title: The experiences of adults assessed for cochlear implantation who did not proceed.
abstract: OBJECTIVE
  The objective of this study was to explore, by interview, the experiences of adults who have undergone assessment for cochlear implantation and were considered unsuitable.
  
  
  METHODS
  Ten adult participants were interviewed. Interviews were transcribed and thematic content analysis was carried out to analyse them. Six main themes and 16 subthemes were identified.
  
  
  RESULTS
  The findings from the study demonstrate that adults who underwent the assessment for cochlear implantation were significantly impacted socially and emotionally as well as at work as a result of their hearing loss. Most participants found the speech testing in the assessment process to be a poor representation of hearing challenges in everyday life. A range of expectations from implantation were noted; the most common one being improvement in speech and communication. The management of these expectations needed attention. After the refusal, participants reported a lack of ongoing support and advice. A number of other suggestions regarding the actual assessment process and aspects around it were highlighted.
  
  
  CONCLUSIONS
  A need to revise audiological criteria and modify speech testing methods to resemble hearing challenges in everyday life is highlighted. The impact of hearing loss on social, emotional, and work aspects need to be addressed thoroughly. An awareness of available technology and other coping strategies should be part of the assessment protocol. Uniformity across different centres in terms of providing information pre-assessment needs to be achieved. Consideration of the individual and his hearing and communication needs in addition to formal hearing assessments before deciding/refusing implantation needs to be developed.
authors.forename: Sheetal
authors.initials: S
authors.lastname: Athalye
authors.forename: Imran
authors.initials: I
authors.lastname: Mulla
authors.forename: Sue
authors.initials: S
authors.lastname: Archbold
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D019929:Cochlear Implantation / Q000379:methods / Q000523:psychology*; D005260:Female; D006310:Hearing Aids / Q000523:psychology; D034381:Hearing Loss / Q000534:rehabilitation; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology; D011584:Psychology; D011788:Quality of Life; D013067:Speech Perception
keywords: Adults; Assessment; Cochlear implants; Hearing loss; Interview study