title: Quality of life outcomes for children with hearing impairment in Singapore.
abstract: OBJECTIVE
  This study aimed to investigate the hearing-related quality of life (hearing-QOL) of children with hearing loss in Singapore using hearing aids (HAs) and/or cochlear implants (CIs). Their health-related QOL (health-QOL) as well as their families' health-QOL were compared with normally hearing (NH) children and their families.
  
  
  METHODS
  This cross-sectional study recruited families (i.e., children aged 2-18 years and their parents) of NH children (n=44), children wearing HAs (n=22) and children wearing CIs (n=14). Hearing-QOL was assessed using the parent-reported Children Using Hearing Devices QOL questionnaire. General health-QOL was assessed using parent and child-reported measures from the PedsQL inventory consisting of the Generic Core Scales, General Well-being Scale and Family Impact Module. The questionnaires were self-administered for children aged 8-18 years, and interviewer-administered for children aged 5-7 years.
  
  
  RESULTS
  The NH children and their families had significantly higher general health-QOL scores compared to the children with hearing loss and their families. This indicates that hearing loss significantly impacts on the well-being of children and their families. Congruence between parent and child reports was only observed in the NH group. Parents of children wearing HAs rated their child's overall hearing-QOL significantly higher than parents of children wearing CIs. Family household income was the only significant predictor of child hearing-QOL scores with parents from the middle income families rating their child's hearing-QOL significantly poorer than parents from high income families.
  
  
  CONCLUSIONS
  Overall, NH children and their families have higher self-rated general health-QOL than children with hearing loss and their families, with children using HAs providing higher hearing-QOL than those using CIs. Evaluating both general health and hearing specific QOL from both the child and their parent/caregiver is worthwhile, allowing a more holistic measure of real-life outcomes and better individualised clinical care.
authors.affiliation: SCIC Cochlear Implant Program, an RIDBC Service, The Australian Hearing Hub, Sydney, Australia. Electronic address: Valerie.looi@scic.org.au.
authors.forename: Valerie
authors.initials: V
authors.lastname: Looi
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Zheng Zheng
authors.initials: ZZ
authors.lastname: Lee
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Jenny H Y
authors.initials: JH
authors.lastname: Loo
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003054:Cochlear Implants; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006309:Hearing; D006310:Hearing Aids; D034381:Hearing Loss / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D012846:Singapore; D011795:Surveys and Questionnaires
keywords: Cochlear implants; Hearing aids; Hearing impairment; Outcomes; Quality of life