Bedarfsanalyse für ein Selbsthilfetraining im Rahmen der Cochlea-Implantat-Rehabilitation

Zusammenfassung

Hintergrund Trotz Cochlea-Implantation erleben CI-Träger*innen Schwierigkeiten in anspruchsvollen Hörsituationen. Im deutschsprachigen Raum gibt es keinerlei Interventionen zur Förderung von gezielten Bewältigungsstrategien für derartige Situationen. Die vorliegende Studie untersucht die nach Implantation fortbestehenden Alltagseinschränkungen sowie die Relevanz potenzieller Interventionsinhalte, um ein Selbsthilfeprogramm für die CI-Rehabilitation zu entwickeln.

Material und Methoden Es wurden 56 CI-Träger*innen aus 3 deutschen CI-Zentren rekrutiert, die eine Online-Befragung zu demografischen Daten, zur Hörbiografie, zum Hörhandicap und zu potenziell relevanten Interventionsinhalten ausfüllten. Die präsentierten Interventionsinhalte umfassten dabei die folgenden Kategorien: medizinische Aspekte, Aspekte zur Kommunikationsverbesserung, psychosoziale Aspekte, technische Aspekte und spezifische Aspekte.

Ergebnisse Das Hörhandicap war in der vorliegenden Stichprobe moderat bis schwerwiegend ausgeprägt. Die vorgestellten Inhaltskategorien für die Gestaltung eines Selbsthilfeprogramms wurden alle als „wichtig“ eingestuft. Die Dauer der CI-Versorgung korrelierte signifikant negativ mit der Einschätzung der Relevanz von psychosozialen Aspekten. Weitere signifikante Zusammenhänge konnten zwischen der Ausprägung des Hörhandicaps und der Einschätzung der Relevanz von Aspekten zur Kommunikationsverbesserung sowie psychosozialer und technischer Aspekte aufgezeigt werden.

Schlussfolgerung Ein Selbsthilfeprogramm, das die untersuchten Inhalte berücksichtigt, könnte eine vielversprechende Unterstützung für den CI-Rehabilitationsprozess darstellen und soll im Folgenden entwickelt sowie evaluiert werden.

Abstract

Objective Despite cochlear implantation, CI users experience difficulties in challenging listening situations. In German-speaking countries, there are no interventions to promote specific coping strategies for such situations. The present study examines persistent everyday limitations and the relevance of potential intervention content in order to develop a self-help program for CI rehabilitation.

Material and Methods 56 CI users from three German CI centers were recruited and completed an online survey on demographic data, hearing biography, hearing handicap and potentially relevant intervention content. The intervention content presented included the following categories: Medical Aspects, Communication Improvement Aspects, Psychosocial Aspects, Technical Aspects, Specific Aspects.

Results The hearing handicap was moderate to severe in this sample. The content categories presented for the design of a self-help program were all rated as “important”. The duration of CI provision correlated significantly negatively with the assessment of the relevance of psychosocial aspects. Further significant correlations were found between the severity of the hearing handicap and the rating of the relevance of aspects for improving communication, psychosocial and technical aspects.

Conclusion A self-help program that takes into account the contents examined could provide promising support for the CI rehabilitation process and will be developed and evaluated subsequently.

