Cochlear implant aesthetics and its impact on stigma, social interaction and quality of life: a mixed-methods study protocol

Abstract

IntroductionAwareness of the benefits of cochlear implants is low, and barriers such as fear of surgery and ongoing rehabilitation have been noted. Perceived stigma associated with hearing loss also plays a key role, with many adults not wanting to appear old or be identified as a person with a disability. In effect, a cochlear implant makes deafness visible. New technologies have led to a smaller external profile for some types of cochlear implants, but qualitative assessments of benefit have not been explored. This study will examine cochlear implant aesthetics and cosmetics, and its impact on perceived stigma, social interactions, communication and quality of life. A particular focus will be the examination of totally implantable device concepts. A secondary aim is to understand what research techniques are best suited and most appealing for cochlear implant recipients, to assist in future study design and data collection methods.Methods and analysisThis study utilises a mixed-methods design. Three datasets will be collected from each participant with an expected sample size of 10–15 participants to allow for data saturation of themes elicited. Each participant will complete a demographic questionnaire, a quickfire survey (a short concise questionnaire on a topic of research familiarity and preference) and a semi-structured interview. Questionnaire and quickfire survey data will be analysed using descriptive statistics. Interviews will be transcribed and analysed thematically. All participants will be adults with more than 1 year of experience using cochlear implants.Ethics and disseminationThis study has been granted ethical approval from Macquarie University (HREC: 520211056232432) and meets the requirements set out in the National Statement on Ethical Conduct in Human Research. Study findings will be disseminated widely through international peer-reviewed journal articles, public and academic presentations, plain language summaries for participants and an executive summary for the project funder. This work was supported by Cochlear Limited (Cochlear Ltd). The funder will have no role in conducting or reporting on the study.

The (in)visibility of deafness: Identity, stigma, quality of life and the potential role of totally implantable cochlear implants

“…31 Thematic analysis was conducted with the support of a groupworking technique in which ideas were shared inductively, as analysis progressed and discussed through fortnightly group working sessions, to ensure consensus opinion on key issues arising, thematic patterns, and incongruities. 27,29,32 Three qualitative expert analysts (C. Y. L., R. C.-W., F. R.) contributed, and their prior experience ensured this collaborative approach and process was robust and rigorous. Multiple discussions worked towards a final thematic framework.…”

“…The protocol article for this study estimated between 10 and 15 participants would be required to reach data saturation. 29 A total of 12 participants (7 women, 5 men) were recruited and all of them had completed tertiary‐level education (certificate/diploma or higher), with the majority being employed, and living in a major Australian city. Eight participants were postlingually deafened, and four participants were bilingual English/Auslan (Australian Sign Language) users.…”

“…Participants completed (1) a demographic questionnaire and (2) individual semistructured interviews. See the published open‐access protocol article for additional detail 29 …”

“…The participant recruitment strategy resulted in participants with a broad range of characteristics across age, gender, bilingual Auslan use, employment status, and pre‐/postlingual implantation. The protocol article for this study estimated between 10 and 15 participants would be required to reach data saturation 29 . A total of 12 participants (7 women, 5 men) were recruited and all of them had completed tertiary‐level education (certificate/diploma or higher), with the majority being employed, and living in a major Australian city.…”

The remaining obstacles for a totally implantable cochlear implant

“…In spite of this, CIs remain underutilized, with less than 10% of potential adult candidates being implanted in the United States and other developed countries [2]. One factor that may contribute to this underutilization is the 'stigma symbol' associated with wearing the external components [3,4], for while CIs have been progressively miniaturized, they still remain semiimplantable devices. An early objective among researchers in the field of hearing rehabilitation has been to provide 'invisible hearing'.…”