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成人人工耳蜗植入术后体验的影响因素:多利益相关者视角。

Factors Influencing Postoperative Experiences in Adult Cochlear Implant Recipients: A Multistakeholder Perspective.

机构信息

Telethon Kids Institute, Nedlands, Australia.

出版信息

Otol Neurotol. 2022 Sep 1;43(8):882-888. doi: 10.1097/MAO.0000000000003630.

Abstract

OBJECTIVE

To explore factors influencing postoperative experiences of adult cochlear implant (CI) recipients, determine the impact of each factor, and conceptualize recipients' postoperative journey.

STUDY DESIGN

Participatory mixed methods; concept mapping.

SETTING

Tertiary care (private and public).

PATIENTS

Ninety-three participated in the brainstorming activity. Eighty-nine completed the sorting tasks (96% retention rate): CI recipients (n = 44), significant others (n = 13), CI audiologists (n = 14) and surgeons (n = 5), CI clinics' administration staff (n = 5) and managers (n = 3), and CI manufactures' clinical support staff (n = 5).

INTERVENTIONS

Rehabilitative (CIs).

MAIN OUTCOME MEASURES

Statements were generated and rated by participants. Similarity of grouping of the statements informed the matrices used for cluster analysis to form concepts.

RESULTS

Eighty-seven unique statements described the factors influencing adapting to, use, and maintenance of CIs after implantation. These were grouped, and five concepts were identified: financial considerations, complications, device usability and durability, device programming and adaptation, and patient motivation and supports. Although statements within the concepts financial considerations and complications were negatively rated, statements within the concepts device programming and adaptation, and patient motivation and supports were mostly rated as having positive influence in patients' postoperative journey. The concept device usability and durability contained both negatively and positively rated statements.

CONCLUSIONS

Postoperative experience of adult CI recipients is a multifaceted journey with several challenges to address to improve services. Although support from and connection with family and clinicians, and simplicity of using a CI device facilitated the experience, medical and surgical complications, durability, and cost of maintaining the device challenged the postoperative experience.

摘要

目的

探讨影响成人耳蜗植入(CI)受者术后体验的因素,确定各因素的影响,并对受者术后的经历进行概念化。

研究设计

参与式混合方法;概念映射。

设置

三级护理(私人和公共)。

患者

93 名患者参加了头脑风暴活动。89 名患者完成了分类任务(保留率 96%):CI 受者(n=44)、重要他人(n=13)、CI 听力学家(n=14)和外科医生(n=5)、CI 诊所行政人员(n=5)和管理人员(n=3)以及 CI 制造商的临床支持人员(n=5)。

干预措施

康复(CI)。

主要观察指标

参与者生成并对陈述进行评分。分组的相似性为聚类分析所使用的矩阵提供了信息,以形成概念。

结果

87 条独特的陈述描述了影响植入后适应、使用和维护 CI 的因素。这些陈述被分组,确定了五个概念:财务考虑因素、并发症、设备可用性和耐用性、设备编程和适应、患者动机和支持。尽管概念财务考虑因素和并发症内的陈述被评为负面,但概念设备编程和适应以及患者动机和支持内的陈述大多被评为对患者术后经历有积极影响。概念设备可用性和耐用性包含了正面和负面评价的陈述。

结论

成人 CI 受者的术后体验是一个多方面的旅程,有几个挑战需要解决以改善服务。尽管来自家庭和临床医生的支持和联系以及使用 CI 设备的简单性促进了体验,但医疗和手术并发症、设备的耐用性和维护成本对术后体验提出了挑战。

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