Satisfaction With Cochlear Implants in Postlingually Deaf Adults and Its Nonaudiological Predictors

Abstract

A postlingually deaf patient who receives a cochlear implant (CI) acquires multiple benefits, not just audiological but also nonaudiological: improvement in quality of life, psychological well-being, and social interaction. The aim of the study was to ascertain the relationship between the CI satisfaction experienced by adult, postlingually deaf individuals and their level of psychological distress, stress coping strategies, and global self-esteem. We also considered sociodemographic variables (such as sex, age, education, marital/partner status, and employment/study status), variables related to their deafness, and their length of experience with a CI. The study had a cross-sectional design in which participants were asked to fill in a mailed personal inquiry form seeking sociodemographic data and one question related to CI satisfaction, and the following questionnaires: General Health Questionnaire-28, the Brief Coping Orientation to Problems Experienced, and the Rosenberg Self-Esteem Scale. This study included 98 patients with postlingual deafness between 19 and 85 years old who had unilateral CIs. For some analyses, the patients were also divided into two groups: younger (≤60 years) and older (>60 years). Two other subgroups were those with shorter CI experience (1 to 2 years) and those with longer CI experience (5 to 6 years). As an objective reference, speech perception scores in quiet and in noise were also used. The majority of postlingually deaf subjects rated their CI satisfaction as high or very high, and this was at similar levels in younger and older subjects, as well as in those who had used CIs for either a short or a long time. CI satisfaction was not related to speech perception scores, duration of deafness, length of CI use, or other sociodemographic factors. Positive self-esteem, having less severe symptoms of depression, and the use of humor or self-distraction were conducive to CI satisfaction. Using a coping strategy of denial had a negative association with CI satisfaction. Coping strategies and symptoms of mental distress varied between younger and older subjects. For younger subjects, higher CI satisfaction was associated with lower severity of depressive symptoms, whereas for the elderly, higher CI satisfaction was associated with less severe social dysfunction symptoms. Over the years of using a CI, the same strategy may have a different psychological function in providing satisfaction: for example, venting, which in the group with a short CI experience is negatively correlated to satisfaction, is positively correlated to satisfaction for those with longer CI experience. The results show that psychological factors—self-esteem, distress, and coping strategies—are important for CI satisfaction in postlingually deaf CI users. The results point to advantages in widening the availability of various tailored forms of psychological intervention for patients with postlingual deafness after receiving a CI.