Lehmann Effi Katharina, Heinze-Köhler Katharina, Glaubitz Cynthia, Liebscher Tim, Engler Max, Hoppe Ulrich
CICERO Cochlear Implant Center, ENT-clinic of the University of Erlangen-Nuremberg, Waldstr. 1, 91054, Erlangen, Germany.
Eur Arch Otorhinolaryngol. 2025 Feb;282(2):981-989. doi: 10.1007/s00405-024-08963-9. Epub 2024 Sep 19.
'Illness perceptions' refers to the thoughts and ideas a person has about an illness. According to Leventhal's Self-Regulatory Model (SRM), changing the threatening illness perceptions of cochlear implant (CI) recipients can be a further step in optimizing hearing outcomes with the CI. The aims of the present study were to assess users' illness perceptions and to determine whether perceptions change during six months of CI rehabilitation.
One hundred and thirty-eight participants completed the Brief Illness Perception Questionnaire (Brief IPQ), assessing their illness perceptions on nine scales. Data were collected at a German CI center at first CI fitting and six-month follow-up. After first fitting, participants underwent intensive rehabilitation including auditory training, medical, audiological and psychological treatments.
At both assessments, participants tended to view their hearing impairment as a severe threat. On the Brief IPQ, the 'consequences' assessment improved during CI rehabilitation, which can be explained by the CI-induced hearing improvement. However, 'understanding' and 'identity' assessments worsened. This could be because CI recipients only come to realize the full complexity of their hearing impairment during rehabilitation. The other scales and the total score remained unaffected.
Current practice in CI rehabilitation seems to be insufficient to improve threatening illness perceptions (except for perceived consequences). This may be because standard information often fails to reach the patients. The development and empirical validation of an intervention program to address individual illness perceptions in CI recipients could be helpful in this context. Further research will be needed to confirm the results.
“疾病认知”指的是一个人对某种疾病的想法和观念。根据莱文索尔的自我调节模型（SRM），改变人工耳蜗（CI）使用者对疾病的威胁性认知可能是进一步优化人工耳蜗听力效果的一个步骤。本研究的目的是评估使用者的疾病认知，并确定在人工耳蜗康复的六个月期间认知是否发生变化。
138名参与者完成了简易疾病认知问卷（Brief IPQ），该问卷从九个维度评估他们的疾病认知。数据在德国一家人工耳蜗中心首次安装人工耳蜗时以及六个月随访时收集。首次安装后，参与者接受了强化康复治疗，包括听觉训练、医学、听力学和心理治疗。
在两次评估中，参与者都倾向于将他们的听力障碍视为严重威胁。在简易疾病认知问卷中，“后果”评估在人工耳蜗康复期间有所改善，这可以通过人工耳蜗带来的听力改善来解释。然而，“理解”和“认同”评估变差。这可能是因为人工耳蜗使用者只有在康复过程中才开始意识到他们听力障碍的全部复杂性。其他维度和总分保持不变。
目前人工耳蜗康复的做法似乎不足以改善威胁性疾病认知（除了感知到的后果）。这可能是因为标准信息往往无法传达给患者。在这种情况下，开发并通过实证验证一个干预项目来解决人工耳蜗使用者的个体疾病认知可能会有所帮助。需要进一步的研究来证实这些结果。
