Study On The Auditory Speech Rehabilitation Effect And Family Life Quality Of Prelingual Deaf Children With Different Hearing Aid Models

Objective Through qualitative interviews,the rehabilitation expectations of parents of children with cochlear implants were profiled,the goals of parental expectations were clarified,and supportive rehabilitation strategies were provided;Simultaneously,differences in hearing speech outcomes and family quality of life among prelingually deaf children with different modes of hearing assistance and the correlation between hearing speech outcomes and family quality of life are explored.MethodsStudy 1: A purposive sampling method was used to select 15 cases of parents of children who underwent CI in a tertiary care hospital in Hefei,Anhui Province,from March to May 2020.After reviewing the literature and discussing the initial interview outline with the subject group,pre-interviews were conducted to determine the final interview outline.After the interviews were completed,the audio recordings were transcribed into text within 24 h.Nvivo 11.0 software was used to organize the analysis data and identify themes according to the Colaizzi seven-step analysis.Study 2: Children with prelingual deafness who underwent cochlear implantation in a tertiary hospital in Hefei City,Anhui Province from March to July 2020 were selected for a prospective cohort study,and 58 of them were included in the study because they met the nadir criteria and were followed up continuously for 1 year.They were divided into 21 cases in the unilateral cochlear implant group（CI）,8 cases in the binaural dual-mode group（CI+HA）,and 29 cases in the bilateral cochlear implant group（BCI）according to the mode of hearing assistance.The Categories of Auditory Performance（CAP）,the Speech Intelligibility Rate（SIR）,the Speech,Spatial and Qualities of Hearing Scale-Parent’s Version（SSQ-P）and the Children Using Hearing Implants Quality of Life（Cu HI Qo L）were used to measure auditory speech outcomes and family quality of life in the three groups of children and to analyze the correlations between them.All of the above scales were administered preoperatively,and the CAP,SIR,and SSQ-P scales were administered at 3,6,and 12 months postoperatively,along with the Cu HI Qo L scale at six-month intervals.ResultsStudy 1: Distilling the 4 themes of parental recovery expectations.（1）Development of auditory training（detecting sounds,distinguishing sounds,recognizing sounds,understanding hearing）.（2）Correction of speech pronunciation（comprehension of language,expansion of vocabulary,expression of utterances）.（3）Improving cognitive behavior（reducing perceptual differences,enhancing memory,strengthening thinking awareness,and promoting personality development）.（4）Adapting to social interactions（harmonious interpersonal relationships and smooth communication）.Study 2:（1）The differences in CAP and SIR scores between the three groups of children before surgery were not statistically significant（P>0.05）,and the CAP and SIR scores of children in the BCI group were higher than those in the CI+HA group at 3,6 and 12months after surgery,and the CI+HA group was in turn higher than the CI group,with statistically significant differences（P<0.05）.（2）Before surgery,there was no significant difference between the three groups in terms of total mean SSQ-P scores（P>0.05）.One year after surgery,the BCI group had significantly higher speech perception,spatial hearing,hearing sound quality and SSQ-P scores than the CI+HA group,and the CI+HA group in turn was superior to the CI group.Especially in spatial hearing and hearing sound quality the BCI group was more superior to the other two groups（P<0.05）.（3）At 6 months after surgery,the BCI group had the highest family quality of life scores.At one year after surgery,the CI+HA group had a higher overall family quality of life than the BCI group,which in turn was slightly better than the CI group.However,the difference between the three groups in terms of family quality of life was not significant at one year postoperatively（P>0.05）,and the advantage of the CI+HA group over the CI group was more significant only in terms of the quality of life of the children（P<0.05）.（4）CAP,SIR,SSQ-P,and Cu HI Qo L scores of children in all three groups showed a progressive increase over time.（5）Family quality of life was positively correlated with auditory behavior,speech intelligibility,and spatial characteristics of speech（p<0.01）,with correlation coefficients of（0.374,0.281,0.319）,respectively.Conclusions（1）Parents’ rehabilitation expectations vary,ranging from functional rehabilitation expectations to restore auditory speech to psychological rehabilitation expectations to promote cognitive interaction,and to promote psychological health based on functional rehabilitation.There are both positive expectations arising from the apparent effectiveness of recovery and negative expectations arising from the family environment and lack of integrated support.Medical staff should guide parents to participate in a parent-child group teaching model,form a multidisciplinary collaborative rehabilitation team,and build the best hearing aid and speech correction support system to achieve the desired goals and promote the child’s full recovery.（2）Bilateral cochlear implants were significantly better than binaural dual modality in terms of auditory behavior,speech intelligibility,speech perception,spatial hearing,and hearing sound quality,which in turn was superior to unilateral cochlear implants.In particular,the bilateral advantages in spatial hearing and hearing sound quality are more prominent than the other two hearing aid modes.At 6 months postoperatively,family quality of life was highest with bilateral implants,while one year postoperatively,the degree of improvement was more pronounced with the binaural dual mode.In the short term,there was no significant difference in family quality of life between the three modalities.In addition,there was a gradual increase in hearing speech outcomes and family quality of life for all modalities with increasing postoperative time.The better the hearing speech outcome,the better the quality of life at home.Therefore,regardless of the mode of hearing assistance,early auditory and speech rehabilitation training is required to maximize children’s auditory and speech ability,which in turn improves the overall quality of life of the family.