Third-party disability in cochlear implant users

Abstract

Objective

To date, auditory rehabilitation mainly focuses on the person with hearing impairment (PHI). This study aimed to analyse the burden of hearing loss on significant others (SOs), and to explore the impact of contextual and mediating psychosocial co-factors and auditory rehabilitation by cochlear implantation (CI).

Design and study sample

Third-party disability (SOS-HEAR) and quality of life (Nijmegen Cochlear Implant Questionnaire) were evaluated in 41 PHI scheduled for CI surgery and their close partners pre- and 6-month post-implantation. Further, age, hearing status, educational level, depressive symptoms (GDS-15), coping strategies (Brief-COPE), resilience (RS-13), stress (PSQ) of SOs and PHI were studied.

Results

Hearing loss imposes a burden on SOs, particularly in relation to changes in communication and socialisation. Third-party disability was higher in SOs of PHI with lower educational background (p = 0.04) and of advanced age (p = 0.008). Hearing status of SOs negatively correlated with SOS-HEAR (p = 0.04). After CI, quality of life of PHI and third-party disability of SOs improved (p < 0.001), except in relationship changes. SOs with higher pre-operative burden also experienced more third-party disability afterwards (p ≤ 0.003).

Conclusion

Audiological rehabilitation should expand to include SOs in the rehabilitation process, as the burden experienced by SOs might persist even after CI.

Keywords:

• Hearing loss
• third party disability
• significant others
• cochlear implant

Author contributions

Design of the study: CV, JPT. Acquisition of data: LH, LG, staff of the Cochlear Implant Centre Bochum. Analysis of data: LG, LH, IB. Interpretation of data: all authors. Drafting and writing of manuscript: CV, LG. Approval of final version of the manuscript: all authors. We are very thankful to Ursula Lehner-Mayrhofer and Patrick Connolly (MED-EL) for proof-reading a version of the manuscript.

Disclosure statements

The study was approved by the ethics institution of the Ruhr-University of Bochum (No. 17-6088-BR) and performed in line with the Declaration of Helsinki. The Department of Otorhinolaryngology, Head and Neck Surgery and the Comprehensive Hearing Centre at Katholisches Klinikum, Ruhr-University Bochum, received unrelated third-party funds from MED-EL. CV, JPT, and SD received travel expense support from MED-EL. LG, IB, and LH have no conflict of interest to declare. The authors declare that the research was conducted in the absence of any commercial or financial relationships.