School of Health Sciences, Manchester Centre for Health Psychology & Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom.
Department of Otolaryngology, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
Ear Hear. 2021 Mar/Apr;42(2):456-464. doi: 10.1097/AUD.0000000000000952.
Bone conduction hearing implants (BCHIs) are an effective option to rehabilitate hearing for people who cannot use conventional, air conduction hearing aids. However, the uptake of such devices in the United Kingdom is lower than might be expected, and the reasons for this are not fully understood. The present study used qualitative methods to explore decision-making about whether to accept or reject BCHIs.
Semistructured telephone interviews were conducted with 17 BCHI candidates who had recently accepted or rejected BCHIs.
A thematic analysis identified four overarching themes: participants wanted to look and feel normal; potential risks were weighed against rewards; participants felt that there was a "right time" to have a BCHI; and information from clinicians and BCHI users was treated differently. Participants' perceptions of normality were influential in the final decision, and the BHCI was seen either as a barrier or facilitator of this. Participants consistently weighed up potential advantages and disadvantages of BCHIs, with potential for hearing improvement typically used as a benchmark against which other factors were measured. Some participants who rejected BCHIs felt that they could reconsider having a BCHI when they felt the time was right for them. Participants highly valued advice from clinicians, but felt that their expertise lacked validity as clinicians typically did not have experience of using BCHIs themselves.
The decision to accept or reject a BCHI was highly individual. Each participant considered a range of factors; the influence of each factor depended on the individual's perceptions and experiences. This work highlights the importance of clinical staff being able to explore the individual priorities and concerns of each patient to ensure that patients feel happy and confident with the decision that they make.
骨导式听力植入物（BCHI）是为无法使用传统空气传导助听器的人恢复听力的有效选择。然而，这类设备在英国的使用率却低于预期，其原因尚未完全了解。本研究采用定性方法探讨了是否接受或拒绝 BCHI 的决策过程。
对最近接受或拒绝 BCHI 的 17 名 BCHI 候选者进行了半结构化电话访谈。
主题分析确定了四个总体主题：参与者希望看起来和感觉正常；权衡潜在风险和收益；参与者认为有一个“合适的时间”接受 BCHI；以及临床医生和 BCHI 用户提供的信息被不同对待。参与者对正常的看法对最终决策有影响，BCHI 被视为正常的障碍或促进因素。参与者始终权衡 BCHI 的潜在优缺点，潜在的听力改善通常用作衡量其他因素的基准。一些拒绝 BCHI 的参与者认为，当他们觉得时机合适时，他们可以重新考虑使用 BCHI。参与者非常重视临床医生的建议，但认为他们的专业知识缺乏有效性，因为临床医生通常自己没有使用 BCHI 的经验。
接受或拒绝 BCHI 的决定高度个体化。每个参与者都考虑了一系列因素；每个因素的影响取决于个人的看法和经验。这项工作强调了临床工作人员能够探讨每位患者的个人优先事项和关注点的重要性，以确保患者对自己做出的决定感到满意和自信。
