Assessment of health-related quality of life 6 years after childhood cochlear implantation
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To examine the impact of cochlear implant (CI) intervention on health-related quality of life (HRQOL) assessed by both self- and parent-reported measures.
In this national study of children implanted between ages 6 months and 5 years, HRQOL of 129 children 6-year post-CI was compared to 62 internal study (NH1) and 185 external (NH2) samples of hearing children frequency-matched to the CI group on sociodemographic variables. HRQOL ratings of children and their parents in each group, measured using the Child Health and Illness Profile-Child Edition, were compared, and their associations with the Family Stress Scale were investigated.
CI children reported overall and domain-specific HRQOL that was comparable to both NH1 and NH2 peers. CI parents reported worse child scores than NH1 parents in Achievement, Resilience, and Global score (p’s < 0.01) but similar or better scores than socioeconomically comparable NH2 parents. Higher family stress was negatively associated with all parent-reported HRQOL outcomes (p’s < 0.01). Parent–child correlations in HRQOL global scores trended higher in CI recipients (r = 0.50) than NH1 (r = 0.42) and NH2 (r = 0.35) controls.
CI recipients report HRQOL comparable to NH peers. These results, from both child and parent perspective, lend support to the effectiveness of CI intervention in mitigating the impact of early childhood deafness. Family stress was associated with worse HRQOL, underscoring a potential therapeutic target. Parent–child agreement in HRQOL scores was higher for CI families than NH families, which may reflect higher caregiver insight and involvement related to the CI intervention.
KeywordsCochlear implants Pediatrics Health-related quality of life Family stress
The authors would like to thank the developers of the CHIP-CE for use of data from the CHIP-CE validation studies to create the NH2 comparison group. The CDaCI Study was supported by grant RO1 DC004797 from the National Institute on Deafness and Other Communication Disorders, the CityBridge Foundation, and the Sidgmore Family Foundation. Warranties on the implant devices used by children with implants in this study were discounted by 50 % by the Advanced Bionics Corporation, Cochlear Corporation, and the MEDEL Corporation.
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