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Outcomes of cochlear implantation and implementation of the ICF model in adults with acquired sensorineural hearing loss​

Boek - Dissertatie

A Cochlear Implant (CI) is an electronic device that can partially restore hearing function in severely-to-profoundly hearing-impaired individuals. The first aim of this PhD was to gain insight in the evolution of cognition and Quality of Life (QoL) after cochlear implantation in older adults. The prospective, longitudinal study in Chapter 1 showed that the cognitive abilities and the speech perception in noise of older adult CI users with poor preoperative cognitive scores significantly improved 12 months after cochlear implantation. Therefore, cochlear implantation is generally not contraindicated in CI candidates with cognitive decline and should be considered after multidisciplinary evaluation. The systematic review in Chapter 2 indicated that a large variety of methods and instruments are used in current literature to measure QoL in older adult CI users, complicating comparisons between studies. The prospective, longitudinal, controlled study in Chapter 3 showed that the Health Utilities Index (HUI), a generic QoL questionnaire, is suitable to detect differences between normal-hearing controls and older CI users, but might underestimate QoL changes after cochlear implantation. The prospective, longitudinal, controlled study in Chapter 4 demonstrated that cochlear implantation has a significant positive effect on Type D personality traits (i.e. negative affectivity and social inhibition) in older adults. Overall, QoL assessment in CI users poses problems because no standardized protocol for CI outcome evaluation currently exists. The International Classification of Functioning Disability and Health (ICF) model could be the foundation of such a protocol, as it provides a theoretical framework and classification for the description of human functioning and disability using standard concepts and terminology. Hence, the second aim of this PhD dissertation was the development and implementation of an ICF-based protocol for CI outcome assessment. In Chapter 5, the ICF-based Work Rehabilitation Questionnaire (WORQ) was revised for CI users. This questionnaire was used to measure part of the CI outcomes in the sixth chapter of this PhD dissertation. The prospective, longitudinal study in Chapter 6 was the first to propose and implement a ready-to-use protocol for CI outcome assessment based on the ICF model. The protocol enables a comprehensive assessment of the most relevant CI outcomes in multiple domains, using a new standardized combination of known and widely used measurement tools in the field of cochlear implantation. The results can be interpreted by individuals with little or no knowledge of the outcome measures and their scores.
Aantal pagina's: 203
ISBN:978-94-6458-989-4
Jaar van publicatie:2023
Trefwoorden:Doctoral thesis
Toegankelijkheid:Open