Satisfaction with life in a sample of prelingually deaf cochlear implant users with a good command of spoken Polish as the primary language.

INTRODUCTION: This study investigated the level of satisfaction with life (SWL) in a group of cochlear implant (CI) users who had been prelingually deaf but were orally educated. They had received one or two CIs (as a child, adolescent, or adult) and were highly competent Polish speakers. This study looked at three factors that may affect SWL - psychosocial, deafness/hearing and communication related, and sociodemographic. METHODS: The participants were prelingually deaf CI users who had learned highly competent spoken Polish as their primary language. They had been educated in mainstream or integrated schools (not schools for the deaf), and had no other disability or severe illness. Measurements were done with 5 questionnaires: the Satisfaction With Life Scale (SWLS), the I-Others Questionnaire, the Patient Health Questionnaire (PHQ-9), the Deaf Identity Development Scale (DIDS), and the Nijmegen Cochlear Implant Questionnaire (NCIQ). RESULTS: The SWL level of the group was similar to that of the standard Polish population. SWL was positively related to positive self-perception, acceptance of oneself as a deaf person, and to perceiving the benefits of having a CI (as measured by three NCIQ domains: self-esteem, activity limitations, and social interactions). On the other hand, negative self-perception, marginal deaf identity, and depressive symptoms were negatively related to SWL. There was no relationship between SWL and knowledge of sign language. Lower depressive symptoms and greater hearing loss were both significant predictors of SWL, although those who used two CIs generally had a lower SWL. CONCLUSIONS: Prelingually deaf CI users with low SWL require psychological support in many spheres, including working through problems of deaf identity, self-acceptance, and depression. Additional research should involve diverse DHH CI users, including those with limited spoken Polish competency or sign language skills, as well as members of the Polish Deaf community.

Ego-resiliency and Tinnitus Annoyance.

BACKGROUND: Tinnitus is a common and, in many cases, chronic condition. Coping with a chronic ailment is a long-term process, which also depends on the personality of the individual. One important personality resource is ego-resiliency, that is, how flexible the person is in adapting to the impulse to control their environment. PURPOSE: The aim of the study was to determine whether ego-resiliency affects the perceived level of tinnitus annoyance. RESEARCH DESIGN: This was a questionnaire study combined with a retrospective analysis of medical data. STUDY SAMPLE: The study involved 176 people with diagnosed chronic tinnitus who volunteered to participate (53 men and 123 women aged 31-80 years). DATA COLLECTION AND ANALYSIS: The following tools were used: Ego-Resiliency Scale to measure ego-resiliency, Tinnitus Functional Index to assess the impact of tinnitus on daily life, and a survey of sociodemographics and tinnitus history. RESULTS: The conducted research showed that men had higher ego-resiliency than women. Older subjects (older than 60 years) had higher ego-resiliency than younger ones. There was a negative correlation between ego-resiliency and the perceived annoyance of tinnitus. Regression analysis showed that a person's ability to cope and to tolerate negative emotions were the only factors of ego-resiliency that were a significant predictor of tinnitus annoyance. CONCLUSION: People with a high level of personal ability to cope and to tolerate negative emotions are likely to experience decreased tinnitus annoyance. Ego-resiliency levels should be considered when diagnosing and planning interventions for people with tinnitus. In psychological intervention programs for people with tinnitus, it is worthwhile developing ego-resiliency, paying particular attention to positive emotions which are crucial in building it. Research should be continued on other personal resources affecting perceived tinnitus annoyance.

Self-perceived stress and the personality of mothers of children with central auditory processing disorders - Differences from mothers of typically developing children.

