The relationship between changes in self-rated quality of life after cochlear implantation and changes in individual complaints

Objectives: To evaluate the changes in self-rated quality of life (QoL) obtained following cochlear implantation in relation to changes in the individual's complaints. Design: We have used repeated responses over a period of at least 4 years following implantation so as to examine within-subject relationships. Participants: Twenty-four consecutive post-lingually deafened patients who had been fitted with cochlear implants between 1991 and December 2000 at the University Hospital of Wales were investigated. Main outcome measures: The open-ended problems questionnaire was used to assess what hearing impaired people themselves considered to be the main problems arising from their hearing loss. The participants were asked to rate the severity of each one of these problems as well as QoL on '0' to '100' visual analogue scales. Both the individual problem ratings and the ratings of QoL were re-administered to the subjects at each follow-up session. Results: Changes in the rated QoL of all patients were significantly associated with changes in specific complaints, for example, the ability to communicate, feeling of isolation, telephone use, self-confidence, enjoyment of music and watching the TV. Multiple stepwise regression analysis showed that, after implantation, improvements in communication abilities, reduced psychological problems and improvements in abilities of daily life were the key determinants of QoL improvement for individual cochlear implant patients. These key predictors reached a plateau at about 1.5-3 years after cochlear implantation. Conclusions: The relationships between changes in specific complaints and the QoL in individual implantees were highlighted. We suggest that cochlear implant outcome measures should continue for at least 3 years after implantation.