Cochlear implants in adults with partial deafness: subjective benefits but associated psychological distress.

PURPOSE: The present study investigated adults with partial deafness (PD) and asked them to rate the benefits of their cochlear implant (CI), their general level of satisfaction with it, and their level of psychological distress. Of particular interest was the role of gender. METHODS: The study comprised 71 participants (41 females) with PD who had been provided with a CI. The Nijmegen Cochlear Implant Questionnaire (NCIQ) was used to assess the benefits of their CI. Satisfaction with their CI was measured using a visual analog scale. The severity of mental distress was assessed with the General Health Questionnaire (GHQ-28). RESULTS: On various NCIQ scales, the average benefits of a CI were rated at 66%. Females gave a lower rating than males. The mental distress experienced by the group was significantly higher than in the general population. Females had more severe symptoms of anxiety and insomnia than males. There was a significant relationship between psychological distress and CI benefit, but only in females. Besides general distress, the most affected spheres were related to psychosocial functioning-"self-esteem", "activity limitation", and "social interaction". Contrary to expectations, there was no relationship between mental distress and CI satisfaction. CONCLUSIONS: The perceived benefits of a CI in subjects with PD relate mostly to the level of mental distress, although gender is an important factor. For females, their emotional state affects how beneficial their CI is perceived. Due to the higher levels of mental distress, females tend to need more psychological intervention and support.

Satisfaction With Cochlear Implants in Postlingually Deaf Adults and Its Nonaudiological Predictors: Psychological Distress, Coping Strategies, and Self-Esteem.

OBJECTIVE: A postlingually deaf patient who receives a cochlear implant (CI) acquires multiple benefits, not just audiological but also nonaudiological: improvement in quality of life, psychological well-being, and social interaction. The aim of the study was to ascertain the relationship between the CI satisfaction experienced by adult, postlingually deaf individuals and their level of psychological distress, stress coping strategies, and global self-esteem. We also considered sociodemographic variables (such as sex, age, education, marital/partner status, and employment/study status), variables related to their deafness, and their length of experience with a CI. DESIGN: The study had a cross-sectional design in which participants were asked to fill in a mailed personal inquiry form seeking sociodemographic data and one question related to CI satisfaction, and the following questionnaires: General Health Questionnaire-28, the Brief Coping Orientation to Problems Experienced, and the Rosenberg Self-Esteem Scale. This study included 98 patients with postlingual deafness between 19 and 85 years old who had unilateral CIs. For some analyses, the patients were also divided into two groups: younger (≤60 years) and older (>60 years). Two other subgroups were those with shorter CI experience (1 to 2 years) and those with longer CI experience (5 to 6 years). As an objective reference, speech perception scores in quiet and in noise were also used. RESULTS: The majority of postlingually deaf subjects rated their CI satisfaction as high or very high, and this was at similar levels in younger and older subjects, as well as in those who had used CIs for either a short or a long time. CI satisfaction was not related to speech perception scores, duration of deafness, length of CI use, or other sociodemographic factors. Positive self-esteem, having less severe symptoms of depression, and the use of humor or self-distraction were conducive to CI satisfaction. Using a coping strategy of denial had a negative association with CI satisfaction. Coping strategies and symptoms of mental distress varied between younger and older subjects. For younger subjects, higher CI satisfaction was associated with lower severity of depressive symptoms, whereas for the elderly, higher CI satisfaction was associated with less severe social dysfunction symptoms. Over the years of using a CI, the same strategy may have a different psychological function in providing satisfaction: for example, venting, which in the group with a short CI experience is negatively correlated to satisfaction, is positively correlated to satisfaction for those with longer CI experience. CONCLUSIONS: The results show that psychological factors­self-esteem, distress, and coping strategies­are important for CI satisfaction in postlingually deaf CI users. The results point to advantages in widening the availability of various tailored forms of psychological intervention for patients with postlingual deafness after receiving a CI.

[Coping strategies in postlingually deafened adult cochlear implant users in comparison to the hearing population]. / Strategie radzenia sobie ze stresem u osób doroslych postlingwalnie ogluchlych korzystajacych z implantu slimakowego, w porównaniu z populacja ogólna slyszacych.

OBJECTIVE: The research question was: what coping strategies are used by the postlingually deafened adult cochlear implant (CI) users, in comparison to the hearing population, taking into account their gender and CI experience. MATERIAL AND METHODS: In the assessment of the coping strategies we used the C.S. Carver's Brief COPE questionnaire in Polish adaptation. The questionnaire and information form have been sent to the adult patients implanted in the Institute of Physiology and Pathology of Hearing in the years 2005 and 2009. The response ratio was 59.5% (n = 78). The control group (n = 77) comprised hearing persons selected at random, allowing for age. RESULTS: The stress coping strategies are different in the postlingually deafened adults and hearing ones. The postlingually deaf more seldom use the effective strategies, such as the active coping, planning and humour, and more often the denial. Also, they significantly more seldom turn to the self-blame and the substance use. People with longer CI experience significantly more often use the denial, more seldom they adopt the substance use and the self-distraction compared with those with shorter CI experience. Female postlingually deafened CI users are significantly less active in coping with stress and more seldom turn to the substance use, but more often, compared with the hearing women in the same age-group, use the denial. Male postlingually deafened CI users differ significantly from the hearing men only in more seldom turning to the self-blame and the substance use. CONCLUSIONS: Postlingually deafened CI patients more often use the ineffective coping strategies. This tendency becomes stronger with the time lapse from the cochlear implantation and is more frequent in women, which corresponds with the data on both the considerably worse mental health of the postlingually deafened people compared to the general population and the deterioration of the mental, social and physical functioning with the lapse of time from the implantation. The standing availability of the psychological support for these patients is essential, as well as the awareness of their problems.

Production and evaluation of a Polish version of the LittlEars questionnaire for the assessment of auditory development in infants.

OBJECTIVE: To adapt the LittlEars questionnaire into Polish and to evaluate the psychometric properties of the Polish version of the questionnaire. METHODS: A back-translation method was used to translate the LittlEars questionnaire into Polish. The translated version was first evaluated by means of an expert-appraisal method. After having improved the Polish version of LittlEars with the results obtained from that evaluation, various psychometric analyses were conducted. Study participants included 310 parents or other caregivers of children with normal hearing whose ages ranged between 0.5 and 24.0 months. Corrected item-total correlations were calculated to evaluate the extent to which the different questions distinguish levels of auditory development of the assessed children. Cronbach's alpha coefficient--to evaluate internal consistency across items--was also calculated. To obtain estimates of validity, correlations between item/total score and age were calculated. A non-linear regression model was derived to obtain normative data for expected and minimum values of total scores from the questionnaire according to age. RESULTS: Corrected item-total correlations ranged from 0.14 to 0.84. The Cronbach's alpha coefficient was 0.95, indicating that the measurements were highly reliable. The linear correlation between total scores and age was 0.90 (p<.001). The regression analysis conducted to obtain normative data showed that 83% of the variance in the total scores can be explained by age. CONCLUSION: The results of psychometric analyses support the use of the Polish version of the LittlEars questionnaire as a sensitive and reliable tool to assess the development of auditory behavior in Polish children between 3 and 24 months of age.