PURPOSE: To investigate the relationship between self-perceived global stress and the personality traits of mothers of children with central auditory processing disorders (APD), and make a comparison with mothers of typically developing (TD) children. DESIGN AND METHODS: A cross-sectional study using two questionnaires - the Perceived Stress Scale (PSS-10) and the Short Big Five Markers (IPIP-BFM-20) - to assess five personality dimensions: extraversion, agreeableness, conscientiousness, emotional stability, and intellect/imagination. The study material included 187 mothers, of whom 108 were mothers of children with APD. The average age of the children with APD was 10 years. RESULTS: The average level of global stress was similar in mothers of children with APD and mothers of TD children. Mothers of APD children had significantly lower scores for personality dimensions such as: emotional stability, conscientiousness, and intellect/imagination. Increased perceived stress level in mothers of children with APD was inversely correlated with extraversion, conscientiousness, and emotional stability. However, for both groups of mothers, the only significant predictor of global stress level was emotional stability. CONCLUSION: Mothers of children with APD, despite having similar global stress levels to other mothers, were different in terms of three personality dimensions, and these, especially lowered emotional stability, may play a negative role in coping with global self-perceived stress. PRACTICE IMPLICATIONS: The results of this study might be helpful in parental support interventions, including psychological therapy and counselling, and also in parental implementation interventions aimed at mothers of children with APD, especially those mothers who have high global stress and/or low emotional stability.

Posttraumatic Growth in Postlingually Deaf Patients With Cochlear Implants: The Effect of Stress-Coping Strategies, Sociodemographics, and Deafness-Related Factors.

The aim of this study was to assess whether cochlear implant (CI) users who had been postlingually deaf developed a more positive outlook on life-the so-called posttraumatic growth (PTG)-as a result of their disability and to examine how PTG related to their stress-coping strategies and personal circumstances. The study group consisted of 119 postlingually deaf CI users. The participants were asked to anonymously fill in several questionnaires: the Post-Traumatic Growth Inventory (PTGI), Coping Orientations to Problems Experienced (Brief COPE), and a form asking for personal details and factors related to their deafness and CI use. The PTG of postlingually deaf CI users was similar to that found in people with other severe health problems. The time that had elapsed since the hearing was lost and the time from receiving a CI were positively correlated with PTG. The level of PTG was correlated with the particular coping strategies used and differed between men and women. We found that the development of PTG could emerge from both approach-oriented coping strategies (e.g., active coping and planning) and avoidance-oriented coping strategies (e.g., denial, self-distraction, and self-blame). Paradoxically, the avoidance strategies could play a positive role in the development of PTG. This reinforces the idea, previously raised in the PTG literature, that such strategies exert a defensive and protective function-an "illusory" side of PTG-which operates together with the positive constructive side, and both help develop the sense of well-being of a person.

Health-related quality of life in adults with profound postlingual hearing loss before and after cochlear implantation.

PURPOSE: In clinical trials and everyday medical practice, health-related quality of life (HRQoL) measures are increasingly being used. That is, in addition to the usual biological health assessment, the impact of disease and treatment on the patient's functioning in the physical, mental, and social areas is an important parameter. The aim of this study was to assess HRQoL before and after using a cochlear implant (CI) in adults with profound hearing loss. METHODS: There were 104 patients who qualified for the study. All gave informed and free consent. The study involved adults with bilateral hearing loss above 81 dB HL and rated according to the World Health Organization (WHO) classification scheme as having profound hearing loss (which includes deafness). In each participant, the hearing loss was postlingual, that is, it occurred after speech and language had developed. The assessment of quality of life (AQoL-8D) questionnaire was used to assess the health-related quality of life in the study participants. RESULTS: Quality of life significantly increased (p < 0.001) after cochlear implantation in almost all domains (except the pain dimension). The mean increase in overall quality of life was 0.16, the greatest improvement was found in the dimensions senses (mean change of 0.17) and self-worth (mean change of 0.16). CONCLUSION: Cochlear implantation improves the health-related quality of life of the postlingually deaf.

Psychomotor development of 4-year-old deaf children with cochlear implants: Three case studies.

