Akceptacja siebie jako osoby głuchej a subiektywna ocena korzyści i satysfakcji z implantu ślimakowego u osób dorosłych z głuchotą prelingwalną

Abstract

Introduction: The subjective assessment of benefits and satisfaction with a cochlear implant (CI) is an essential index of the effectiveness of that medical intervention in different groups of patients with hearing disorders. Regardless of pre- or postlingual onset of deafness, the adult users assess their CI satisfaction as high or very high. There are few published studies of the psychological determinants of the subjective assessment of CI benefits and satisfaction, such as personality traits or mental health status.Aim: The study aims to assess the self-acceptance of deaf persons in the group of prelingually deaf CI users, and the assessment of CI benefits and satisfaction. The question was if there is a relationship between the self-acceptance of deaf persons and perception of CI benefits and satisfaction.Material and methods: The study included prelingually deaf adults aged from 18 to 45 years, using one (81%) or two cochlear implants. The group size was n = 84. Age at the time of the first implantation varied within the range of 2–42 years. Age at the second implantation was on average 22 years (SD = 6.67). The mean time of cochlear implant use for the first implant was 11 years, for the second 4 years. Studied persons were highly competent in Polish phonic language. The study had been conducted by mail; the rate of returned responses was 32.2%. Self-acceptance of deaf persons and CI satisfaction have been measured using the VAS-type scales, CI benefit has been measured using the Nijmegen Cochlear Implant Questionnaire (NCIQ) that allows for describing the subjective benefits from the CI in three areas: basic and advanced auditory perception, speech, and psychosocial functioning as a (deaf) person with CI, which encompasses self-esteem, perception of limitations in activities and social interactions.Results: Self-acceptance as a deaf person was on average 74.5% (SD = 25). The mean CI satisfaction was 80%. The prelingually deaf persons experience the largest CI benefits in the area of Activity Limitations (AL – 74.5%) and Social Interactions (SI – 73.6%), the smallest in the field of Self-Esteem (SE – 54.4%). Self-acceptance of a deaf person is related to psychosocial functioning with a CI, which means that higher level of self-acceptance of a deaf person is linked to perceived higher benefits in these areas. Similarly, higher level of self-acceptance of a deaf person is related to a higher CI satisfaction.Conclusions: Self-acceptance of a deaf person is one of the important factors deciding about the CI benefits and satisfaction in the studied persons’ subjective assessment. This relationship exists only in the sphere of psychosocial functioning of the prelingually deaf CI users. The prelingually deaf CI users should be offered a psychological intervention to improve their acceptance of self as a deaf person and own deafness. Different forms of psychological intervention may facilitate not only improvement of psychological wellbeing but also increase of effectiveness of cochlear implantation in this group of CI users.