Schlüsselwörter

Cochlea Implantat - Rehabilitation - Selbsthilfe - Hörbehinderung - Wohlbefinden

Keywords

Cochlear Implant - Rehabilitation - self-management

Publikationsverlauf

Eingereicht: 08. Juli 2024

Angenommen nach Revision: 15. August 2024

Artikel online veröffentlicht:
03. September 2024

• Literatur

• 1 Boisvert I, Reis M, Au A. et al. Cochlear implantation outcomes in adults: A scoping review. PLoS One 2020; 15: e0232421
• 2 McRackan TR, Bauschard M, Hatch JL. et al. Meta-analysis of Cochlear Implantation Outcomes Evaluated With General Health-related Patient-reported Outcome Measures. Otol Neurotol 2018; 39: 29-36
• 3 Zaltz Y, Bugannim Y, Zechoval D. et al. Listening in Noise Remains a Significant Challenge for Cochlear Implant Users: Evidence from Early Deafened and Those with Progressive Hearing Loss Compared to Peers with Normal Hearing. J Clin Med 2020; 9
• 4 Philips C, Jacquemin L, Lammers MJW. et al. Listening effort and fatigue among cochlear implant users: a scoping review. Front Neurol 2023; 14: 1278508
• 5 OʼNeill ER, Basile JD, Nelson P. Individual Hearing Outcomes in Cochlear Implant Users Influence Social Engagement and Listening Behavior in Everyday Life. J Speech Lang Hear Res 2021; 64: 4982-4999
• 6 Iwagami M, Kobayashi Y, Tsukazaki E. et al. Associations between self-reported hearing loss and outdoor activity limitations, psychological distress and self-reported memory loss among older people: Analysis of the 2016 Comprehensive Survey of Living Conditions in Japan. Geriatr Gerontol Int 2019; 19: 747-754
• 7 Helvik AS, Jacobsen G, Hallberg LR. Psychological well-being of adults with acquired hearing impairment. Disabil Rehabil 2006; 28: 535-545
• 8 Hallberg LR, Hallberg U, Kramer SE. Self-reported hearing difficulties, communication strategies and psychological general well-being (quality of life) in patients with acquired hearing impairment. Disabil Rehabil 2008; 30: 203-212
• 9 Barker AB, Leighton P, Ferguson MA. Coping together with hearing loss: a qualitative meta-synthesis of the psychosocial experiences of people with hearing loss and their communication partners. Int J Audiol 2017; 56: 297-305
• 10 Timmer BHB, Bennett RJ, Montano J. et al. Social-emotional well-being and adult hearing loss: clinical recommendations. Int J Audiol 2023; 1-12
• 11 Michaud HN, Duchesne L. Aural Rehabilitation for Older Adults with Hearing Loss: Impacts on Quality of Life-A Systematic Review of Randomized Controlled Trials. J Am Acad Audiol 2017; 28: 596-609
• 12 Hawkins DB. Effectiveness of counseling-based adult group aural rehabilitation programs: a systematic review of the evidence. J Am Acad Audiol 2005; 16: 485-493
• 13 Kramer SE, Allessie GH, Dondorp AW. et al. A home education program for older adults with hearing impairment and their significant others: a randomized trial evaluating short- and long-term effects. Int J Audiol 2005; 44: 255-264
• 14 Hickson L, Worrall L, Scarinci N. A randomized controlled trial evaluating the active communication education program for older people with hearing impairment. Ear Hear 2007; 28: 212-230
• 15 Williams KC, Falkum E, Martinsen EW. A cognitive therapy program for hearing-impaired employees suffering from mental distress. Int J Audiol 2015; 54: 227-233
• 16 Garnefski N, Kraaij V. Effects of a Cognitive Behavioral Self-help program on emotional problems for people with acquired hearing loss: a randomized controlled trial. J Deaf Stud Deaf Educ 2012; 17: 75-84
• 17 Thorén ES, Oberg M, Wänström G. et al. A randomized controlled trial evaluating the effects of online rehabilitative intervention for adult hearing-aid users. Int J Audiol 2014; 53: 452-461
• 18 Malmberg M, Lunner T, Kähäri K. et al. Evaluating the short-term and long-term effects of an internet-based aural rehabilitation programme for hearing aid users in general clinical practice: a randomised controlled trial. BMJ Open 2017; 7: e013047
• 19 Ventry IM, Weinstein BE. The hearing handicap inventory for the elderly: a new tool. Ear Hear 1982; 3: 128-134
• 20 Moser S, Luxenberger W, Freidl W. Wahrnehmung von Hörproblemen bei älteren Menschen. HNO 2017; 65: 671-679
• 21 Newman CW, Weinstein BE, Jacobson GP. et al. The Hearing Handicap Inventory for Adults: psychometric adequacy and audiometric correlates. Ear Hear 1990; 11: 430-433
• 22 Geßner S, Fuchs M, Pieper LH. et al. Wie können Menschen mit einer Hörbehinderung über eine Hörsystemversorgung hinaus unterstützt werden? – Ein systematisches Review zu Selbstmanagement-Interventionen. PPmP 2024; 74: 311-322
• 23 Park E, Shipp DB, Chen JM. et al. Postlingually deaf adults of all ages derive equal benefits from unilateral multichannel cochlear implant. J Am Acad Audiol 2011; 22: 637-643
• 24 Capretta NR, Moberly AC. Does quality of life depend on speech recognition performance for adult cochlear implant users?. Laryngoscope 2016; 126: 699-706
• 25 Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde K-uH-CeV. S2k-Leitlinie: Cochlea-Implantat Versorgung. 3.0. Aufl; 2020.
• 26 Kim AS, Betz JF, Nieman CL. et al. Long-term Impact of Hearing Aid Provision or Cochlear Implantation on Hearing Handicap. Laryngoscope 2021; 131: 1122-1126
• 27 Voola M, Távora-Viera D. Quality of Life handicap measured in patients with profound unilateral or bilateral deafness. Tasman Medical Journal 2021; 3: 52-56
• 28 Iwasaki S, Sano H, Nishio S. et al. Hearing handicap in adults with unilateral deafness and bilateral hearing loss. Otol Neurotol 2013; 34: 644-649
• 29 Nordvik Ø, Heggdal POL, Brännström KJ. et al. Importance of personality and coping expectancy on patient-reported hearing disability, quality of life and distress level: a study of patients referred to an audiology service. Health Qual Life Outcomes 2021; 19: 168
• 30 Quinlan BP, Africa RE, McKinnon BJ. Familial psychosocial impact of cochlear implatation. Am J Otolaryngol 2023; 45: 104137
• 31 Preminger JE, Meeks S. Evaluation of an audiological rehabilitation program for spouses of people with hearing loss. J Am Acad Audiol 2010; 21: 315-328
• 32 Andersson G, Melin L, Scott B. et al. Behavioral counselling for subjects with acquired hearing loss. A new approach to hearing tactics. Scand Audiol 1994; 23: 249-256
• 33 Bergman P, Lyxell B, Harder H. et al. The Outcome of Unilateral Cochlear Implantation in Adults: Speech Recognition, Health-Related Quality of Life and Level of Anxiety and Depression: a One- and Three-Year Follow-Up Study. Int Arch Otorhinolaryngol 2020; 24: e338-346