OBJECTIVES: Hearing is one of our most important senses, and hearing ability has an enormous impact on a child's psychomotor development. Children with auditory perception disorders may show abnormal development in terms of speech, language, and communication skills, as well as other disorders involving the cognitive sphere, social-emotional interactions, and motor development. This paper describes different paths of psychomotor development in three 4-year-old children. All were born with bilateral profound sensorineural hearing loss and were implanted early on with a cochlear implant. A longitudinal study of the children's psychomotor development was done for 3 years from the time of cochlear implantation. METHODS: We present three children with congenital, profound bilateral sensorineural hearing loss. Psychomotor development was evaluated using the Children Development Scale (CDS) and the Psychomotor Development Evaluation Cards (PDEC). The three children were: Girl A (4 years 2 months 17 days) - a user of one CI, last assessment of psychomotor development (PDEC) was 37 months after CI activation; Boy B (4 years 3 months 21 days) - a user of two CIs, last assessment of psychomotor development (PDEC) was 39 months after activation of first CI; Boy C (4 years 1 month 5 days) - user of two CIs, last assessment of psychomotor development (PDEC) was 36 months after activation of the first CI. RESULTS: Analysis of the results from Girl A showed very poor dynamics of development from the age of 12 months, when the first CDS evaluation was performed, up to the PDEC evaluation performed at age 4 years. The CDS score of Boy B showed a very high level of psychomotor development. The PDEC evaluation performed after 39 months of using the first CI showed that the psychomotor development of Boy B was consistent with his chronological age. Boy C presented an average level of psychomotor development (compared to typically developing children) in his CDS scores in the perioperative period and then at 4, 9, and 14 months after cochlear implantation. After 24 months, his CDS scores showed a high level of psychomotor development. After 3 years of CI use, the PDEC evaluation showed that Boy C had an average score in five tested areas, a high score in the area of fine motor skills and lateralization, and a low score in knowledge and learning competencies. CONCLUSIONS: Children with bilateral profound hearing loss can present different paths of psychomotor development. Children who receive a CI may show an age-appropriate level of psychomotor development compared to typically developing children. However, a hearing, speech, and language rehabilitation specialist responsible for the child still needs to perform regular checkups to monitor all areas of psychomotor development. Also, the effects of the deaf child's environmental determinants on psychomotor development should be studied in detail. These determinants include the parents' emotional state, the parents' involvement in the child's rehabilitation, the family's quality of life, and the presence of deaf siblings. In particular, the difficulties encountered by the mother (or father) in being the parent of a deaf child may hinder the family from receiving adequate support.

Developmental outcomes of young deaf children and the self-perceived parental role of their hearing mothers.

BACKGROUND: There is little research into the relationship between a deaf child's developmental outcomes and their mother's self-perceived parental role. The aim of this study was to find out whether the different levels of global psychomotor development in young deaf children who had a cochlear implant (CI), or were candidates for a CI, were related to particular family factors: the self-perceived parental role and the family quality of life (FQoL) as gauged by their hearing mothers, as well as the child's sociodemographic and deafness-related factors and the sociodemographic characteristics of the mothers. METHODS: The study was conducted on a group of 64 children with bilateral severe or profound sensorineural hearing loss (SNHL) who were CI users (36 children) or qualified for cochlear implantation (28 children) and their hearing mothers. The age of the children ranged from 6.5 to 47 months (M = 23.6; SD = 10.1), among whom 55% were girls (n = 35). The mothers of the children were aged 24-48 years (M = 32.7; SD = 5.3). Information was collected via the Children Development Scale (CDS), the Self-Perception of Parental Role (S-PPR), the Family Quality of Life Survey (FQOLS-2006), and an additional information questionnaire which included questions about sociodemographic variables of the child and the mother, as well as questions related to deafness, the CI, and the child's rehabilitation. RESULTS: Based on results of the CDS, the deaf children were divided into two groups: those who had a low level of global psychomotor development (Low global psychomotor development subgroup - LGPD) and others with medium or high scores (Medium/high global psychomotor development subgroup - MHGPD). The mothers of deaf children in the LGPD group assessed their investment in motherhood lower than did mothers from the MHGPD group. The mothers of the LGPD group rated their satisfaction with the child's rehabilitation lower than did mothers from the MHGPD group. The two subgroups did not differ in FQOLS-2006 domains except for community interactions, which were significantly higher in the MHGPD families. CONCLUSIONS: Among the determinants of the global psychomotor development of a young deaf child, the most important ones relate to the use of a CI, but maternal investment in parenting is also important. Community interactions of the family with a deaf child are also crucial, as they create a framework for social network and support for the deaf child's optimal development. Any psychological diagnosis should include, apart from psychomotor development of the deaf child, an assessment of how the mother is coping with their parenting. Mothers of deaf children, especially those with LPGD, need additional support in parenting.

