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基于知信行理论探讨影响儿童人工耳蜗植入术后康复质量的因素

Factors affecting the quality of postoperative rehabilitation in children with cochlear implants based on the theory of knowledge, attitude and practice.

作者信息

Lin Ken, Zhang Yiyun, Chi Wenyue, Li Xia, Ma Xiuli, Su Dong, Du Yuling, Ma Jing, Zhang Tiesong

机构信息

Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, Yunnan, China.

School of Ethnology and Sociology, Yunnan University, Kunming, Yunnan, China.

出版信息

BMJ Open. 2025 Jan 8;15(1):e084278. doi: 10.1136/bmjopen-2024-084278.

Abstract

OBJECTIVES

This study aimed to examine factors that influence postoperative rehabilitation outcomes in children with cochlear implants, using a knowledge-attitude-practice (KAP) framework.

DESIGN

A total of 683 children with cochlear implants participated in this study. Hearing and speech assessments were conducted through face-to-face and/or telephone interviews, while parents' or guardians' KAP were assessed following detailed instructions provided beforehand. Responses were recorded meticulously.

SETTING

Data were collected through a convenience sampling method at a children's hospital.

PARTICIPANTS

Out of 840 questionnaires distributed, 683 completed questionnaires were retained for analysis after excluding responses with missing data.

RESULTS

Parents' average KAP score was 8.03 (SD = 3.13). Household income and education levels directly influenced KAP scores, while certain child characteristics were significantly associated with higher scores on the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS). Children who were outgoing (32.29 points), had used a cochlear implant for more than 3 years (32.78 points), and had surgery funded by state support (32.14 points) demonstrated higher MAIS scores. Factors such as personality, monthly family income, surgery funding and parents' beliefs significantly affected rehabilitation outcomes among children.

CONCLUSION

Parental knowledge about deafness, trust in cochlear implant procedures and healthcare providers, and parental behaviours during the treatment and rehabilitation process have a direct impact on children's health outcomes. Enhancing parents' KAP levels is critical to improve rehabilitation outcomes for children with cochlear implants.

摘要

目的

本研究旨在使用知识-态度-实践(KAP)框架,探讨影响人工耳蜗植入儿童术后康复效果的因素。

设计

共有683名人工耳蜗植入儿童参与了本研究。通过面对面和/或电话访谈进行听力和言语评估,同时按照事先提供的详细说明评估家长或监护人的KAP。对回答进行了细致记录。

地点

通过便利抽样法在一家儿童医院收集数据。

参与者

在分发的840份问卷中,排除有缺失数据的回答后,保留了683份完整问卷用于分析。

结果

家长的KAP平均得分为8.03(标准差 = 3.13)。家庭收入和教育水平直接影响KAP得分,而某些儿童特征与婴幼儿有意义听觉整合量表(IT-MAIS)的较高得分显著相关。性格外向的儿童(32.29分)、使用人工耳蜗超过3年的儿童(32.78分)以及手术由国家资助的儿童(32.14分)的MAIS得分较高。性格、家庭月收入、手术资助和家长信念等因素对儿童的康复效果有显著影响。

结论

家长对耳聋的知识、对人工耳蜗植入程序和医疗服务提供者的信任,以及在治疗和康复过程中的家长行为,对儿童的健康结果有直接影响。提高家长的KAP水平对于改善人工耳蜗植入儿童的康复效果至关重要。

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