Quality of Life Measures for Patients With Bilateral Cochlear Implants

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Quality of Life Measures for Patients With
Bilateral Cochlear Implants

• Roberta Buhagiar

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Objectives of the study

• To investigate the effects of a second CI on
  quality of life
• To design and validate a questionnaire which
  measures the quality of life of patients with
  bilateral CI (received sequentially)

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Dimensions of QoL

• Physical status and functioning
• Social/role functioning
• Emotional/psychological status
• Disease- and/or treatment-related symptomatology

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Rolls Royce Model

• Item selection
• Reduction of number of items
• Questionnaire format
• Pretesting
• Reliability and responsiveness
• Validity
• (Guyatt et al., 1986)

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Subjects

• 13 patients with 2 CI received sequentially
  time between implants ranges from 7 to 48 months
• 3 different centres in the UK
• Age range 57 to 84 years
• Have had their second CI for at least 6 months

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Stage 1

• Open ended questionnaire 26 questions
• Format of questionnaire was retrospective
• Starts with reason why they wanted a second CI
• Leads to changes experienced by having two CI vs
  one
• Ends with thoughts about the future

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Patient responses Advantages
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• Psychological aspects
• Reduced sense of isolation
• Increased happiness
• Increased energy
• More relaxed
• Reduced depression
• More confident
• Increased independence

• Lifestyle aspects
• Improvement for work
• Improved social life
• Increased independence
• Increased drive
• Better family relationships
• Have an extra CI in case one fails

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Stage 2 - Interviews

• Based on Grounded Theory
• Discuss the categories developed from the
  questionnaires
• Aimed at exploring which constructs are viewed to
  be important for inclusion in the final
  questionnaire
• Development and first stage of refinement of
  questionnaire

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What did participants say.

• All participants except one said
• they would not hesitate to recommend to someone
  to have a second CI
• they would rather have a second CI than accept
  money in exchange

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I found that (with 2 CI) I could pick that bit
much more in a conversation that it makes it
easier to communicate in places like banks
If people stop me to ask for directions Ill stop
and help them whereas before (with 1 CI) I
would have just said sorry I cant help you. I
have now actually gone up to people and said can
I help you? I would have never done that before
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The main difference is that now I am confident to
baby sit for my family
Because with one all the sounds are confusing, I
had to look around a lot, whereas now I dont
look around as much and it makes things more easy
and relaxing
Ill go to the shops now without a care in the
world - I had stopped doing that
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Listening with one CI is like eating a meal of
fish and chips, but listening with 2 CI is like
having a 6 course meal on Mount Olympus
At work they were not always able to give me
verbal instructions but it is different now
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What next..

• Internal consistency
• Test-retest reliability
• Criterion validity
• Construct validity

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Thank you