Evaluating the health-related quality of life effects of cochlear implants: a prospective study of an adult cochlear implant program.

This paper prospectively documents the health-related quality of life (HRQoL) and social participation benefits of adult patients receiving cochlear implants in Australia and New Zealand. Thirty-four consecutively implanted patients completed the Assessment of Quality of Life (AQoL) and Hearing Participation Scale (HPS) instruments before implantation, and at 3- and 6-month follow-ups. Implantation resulted in significant improvements in AQoL and HPS scores, The effect size was 1.09 for both measures. Those in the top socio-economic tertile obtained the greatest gains. The HRQoL and social participation benefits were slightly larger than those reported elsewhere. This may be because participants used more recent technology (Nucleus 24 rather than Nucleus 22) and received auditory and self-efficacy training as part of their rehabilitation. The results suggest that cochlear implants have a large beneficial effect. They show that social and HRQoL outcomes can be parsimoniously measured using the HPS and AQoL instruments.

It's a whole new ball game! Employment experiences of people with a cochlear implant.

Many implantees anecdotally report employment benefits being associated with implantation. This benefit has not been routinely reported in prospective studies of implant outcomes. It is important therefore to establish the nature of benefit reported by implantees so that further studies may document such outcomes in a representative fashion. To this end, a qualitative study of the experiences of 12 people with cochlear implants in the workplace is presented. A focus group methodology was used to collect the data. Patients use a before and after narrative style to relate the impact of the device on their working lives. Prior to implantation, deafened adults report being on the margins of the workplace, mostly concerned with holding on to a job that was quite difficult to obtain in the first place. Under-employment (working below their ability levels) was a key issue. Following implantation, working life was markedly better. Implantees report being able to pursue the jobs they were trained for with greater confidence. They also reported a greatly enhanced sense of job security. They had moved from the margins to the centre of working life, participating in non-vital, spontaneous conversations, and generally felt part of the workplace. Most notably, implantees felt able to take career risks such as seeking out better employment opportunities. Respondents note that a variety of accommodations still need to be made so that they can more readily take part in workplace communication. Overall, the post-implant transition back to work could be made simpler for implantees if appropriate vocational services were offered as part of their rehabilitation programme.