Cochlear implants in adults with partial deafness: subjective benefits but associated psychological distress.

PURPOSE: The present study investigated adults with partial deafness (PD) and asked them to rate the benefits of their cochlear implant (CI), their general level of satisfaction with it, and their level of psychological distress. Of particular interest was the role of gender. METHODS: The study comprised 71 participants (41 females) with PD who had been provided with a CI. The Nijmegen Cochlear Implant Questionnaire (NCIQ) was used to assess the benefits of their CI. Satisfaction with their CI was measured using a visual analog scale. The severity of mental distress was assessed with the General Health Questionnaire (GHQ-28). RESULTS: On various NCIQ scales, the average benefits of a CI were rated at 66%. Females gave a lower rating than males. The mental distress experienced by the group was significantly higher than in the general population. Females had more severe symptoms of anxiety and insomnia than males. There was a significant relationship between psychological distress and CI benefit, but only in females. Besides general distress, the most affected spheres were related to psychosocial functioning-"self-esteem", "activity limitation", and "social interaction". Contrary to expectations, there was no relationship between mental distress and CI satisfaction. CONCLUSIONS: The perceived benefits of a CI in subjects with PD relate mostly to the level of mental distress, although gender is an important factor. For females, their emotional state affects how beneficial their CI is perceived. Due to the higher levels of mental distress, females tend to need more psychological intervention and support.

Role of personal resources from the perspective of experiencing tinnitus annoyance in adults.

PURPOSE: Occurrence of tinnitus can be, for a person who experiences it, a disorder affecting the overall equilibrium of the organism. To cope with it a variety of personal resources, such as positive orientation and basic hope, are mobilized. The aim of this study was to determine whether these resources are associated with the evaluation of the impact of tinnitus on the functioning of the study participants. METHODS: Study involved 176 tinnitus sufferers, including 123 women and 53 men. The results were compiled using: Positivity Scale (P-scale) for measuring positive orientation, Basic Hope Inventory (BHI-R) for measuring basic hope, the questionnaires: Tinnitus Handicap Inventory (THI) and Tinnitus Functional Index (TFI) evaluating the impact of tinnitus on the daily functioning of the subjects, as well as a survey designed for the study, comprising questions about sociodemographic data and tinnitus history. RESULTS: Results of regression analysis indicated that positive orientation is the most important for the perceived tinnitus annoyance. However, no significant influence of basic hope on tinnitus annoyance was found. Among other variables taken into account in regression analysis, age and presence of additional diseases proved to be important predictors of tinnitus annoyance. CONCLUSIONS: Personality determinants (positive orientation) are related to the perception of tinnitus annoyance. When working with a tinnitus patient, it is justified to pay attention to the existence of the positive orientation and to work on its development. Research should also be continued to search for other personal resources that affect the perceived tinnitus annoyance.

Self-esteem in the deaf who have become cochlear implant users as adults.

