成人聽覺障礙者功能性溝通評量之發展

Abstract

國內聽覺障礙人口數逐漸成長，其中成人在所有的聽覺障礙者中佔有很大的比例。聽覺損傷所帶來的溝通問題，讓聽覺障礙族群在學習發展、人際互動、社會情緒，以及職涯/生涯規劃帶來影響，但國內目前現有的測驗工具以聽覺評估和語言能力評估為主，無法反映出聽覺障礙者於真實生活中的溝通表現，故不適用於聽覺障礙族群。 本研究之目的為發展適用於國內聽覺障礙者之功能性溝通評估工具，從功能性的角度探討成人聽覺障礙者之功能性溝通需求及表現。本研究工具參照國內自編之ASHA-FACS中文版，改編為「成人聽覺障礙功能性溝通量表」施測於國內20-40歲成人聽覺障礙者。本研究採便利性及滾雪球抽樣進行收案，研究受試者為16位成人聽覺障礙者，同時收案16位一般成年人進行對照。測驗結果以（SPSS Statistics 23）Windows版本統計分析，使用「Pearson 積差相關」進行評分者間信度分析及相關量表效度分析，使用「獨立樣本t檢定」來比較聽覺障礙組及對照組之溝通獨立性和質性向度分數表現。 研究結果顯示，「成人聽覺障礙功能性溝通量表」具有中高度評分者間一致性(.55~.97)，僅在「基本需求」的獨立性分數表現為低度相關(.39)。在效度分析的部份，有鑑於選用之對照工具未有常模檢驗且兩量表題目設計不同，故無法逐題對照，僅將兩量表之測驗結果進行關係性比對，在「社交溝通」及「整體總分」之溝通獨立性表現達顯著相關(.65~.68)，質性向度無法分析。此外，將成人聽覺障礙者與一般成年人分數表現進行對照，成人聽覺障礙者在「閱讀/書寫/數字概念」及「日常計畫」領域均能獨立完成，溝通獨立性平均分數表現與一般成年人無差異，而兩組在「社交溝通」、「基本需求」及「整體總分」領域的溝通獨立性平均分數表現，與質性向度之「迅速性」表現在「社交溝通」及「整體總分」領域，一般成年人表現優於成人聽覺障礙者。本研究初步發展提供臨床專業人員，應用於成人聽覺障礙者之功能性溝通評量工具。The number of people with hearing impairment in Taiwan has gradually grown. Adults were accounting for a large proportion of all people with hearing impairment. The communication problems caused by hearing impairment made the hearing impairment people have influence in learning development, interpersonal interaction, social emotion, and career planning. However, the clinically used assessment tools were mainly based on auditory assessment and language assessment. It couldn’t reflect the functional communication of people with hearing impairment in real life, so it wasn’t applicable to the hearing impairment people. The purpose of this study was to develop a functional communication assessment for people with hearing impairment in Taiwan, and to explore the functional communication needs and performance of adults with hearing impairment from a functional perspective. The study analyzed functional communication for adults with hearing impairment as assessed by the Chinese version of ASHA-FACS. The study was applied the "Functional Communication Scale for Adult Hearing Impairment" to adults with hearing impairment in aged 20-40. In the study, convenience sampling and snowball sampling were used to collect the cases. The study subjects were 16 adults with hearing impairment, and 16 general adults were included for comparison. The data was analyzed by SPSS Statistics 23 for Windows. The " Pearson product-moment correlation " was used for inter-rater reliability and related scale validity analysis. The "Independent Sample t-test" was used to compare communication independence score and qualitative score of the hearing impairment group and the control group. The results showed that the inter-rater reliability ranged from moderate to almost perfect agreement for "Functional Communication Scale for Adult Hearing Impairment" (.55~.97). According to no suitable standardized test for comparison, and the design of the table topics were different, it was impossible to compare two scales one by one. The study compared the test results of the two scales. The communication independence performance of "Social Communication" and "total score" is significantly correlated (.65~.68). The qualitative score couldn’t be analyzed. In addition, hearing impaired adults are compared with general adult in score performance. Hearing impaired adults could independently complete the fields of "Reading, Writing, Numbers Concepts" and "Daily Planning". The average score of communication independence were no difference in two groups. In the average scores of the communication independence in the areas of "Social Communication", "Communication of Basic Needs", and "total score", adults generally performed better than adults with hearing impairment. In the "Promptness" of qualitative score in the areas of "Social Communication" and "total score", adults generally also performed better than adults with hearing impairment. The initial development of this study provided clinical professionals to apply functional communication assessment tools for adults with hearing impairment.