48.l 30.2 <0.000 l7.9 4l.2
RV 5 83 58.8 34.8 <0.000 24.0 37.6
BN 6 9l 64.6 39.3 <0.000 25.3 37.9
BN 7 96 58.6 34.6 <0.000 24.0 36.l
AV 8 95 23.8 45.8 <0.000 -22.0 38.0
RV 9* 94 36.4 57.6 <0.000 2l.2 38.l
EC 10 88 52.5 34.5 <0.000 l8.0 4l.8
RV 11* 87 3l.4 55.6 <0.000 24.l 35.0
EC l2 94 56.0 29.8 <0.000 26.2 38.6
AV l3 96 l7.0 33.4 <0.000 -l6.4 32.l
EC l4 93 69.9 43.0 <0.000 26.9 34.4
EC l5 95 6l.5 33.0 <0.000 28.5 39.9
BN 16* 9l 35.8 53.4 <0.000 l7.6 38.3
AV l7 93 3l.6 49.9 <0.000 -l8.3 35.3
RV l8 82 63.l 36.9 <0.000 26.2 38.3
BN 19* 88 30.7 52.2 <0.000 2l.5 38.l
AV 20 93 25.2 43.4 <0.000 -l8.2 35.0
RV 21* 84 33.2 60.7 <0.000 27.5 37.8
AV 22 86 26.7 44.0 <0.000 -17.3 36.0
EC 23 93 60.8 29.5 <0.000 3l.3 35.4
BN 24 92 58.7 35.l <0.000 23.6 37.1

* reversed items. Hearing aid benefit: computed by subtracting the results for โ€œwith hearing aidโ€ from those for โ€œwithout hearing aidโ€, Hearing aid benefit of reversed items: computed by subtracting the results for โ€œwithout hearing aidโ€ from those for โ€œwith hearing aidโ€. K-APHAB: Korean version of abbreviated profile of hearing aid benefit, EC: ease of communication, BN: background noise, RV: reverberation, AV: aversiveness, SD: standard deviation

Appendix 3.

Results of the Principal Component Factor Analysis of the K-APHAB
Subscale Item Factor
1 2 3
BN 1 -0.19 0.14 0.70
RV 2 0.67 -0.06 -0.12
AV 3 0.24 0.55 -0.35
EC 4 0.79 -0.07 -0.04
RV 5 0.84 -0.03 -0.10
BN 6 0.80 0.03 -0.12
BN 7 0.83 -0.08 0.01
AV 8 0.11 0.74 -0.22
RV 9 0.21 -0.24 0.60
EC 10 0.56 -0.28 -0.02
RV 11 0.08 -0.17 0.70
EC 12 0.74 0.04 0.01
AV 13 -0.003 0.71 -0.04
EC 14 0.78 0.03 0.24
EC 15 0.76 0.06 0.03
BN 16 0.13 -0.26 0.58
AV 17 -0.23 0.73 -0.23
RV 18 0.64 0.24 0.27
BN 19 0.04 -0.25 0.62
AV 20 0.02 0.79 -0.20
RV 21 0.15 -0.36 0.57
AV 22 0.05 0.81 -0.35
EC 23 0.79 -0.03 0.12
BN 24 0.73 0.02 0.27

K-APHAB: Korean version of abbreviated profile of hearing aid benefit, EC: ease of communication, BN: background noise, RV: reverberation, AV: aversiveness

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Fig.ย 1.
Scree plot.
kjorl-hns-2016-17398f1.tif
Tableย 1.
Clinical characteristics enrolled in the study
Category n %
Gender
โ€ƒMale 92 47
โ€ƒFemale 105 53
Age
โ€ƒ๏ผœ40 20 10
โ€ƒ40-49 10 5
โ€ƒ50-59 14 7
โ€ƒ60-69 44 22
โ€ƒ70-79 79 40
โ€ƒโ‰ฅ80 30 15
Pure-tone average in the better ear (dB HL)
โ€ƒโ‰ค40 14 7
โ€ƒ41-55 24 12
โ€ƒ56-70 37 19
โ€ƒ71-90 96 49
โ€ƒ๏ผž90 26 13
Hearing aid experience
โ€ƒ๏ผœ6 weeks 42 21
โ€ƒ6 weeksโ€“11 months 55 28
โ€ƒ1-10 years 78 40
โ€ƒโ‰ฅ10 years 18 9
โ€ƒNot reported 4 2
Average daily use
โ€ƒNone 7 4
โ€ƒ๏ผœ1 hour 5 3
โ€ƒ1-4 hours 24 12
โ€ƒ4-8 hours 73 37
โ€ƒ8-16 hours 83 42
โ€ƒNot reported 5 3
Tableย 2.
Means and SDs of hearing aid benefit for each subscale of K-APHAB and pure tone audiogram
Category Mean of hearing aid benefit SD
K-APHAB subscales
โ€ƒEC 24.8 30.7
โ€ƒBN 22.5 22.3
โ€ƒRV 23.5 24.4
โ€ƒAV -18.7 28.2
PTA (dB) 18.6 9.3

K-APHAB: Korean version of abbreviated profile of hearing aid benefit, EC: ease of communication, BN: background noise, RV: reverberation, AV: aversiveness, SD: standard deviation, PTA: pure tone audiometry

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