The Quality of Life from the Point of View of Parents in Pre-Lingual Deaf Children after 1.5 Years of Cochlear Implantation in Shiraz, Southern Iran

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Article Information:


Group: 2011
Subgroup: Volume 13, Issue 6, Jun
Date: June 2011
Type: Short Communication
Start Page: 431
End Page: 433

Authors:

  • SB Hashemi
  • Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
  • L Monshizadeh
  • Department of Speech and Language, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, Fars, Iran

      Correspondence:

      Affiliation: Department of Speech and Language, Khalili Hospital, Shiraz University of Medical Sciences
      City, Province: Shiraz, Fars
      Country: Iran
      Tel: +98-711-6471934
      Fax: +98-711-6471934
      E-mail: lmon1008@yahoo.com

Abstract:


Background: As much of the studies on cochlear implantation (CI) have concentrated on aspects of speech perception and production, we studied the quality of life in pre-lingual deaf children in Shiraz, southern Iran.

Methods: Twenty four parents were selected from those pre-lingual deaf children that their children were implanted by Fars CI Center. The quality of life questionnaire was used and after 3 months was evaluated again.

Results: Significant changes were noticed in parent's satisfaction. The parents believed that the children communicated better, but they still needed special care to do school works, etc. Also they had still difficulty in articulation.

Conclusion: CI was significantly associated with improvement of quality of life, especially in communication, happiness and relations with their friends and family members.       

Keywords: Quality of life; Cochlear implant; Pre-lingual; Deaf; Children; Iran

Manuscript Body:


Introduction

Rehabilitation after cochlear implantation (CI) provides far better chances for children to learn their language and to be integrated in mainstream schools.1 As much of the studies on CI tend to be from a professional perspective and have concentrated on aspects of speech perception and production,2,3 we aimed to study the quality of life from the point of view of parents in pre-lingual deaf children after 1.5 years of cochlear implantation in Shiraz, southern Iran.  

 

Materials and Methods

Twenty four parents were selected from those children who were implanted in Fars CI Center affiliated to Shiraz University of Medical Sciences in Shiraz, southern Iran. The inclusion criteria were that the children should be born deaf or were deaf after 3 years and were implanted for at least 1.5 years ago. The parents were asked to complete and return a questionnaire that its reliability was determined by α coefficient which was 0.82. After one month, all questionnaires were collected and again, the same procedure was performed 3 months later. Part one of the questionnaire compromised 14  and part 2, 11 questions on child communication, happiness, school activities, and its relation with child's need, expenses, child's speech intelligibility and family wishes. All 24 questionnaires were also received after the 3 months period. SPSS software (Version 15, Chicago, IL, USA) was used for statistical analysis. Wilcoxon signed ranks test was used or assessment of changes in responses during the time also recognition in order to determine the agreement of the factors. A p value less than 0.05 was considered significant.    

 

Results

Table 1 shows the changes as mean and standard deviation in two steps of giving questionnaire to the parents.

Table 1: Changes in mean and standard deviation in two steps of questionnaires

p-value

Standard deviation

2

Average

 

2

Standard

deviation 

1 

Average

 

1

Factors

0.09

9.35

8.88

41.58

37.95

Child’s general functioning and family view

0.09

5.53

7.55

39.66

37.66

Limitations, disadvantages and supporting the child

0.44

3.3

3.94

19.2

18.13

Child's education and your expectation

0.15

1.41

1.52

9.08

8.58

Decision to implant

0.29

2.25

3.12

11.16

10.5

Child's status before operation and suggestions after operation

0.21

1.84

2.8

15.5

14.7

changes

0.59

0.72

0.65

2.54

2.45

Child's advancement

0.60

3.12

3.38

18.04

18.62

Weakness

0.52

2.05

2.04

9.7

9.41

Effects of implantation

0.08

1.71

2.03

5.62

5.04

Difficulties

0.24

2.05

2.25

8.66

8.25

Social relationship

0.80

1.7

1.71

5.7

5.62

Feelings

0.03

2.17

1.99

6.29

5.41

Cochlear implant benefits

0.06

4.3

5.36

31.66

30.7

Process of implantation

 

 

 

 

 

Table 2 demonstrates the distribution of changes in responses. Significant changes were noticed in responses (p=0.03).

