American parent perspectives on quality of life in pediatric cochlear implant recipients.
OBJECTIVE
Cochlear implantation influences not only communication but also psychosocial outcomes in children with severe to profound hearing loss. Focusing on issues specific to cochlear implantation (e.g., self-reliance, social relations, education, effects of implantation, and supporting the child) may provide a more accurate and relative view of functional status of pediatric cochlear implant (CI) recipients. The present study analyzes parental perspectives of CI-specific health-related quality of life (HRQoL) in children with CIs to determine (a) if parents differentially rate their child's quality of life according to psychosocial domain (e.g., communication, self-reliance, education); (b) if associations exist between quality of life domains specific to cochlear implantation in pediatric implant recipients; and (c) if demographic variables (i.e., chronologic age, age at cochlear implantation, duration of device experience) mediate parent ratings of quality of life in pediatric CI recipients.


METHODS
Parents of 33 children with CIs (mean age, 9.85 years; mean age of CI activation, 2.47 years; mean device experience, 7.47 years) completed a validated condition-specific questionnaire, Children With Cochlear Implants: Parental Perspectives.


RESULTS
Parents positively rated most HRQoL domains, although education and effects of implantation received significantly less positive ratings (p < 0.01). Three domains (communication, self-reliance, and well-being) significantly correlated with at least 5 other domains, suggesting that positivity in one domain co-occurs with positivity in other domains. Demographic variables (chronologic age, CI activation age, and duration of CI use) did not correlate significantly with psychosocial outcomes; rather, parents reported positive HRQoL and successful functional use of CI across demographic variables.


CONCLUSIONS
Parents of children and adolescents with CIs rate overall HRQoL positively across psychosocial domains. Significantly less positive ratings of education and effects of implantation may result from limited access to CI-related accommodations and varying parent expectations, warranting further exploration to maximize psychosocial and performance outcomes in pediatric CI users.
1Department of Pediatric Psychiatry, Children's Medical Center, Dallas, Texas, USA; 2Department of Rehabilitation Counseling Psychology, University of Texas Southwestern Medical Center, Dallas, Texas, USA; 3Dallas Cochlear Implant Program, Dallas, Texas, USA; 4Department of Communication Sciences and Disorders, University of Texas at Dallas, Dallas, Texas, USA; 5Department of Enterprise Planning, Children's Medical Center, Dallas, Texas, USA; and 6Department of Otolaryngology - Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Roshini
R
Kumar
Andrea
A
Warner-Czyz
Cheryl H
CH
Silver
Betty
B
Loy
Emily
E
Tobey
D000124:Achievement; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001294:Attitude to Health; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation; D003054:Cochlear Implants; D003142:Communication; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D011788:Quality of Life; D012737:Sex Factors; D012919:Social Behavior; D011795:Surveys and Questionnaires; D014481:United States