Cross-Cultural Comparison of Parental Perspectives of Health-Related Quality of Life in Children with Cochlear Implants
Kumar, Roshini Ruth
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BACKGROUND: Assessing health-related quality of life (HRQoL) is a useful way to quantify benefits that cochlear implants (CI) provide children with hearing loss. Since children often are too young or lack communication skills to convey their HRQoL, parents serve as a reliable proxy. This study examines parent report of HRQoL (categorized in eight domains) and demographic variables in children with CI. Lastly, this study compares parent HRQoL ratings in the United States (US) to parent ratings in the Netherlands, Finland and the United Kingdom (UK). SUBJECTS: Parents of 33 children with CIs participated in the US component of this study. METHOD: An analysis of variance was used to measure differences among HRQoL domains. Correlations between HRQoL and demographic variables, and correlations among HRQoL domains were assessed using Spearman and point bi-serial correlations. Cross-cultural differences in HRQoL domain scores were computed using one sample t-tests. RESULTS: In this US sample, education and effects of CI domains were rated least positively. Cross-culturally, US parents rated HRQoL more positively than parents in the Netherlands, generally less positively than parents in Finland and aligned most closely with parents in the UK. DISCUSSION: Limited access to CI-related accommodations and varying parent expectations likely explain the differences in low ratings of education and effects of implantation in the US, as well as the differences seen cross-culturally. Providing useful CI accommodations at school and preparing parents for realistic outcomes could greatly benefit children with CI and their families.