Deciding to Have a Cochlear Implant and Subsequent After-care: Parental Perspectives

Cochlear implantation provides a means of hearing to profoundly deaf children. As it is an elective procedure, parents must make the decision to proceed with this option if their child is suitable. The processes involved are complex and stressful, involving hope and expectation on the one hand, and doubts and caution on the other. This study explored parental perspectives on the process of implantation via an established questionnaire completed by parents three years after implantation. The parents of 101 consecutively implanted children completed the questionnaire: Children with cochlear implants: parental perspectives. Average age of implantation was 4.7 years (range 1.3-12.4 years), with 86% congenitally deaf and 14% acquired deafness. Parents responded to 74 statements on a Likert scale; the responses exploring the experience of the process of implantation, including decision making, were analysed for this paper. The study revealed a substantial consensus on parents' expectations, but there was also interesting diversity. Parents generally agreed that there was a need for regular checking and tuning of the device, that only experienced teams should carry out implantation and that reliability was a major factor in device choice. Need for as much information as possible prior to implantation and for long-term support with annual visits from the implant team on a regular basis was endorsed. Parents also valued their own role: a positive attitude was considered vital. Areas of diversity included how stressful the decision making and the process were considered. Parents' needs may also differ from the traditional implant team view; in this study, while the main goal was spoken language, sign language was also valued.In times of increasing accountability and demands on healthcare services, how the varied needs of families can be met in the long term to maximise successful implant use remains a major challenge. Copyright (C) 2006 John Wiley & Sons, Ltd.