Meserole Rachel L, Carson Christine M, Riley Anne W, Wang Nae-Yuh, Quittner Alexandra L, Eisenberg Laurie S, Tobey Emily A, Francis Howard W, Niparko John K
Department of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, MD, USA,
Qual Life Res. 2014 Mar;23(2):719-31. doi: 10.1007/s11136-013-0509-3. Epub 2013 Aug 23.
To examine the impact of cochlear implant (CI) intervention on health-related quality of life (HRQOL) assessed by both self- and parent-reported measures.
In this national study of children implanted between ages 6 months and 5 years, HRQOL of 129 children 6-year post-CI was compared to 62 internal study (NH1) and 185 external (NH2) samples of hearing children frequency-matched to the CI group on sociodemographic variables. HRQOL ratings of children and their parents in each group, measured using the Child Health and Illness Profile-Child Edition, were compared, and their associations with the Family Stress Scale were investigated.
CI children reported overall and domain-specific HRQOL that was comparable to both NH1 and NH2 peers. CI parents reported worse child scores than NH1 parents in Achievement, Resilience, and Global score (p's < 0.01) but similar or better scores than socioeconomically comparable NH2 parents. Higher family stress was negatively associated with all parent-reported HRQOL outcomes (p's < 0.01). Parent-child correlations in HRQOL global scores trended higher in CI recipients (r = 0.50) than NH1 (r = 0.42) and NH2 (r = 0.35) controls.
CI recipients report HRQOL comparable to NH peers. These results, from both child and parent perspective, lend support to the effectiveness of CI intervention in mitigating the impact of early childhood deafness. Family stress was associated with worse HRQOL, underscoring a potential therapeutic target. Parent-child agreement in HRQOL scores was higher for CI families than NH families, which may reflect higher caregiver insight and involvement related to the CI intervention.
通过自我报告和家长报告的方式，研究人工耳蜗（CI）干预对健康相关生活质量（HRQOL）的影响。
在这项针对6个月至5岁接受人工耳蜗植入儿童的全国性研究中，将129名人工耳蜗植入术后6年儿童的HRQOL与62名内部研究样本（NH1）和185名外部样本（NH2）的听力正常儿童进行比较，这些听力正常儿童在社会人口统计学变量上与人工耳蜗植入组进行了频率匹配。使用儿童健康与疾病概况-儿童版对每组儿童及其父母的HRQOL评分进行比较，并研究其与家庭压力量表的关联。
人工耳蜗植入儿童报告的总体和特定领域的HRQOL与NH1和NH2同龄人相当。人工耳蜗植入儿童的家长报告的儿童得分在成就、恢复力和总体得分方面比NH1家长差（p值<0.01），但比社会经济状况相当的NH2家长得分相似或更好。较高的家庭压力与家长报告的所有HRQOL结果呈负相关（p值<0.01）。人工耳蜗植入受者的HRQOL总体得分中亲子相关性（r = 0.50）比NH1（r = 0.42）和NH2（r = 0.35）对照组更高。
人工耳蜗植入受者报告的HRQOL与NH同龄人相当。从儿童和家长的角度来看，这些结果支持了人工耳蜗植入干预在减轻幼儿期耳聋影响方面的有效性。家庭压力与较差的HRQOL相关，突出了一个潜在的治疗靶点。人工耳蜗植入家庭在HRQOL得分上的亲子一致性高于NH家庭，这可能反映了照顾者与人工耳蜗植入干预相关的更高洞察力和参与度。
