Abstract
Objectiveto understand the meanings the family attributes to the phases of the decision-making process on a cochlear implant for their child. Methodqualitative research, using Symbolic Interactionism and Grounded Theory as the theoretical and methodological frameworks, respectively. Data collection instrument: semistructured interview. Nine families participated in the study (32 participants). Resultsknowledge deficit, difficulties to contextualize benefits and risks and fear are some factors that make this process difficult. Experiences deriving from interactions with health professionals, other cochlear implant users and their relatives strengthen decision making in favor of the implant. Conclusiondeciding on whether or not to have the implant involves a complex process, in which the family needs to weigh gains and losses, experience feelings of accountability and guilt, besides overcoming the risk aversion. Hence, this demands cautious preparation and knowledge from the professionals involved in this intervention.
Highlights
The cochlear implant (CI) consists of an external component located behind the ear, which captures, processes, codes the sound energy and send it to the internal receiverstimulator through radiofrequency: and an internal component surgically implanted under the skin in the mastoid bone, which has a beam of electrodes inserted in the cochlea to stimulate the hearing nerve fibers, which spreads neural impulses to the hearing area of the brain stem
Nine families participated in the study, totaling 32 family members (Figure 1)
The family may hesitate to agree with the surgery in some circumstances: when the fear of the risks is greater than the benefit envisaged; in case of a knowledge deficit; knowing that the electromagnetic device will restrict some of the child’s activities and; that the decision may arouse future questions about the decision made, whether in favor or against the implant
Summary
Studies have been undertaken about parental decision making with regard to the choice of the communication modality for deaf children[1,2,3,4,5,6,7], in which medical, sociocultural, economic and bioethical aspects are analyzed[8,9,10].The early diagnosis of hearing impairment (HI) demands that the parents, despite a lack of information at that moment, make a series of decisions in quick succession, which includes choosing the best intervention and treatment for their child and assessing different communication, skills development and education options[11]. Among the available resources to treat the HI, the cochlear implant (CI) figures as an efficient and effective for the development of deaf children’s communicative skills Through this device, the first generation of implanted children has reached linguistic and academic competency levels similar to their normal hearing peers[12]. Decision making is a difficult and stressful process due to the complexity to determine whether what they believe to be the best for their child is. After all, this decision is loaded with influences from parental preferences, linked with their values, beliefs, practical considerations and resource availability[6,13,14]. They need to decide without any guarantees about the level of benefit their children will receive[6]
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