OBJECTIVE: Self-esteem is a good predictor of mental health and is crucial for well-being and psychological functioning. It is especially important in situations where there are potential mental health problems, such as in people suffering from hearing loss or total deafness. This study aims to gauge the level of self-esteem in adults with hearing problems, in particular those who, in adulthood, had received a cochlear implant (CI). The subjects had different onset (pre-lingual/post-lingual) and amount (deafness/partial deafness) of hearing loss, and their current level of self-esteem was compared to that of the general population. The association of self-esteem with other deafness-related variables (e.g. satisfaction with their CI or whether they also used a hearing aid) and sociodemographic factors was also investigated. METHODS: Data were obtained from questionnaires mailed to patients who, when adult, had received a CI. The subjects were divided into four subgroups: subjects with pre-lingual deafness, post-lingual deafness, pre-lingual partial deafness, and post-lingual partial deafness. To evaluate their self-esteem, the Rosenberg Self-Esteem Scale (RSES) was used. For data on sociodemographic status and information related to deafness and CI, we used our own Information Inquiry form. For statistical analysis of the results, we compared means (t-test, ANOVA), investigated correlations, and applied linear regression. RESULTS: The self-esteem of deaf and partially deaf CI users was significantly lower than in the general population, especially for post-lingually deafened subjects. The only factor related to deafness and CIs that explained self-esteem was self-rated satisfaction with the CI-meaning that higher satisfaction was associated with higher self-esteem. The major sociodemographic factor that explained self-esteem was marital/partnership status (being in a relationship was helpful). Also men had higher self-esteem than women. Those with higher levels of education, and those working or studying, had higher self-esteem than those who did not. RSES was found to have a single-factor structure. CONCLUSION: Deafness and partial deafness appear to be risk factors for lower self-esteem, a finding that rehabilitation, medical, educational, and employment communities should be made aware of. Medical intervention in the form of a CI supplies the person with improved hearing, but it is not a panacea: their self-esteem is still vulnerable, and reinforcement of self-esteem is an aspect that professionals should focus on. Psychological, psycho-educational, and psychotherapeutic interventions have important roles to play for CI recipients.

Satisfaction With Cochlear Implants in Postlingually Deaf Adults and Its Nonaudiological Predictors: Psychological Distress, Coping Strategies, and Self-Esteem.

OBJECTIVE: A postlingually deaf patient who receives a cochlear implant (CI) acquires multiple benefits, not just audiological but also nonaudiological: improvement in quality of life, psychological well-being, and social interaction. The aim of the study was to ascertain the relationship between the CI satisfaction experienced by adult, postlingually deaf individuals and their level of psychological distress, stress coping strategies, and global self-esteem. We also considered sociodemographic variables (such as sex, age, education, marital/partner status, and employment/study status), variables related to their deafness, and their length of experience with a CI. DESIGN: The study had a cross-sectional design in which participants were asked to fill in a mailed personal inquiry form seeking sociodemographic data and one question related to CI satisfaction, and the following questionnaires: General Health Questionnaire-28, the Brief Coping Orientation to Problems Experienced, and the Rosenberg Self-Esteem Scale. This study included 98 patients with postlingual deafness between 19 and 85 years old who had unilateral CIs. For some analyses, the patients were also divided into two groups: younger (≤60 years) and older (>60 years). Two other subgroups were those with shorter CI experience (1 to 2 years) and those with longer CI experience (5 to 6 years). As an objective reference, speech perception scores in quiet and in noise were also used. RESULTS: The majority of postlingually deaf subjects rated their CI satisfaction as high or very high, and this was at similar levels in younger and older subjects, as well as in those who had used CIs for either a short or a long time. CI satisfaction was not related to speech perception scores, duration of deafness, length of CI use, or other sociodemographic factors. Positive self-esteem, having less severe symptoms of depression, and the use of humor or self-distraction were conducive to CI satisfaction. Using a coping strategy of denial had a negative association with CI satisfaction. Coping strategies and symptoms of mental distress varied between younger and older subjects. For younger subjects, higher CI satisfaction was associated with lower severity of depressive symptoms, whereas for the elderly, higher CI satisfaction was associated with less severe social dysfunction symptoms. Over the years of using a CI, the same strategy may have a different psychological function in providing satisfaction: for example, venting, which in the group with a short CI experience is negatively correlated to satisfaction, is positively correlated to satisfaction for those with longer CI experience. CONCLUSIONS: The results show that psychological factors­self-esteem, distress, and coping strategies­are important for CI satisfaction in postlingually deaf CI users. The results point to advantages in widening the availability of various tailored forms of psychological intervention for patients with postlingual deafness after receiving a CI.

