成人補聴器臨床における言語聴覚士の役割の検討—耳鼻咽喉科クリニックの補聴器外来における役割分担の違いから

The role of speech-language-hearing therapists in hearing aid fitting for adults:Comparison of 3 styles of hearing aid provision in an otolaryngology clinic

　耳鼻咽喉科クリニックの補聴器外来業務における言語聴覚士（以下，ST）の役割により3期に分け〔Ⅰ期：STが販売以外の全業務を担う，Ⅱ期：認定補聴器技能者（以下，技能者）に委託しSTの介入なし，Ⅲ期：STが初回ガイダンス，補聴器適合検査（以下，適合検査），装用指導を行い，技能者が調整・販売を行う〕，診療録を後方視的に分析した．Ⅱ期とⅢ期は同一調整者であるが，Ⅱ期に比しⅢ期では相談回数は低下し新規補聴器購入率が向上した．Ⅲ期において実施されたSTによる初回ガイダンス，適合検査の実施および結果に基づく調整，本人および家族に対するコミュニケーションストラテジーの指導を含む装用指導が重要であることが示唆された．補聴器臨床において客観的評価に基づく適切な補聴器調整が重要であり，そのためには十分な知識と技量をもつSTの養成と人員配置が喫緊の課題であると考察された．

　In our otolaryngology clinic, speech-language-hearing therapists (SLHTs) and/or certified hearing aid technicians (technicians) have been involved in the fitting of hearing aids. The clinic ran in three phases with different roles for SLHTs and technicians in each phase. In phase 1, SLHTs acted alone；in phase 2, technicians acted alone, and in phase 3, SLHTs and technicians worked together. In this final phase, the SLHTs provided initial guidance, hearing aid fitting tests, and communication instruction for the patients and their families, while the technicians were in charge of adjustment and sales. Compared to the second phase, the third phase had a greater purchase rate and fewer sessions, which suggests that the role played by SLHTs in hearing aid fitting during the third phase was significant. We therefore expect that in the future SLHTs will play a coordinating role in the overall process. However, there is currently a shortage of SLHTs specializing in hearing aids, so training and appropriate staffing of SLHTs with expertise in hearing aids are urgent issues.