Department of Otolaryngology, University of Miami Ear Institute, Miami, FL.
Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
Otol Neurotol. 2021 Dec 1;42(10S):S11-S18. doi: 10.1097/MAO.0000000000003374.
This study evaluated associations among parenting stress, self-efficacy, and involvement in relation to spoken language outcomes in young children 3 years following cochlear implantation.
Cross-sectional.
Six university tertiary medical centers.
One hundred sixty-four young children with bilateral, severe-to-profound sensorineural hearing loss who had 3 years of experience with a CI; children with substantial cognitive impairments were excluded from the study.
Family Stress Scale (FSS), Scale of Parental Involvement and Self-Efficacy (SPISE), Oral and Written Language Scales (OWLS).
Correlations were of moderate strength between FSS scores and SPISE scores (Parental Self-Efficacy, r = -0.45, p < 0.01, Parental Involvement r = -0.32, p < 0.01). As hypothesized, parents reporting higher levels of stress reported lower perceptions of self-efficacy and involvement. In addition, results showed that family stress had a direct, negative effect on spoken language (-4.43 [95% confidence interval: -6.97; -1.89]). After controlling for maternal education and activation age, parental self-efficacy mediated the negative effect between family stress and spoken language (indirect effect = -1.91 [3.45; -0.69]; proportion mediated = 0.43). No mediating effects were found for parental involvement.
These findings highlight the need for parenting interventions that focus on reducing stressors and increasing parents' perceptions of self-efficacy in families of children using cochlear implants. Integration of mental health screening and tailored parenting interventions in CI clinics may increase parental self-efficacy and involvement, with measurable benefits in the child's use of spoken language.
本研究评估了在植入人工耳蜗 3 年后，父母压力、自我效能感和参与度与儿童口语语言结果之间的关系。
横断面研究。
六所大学三级医疗中心。
164 名患有双侧重度至极重度感音神经性听力损失的幼儿，他们有 3 年的人工耳蜗使用经验；研究排除了有严重认知障碍的儿童。
家庭压力量表（FSS）、父母参与和自我效能量表（SPISE）、口语和书面语言量表（OWLS）。
FSS 评分与 SPISE 评分（父母自我效能感，r=-0.45，p<0.01，父母参与，r=-0.32，p<0.01）之间存在中度强度的相关性。正如假设的那样，报告压力水平较高的父母报告自我效能感和参与度较低。此外，研究结果表明，家庭压力对口语语言有直接的负面影响（-4.43[95%置信区间：-6.97；-1.89]）。在校正了母亲教育和激活年龄后，父母自我效能感介导了家庭压力和口语语言之间的负向关系（间接效应=-1.91[3.45；-0.69]；中介比例=0.43）。父母参与没有中介作用。
这些发现强调了需要针对人工耳蜗使用者家庭的育儿干预措施，重点是减轻压力源并增强父母的自我效能感。在人工耳蜗诊所中整合心理健康筛查和量身定制的育儿干预措施，可能会提高父母的自我效能感和参与度，从而使儿童在使用口语语言方面受益。