Table 2: Frequency in distribution of changes in responses

Frequency

 

 

Number of questions

 

  +  3

+2

+1 

  0

-1

-2

-3

0

0

5

19

0

0

0

24

1

0

0

6

18

0

0

0

24

2

0

0

3

11

6

2

2

24

3

0

0

6

16

1

0

0

23

4

0

0

0

13

2

1

0

16

5

0

2

2

11

1

0

0

16

6

1

3

6

5

3

1

0

19

7

1

1

5

11

3

0

0

21

8

0

2

5

15

1

0

0

23

9

1

7

6

4

5

1

0

24

10

0

4

5

13

2

0

0

24

11

 

 

 

 

 

 

In four questions related to social relationship, child’s happiness, family relationship and school support services, responses were indicative of converge to positive zone. In the question of ‘He does not make friends easily outside the family’, the answers converge to the negative zone .41.6% of parents reported that it is vice versa and the child was more sociable than before. Although 12.5% of parents believed that their child had difficulty in social relationship. In 5 questions related to child's general functioning, school activities, education, CI expenses, speech condition and parent's wishes about the time that children started to speak, the responses were in the positive zone. The improvement in child's functioning after 1.5-2 years of implantation was significant regarding communication and relation with friends and family members.

 

Discussion

There have been fewer studies about the effects of CI on children from the point of view of their parents. Kelsay and Tyler used an open format questionnaire to find the annual expected benefits and problems prior to implantation and the resultant benefits and problems following implantation. Parents were realistic about the potential advantages and disadvantages prior to implantation. The disadvantages were evaluated for the size and maintenance of equipment. They reported that subjective questionnaires were useful to provide information on child progress following implantation.4 

Generally CI recipients achieved statistically significant improvements in the ability to communicate. It is an important aspect of quality of life after the definition of WHO "Physical health, psychological state, level of independence, social relationship and their relation to salient features of environment" mentioned as important factors.5,6  

In our study, significant changes were noticed in responses showing parent's satisfaction (p=0.03). In four questions related to social relationship, child’s happiness, family relationship and school support services, responses were indicative of converge to positive zone, being the sign of parent's satisfaction in these four questions too. In the question of ‘He does not make friends easily outside the family’, the answers converge to the negative zone .41.6% of parents reported that it is vice versa and the child was more sociable than before. Although 12.5% of parents believed that their child had difficulty in social relationship.

According to these factors we came to a conclusion that after CI the children were happy and established a better communication. In 5 questions related to child's general functioning, school activities, education, CI expenses, speech condition and parent's wishes about the time that children started to speak, the responses were in the positive zone indicating to the parent's relatively consent. The improvement in child's functioning after 1.5-2 years of implantation was significant regarding communication and relation with friends and family members that improved the relatives' daily lives too. We can conclude that CI was significantly associated with improvement of quality of life, especially in communication, happiness and relations with their friends and family members.

 

Acknowledgement: We are deeply grateful for Mr Tabatabaie for statistical advices and for his great support and help in this study.

Conflict of Interest: None declared.

Table 1: Changes in mean and standard deviation in two steps of questionnaires

p-value

Standard deviation

2

Average

 

2

Standard

deviation 

1 

Average

 

1

Factors

0.09

9.35

8.88

41.58

37.95

Child’s general functioning and family view

0.09

5.53

7.55

39.66

37.66

Limitations, disadvantages and supporting the child

0.44

3.3

3.94

19.2

18.13

Child's education and your expectation

0.15

1.41

1.52

9.08

8.58

Decision to implant

0.29

2.25

3.12

11.16

10.5

Child's status before operation and suggestions after operation

0.21

1.84

2.8

15.5

14.7

changes

0.59

0.72

0.65

2.54

2.45

Child's advancement

0.60

3.12

3.38

18.04

18.62

Weakness

0.52

2.05

2.04

9.7

9.41

Effects of implantation

0.08

1.71

2.03

5.62

5.04

Difficulties

0.24

2.05

2.25

8.66

8.25

Social relationship

0.80

1.7

1.71

5.7

5.62

Feelings

0.03

2.17

1.99

6.29

5.41

Cochlear implant benefits

0.06

4.3

5.36

31.66

30.7

Process of implantation

References: (6)

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