(Re)habilitation and Counseling (C)
Amy M. Myers, AuD
AP Assistant Professor, Audiology
UNC Greensboro
Greensboro, North Carolina, United States
Denise Anne Tucker, Ph.D
Professor, Audiology
University of North Carolina Greensboro
Greensboro, North Carolina, United States
Lisa McDonald, MA, CCC-SLP
AP Professor, Director UNCG Speech and Hearing Center
University of North Carolina Greensboro
Greensboro, North Carolina, United States
The QOL social outcomes of a ten-week online group aural rehabilitation (AR) therapy program with late deafened adults (LDAs) with cochlear implants (CIs) is reported. Results of the Social subdomain of the Nijmegen Cochlear Implant Questionnaire (NCIQ) indicated that participants’ activity limitations and social interactions scores improved post therapy. These results document that the participants’ social limitations decreased, and their social interactions increased. Implications for assessing the outcomes of group AR using a measure of QOL and social functioning designed for adult CI users affirm the centrality of the social context in which AR therapy can be implemented and evaluated.
Summary:
Rationale:
Hearing health care professionals need to consider social outcomes of AR within a patient-centered, holistic health care framework (Glade et al., 2020). Group AR with LDAs with CIs reflects the principles of Boothroyd (2010), Montano (2014) and Erdman (2009) biopsychosocial models in conjunction with components of social interaction and social support as advocated by Preminger and Yoo, 2010 and Oesterich, 2018. The interactive, social context of group AR becomes how the QOL as well as the auditory and cognitive perceptual abilities of LDAs with CIs can be improved (Tucker, et al., 2014; Abdrabbou et al., 2018).
The UNCG Cochlear Implant Connections (CIC), a ten-week, research-focused, program of group AR for LDAs with CIs delivered via Zoom, incorporates the framework of social cognitive intervention derived from social work (Dennison, 2008). This model emphasizes the central role of interpersonal communication and socialization among participants facilitated by clinicians as they acquire auditory perceptual skills, participate in counseling, and engage in instruction. Thus, group members become a community of practice in reflecting on their progress and expanding on their listening skills, sharing assistive device usage tips, and offering each other strategies in self-managing challenging listening situations. The purpose of this study was to examine changes in a small sample of CI users’ QOL and social functioning and to affirm the need for QOL assessment measures to document CI outcomes.
Design: A group of 12 adults (eight males and four females) with CIs were participants in this study. Hearing thresholds and speech perception measures were obtained before and after group AR via CNC word list and AZBio Sentences. The Nijmegen Cochlear Implant Questionnaire (NCIQ) (Hinderink et al, 2000) was administered pre- and post CIC. Six NCIQ subdomains included 10 statements formulated on a 5 -point scale with response categories of: never (1), sometimes (2), often (3), mostly (4), and always (5). The NCIQ subdomains were scored by assigning values to survey statements as follows: 1=0, 2=25,3=50,4=75, and 5=100. Repeated Measures ANOVA for each of the subdomains were calculated. This presentation reports the results of two NCIQ Social Subdomains: Social Activity Limitations, and Social Interactions.
Results: Twelve adults with CIs participated in the study. Speech perception skills improved post CIC. However, these measures did not reach statistical significance. NCIQ results showed that participants’ Social Activity Limitations (F=7.048, p=.029) and Social Interactions (F=13.203, p=.007) statistically improved after participating in group AR. Responses to NCIQ questions revealed that participants perceived their hearing loss to be a less serious problem in communicating with friends and neighbors after participating in the CIC group AR program. Results also revealed that participants felt their hearing impairments were less of a problem when communicating with family members and people they live with and when going outside the home on trips.
Conclusions: A measure documenting social aspects of overall QOL such as the NICQ provides hearing health care professionals with essential psychosocial information regarding CI users’ social activities and interactions that can be implemented in evaluating the outcomes of AR therapy.