[Mental health problems of mothers and fathers of the deaf children with cochlear implants]. / Problemy zdrowia psychicznego matek i ojców dzieci gluchych z implantem slimakowym.

INTRODUCTION: Child's deafness is a risk factor for the mental health of its parents. This study addresses a question whether mothers and fathers of the prelingually deaf children using cochlear implants (CI) experience a different intensity of psychopathology symptoms than parents of the hearing, typically developing children, and also if the intensity of those symptoms experienced by parents is related to how long their child is a cochlear implant user. MATERIAL AND METHODS: In this study participated 153 hearing parents of the deaf children using a single cochlear implant (111 mothers, 42 fathers), and parents of the hearing children. Mean age of deaf children was 72 months, cochlear implant use duration was between 1 and 124 months. The control group of parents has been selected taking into account their typically developing child's sex and age. The parents' mental health has been assessed with Goldberg General Health Questionnaire GHQ-28 in Polish adaptation. RESULTS: Mothers of deaf, CI using children experience significantly more symptoms of anxiety and insomnia compared to the mothers of typically developing children, while fathers of these children show the tendency for the increased level of depression symptoms compared to the fathers from the control group. In the group of deaf CI children mothers relate substantially more somatic and anxiety symptoms than fathers, whereas level of experiencing depression symptoms and problems in everyday functioning is similar in mothers and fathers. No relation between the duration of child's CI use and parents' mental health has been ascertained. CONCLUSIONS: The mental health of parents of the deaf CI using children indicates that both mothers and fathers have problems in this sphere related to their child's deafness, but not to the duration of child's CI use. Parents of deaf, CI using children may need psychological help regardless of the time their child has been using the cochlear implant.

[Coping strategies in postlingually deafened adult cochlear implant users in comparison to the hearing population]. / Strategie radzenia sobie ze stresem u osób doroslych postlingwalnie ogluchlych korzystajacych z implantu slimakowego, w porównaniu z populacja ogólna slyszacych.

OBJECTIVE: The research question was: what coping strategies are used by the postlingually deafened adult cochlear implant (CI) users, in comparison to the hearing population, taking into account their gender and CI experience. MATERIAL AND METHODS: In the assessment of the coping strategies we used the C.S. Carver's Brief COPE questionnaire in Polish adaptation. The questionnaire and information form have been sent to the adult patients implanted in the Institute of Physiology and Pathology of Hearing in the years 2005 and 2009. The response ratio was 59.5% (n = 78). The control group (n = 77) comprised hearing persons selected at random, allowing for age. RESULTS: The stress coping strategies are different in the postlingually deafened adults and hearing ones. The postlingually deaf more seldom use the effective strategies, such as the active coping, planning and humour, and more often the denial. Also, they significantly more seldom turn to the self-blame and the substance use. People with longer CI experience significantly more often use the denial, more seldom they adopt the substance use and the self-distraction compared with those with shorter CI experience. Female postlingually deafened CI users are significantly less active in coping with stress and more seldom turn to the substance use, but more often, compared with the hearing women in the same age-group, use the denial. Male postlingually deafened CI users differ significantly from the hearing men only in more seldom turning to the self-blame and the substance use. CONCLUSIONS: Postlingually deafened CI patients more often use the ineffective coping strategies. This tendency becomes stronger with the time lapse from the cochlear implantation and is more frequent in women, which corresponds with the data on both the considerably worse mental health of the postlingually deafened people compared to the general population and the deterioration of the mental, social and physical functioning with the lapse of time from the implantation. The standing availability of the psychological support for these patients is essential, as well as the awareness of their problems.