Understanding Public Perceptions Regarding Cochlear Implant Surgery in Adults.
Understanding Public Perceptions Regarding Cochlear Implant Surgery in Adults.
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了解公众对成人人工耳蜗植入手术的看法。
DOI：
10.1097/mao.0000000000003439
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Creighton,FrancisX
中科院分区：
文献类型：
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作者：
Zhang,Lisa;Ding,AndyS;Xie,DeborahX;Creighton,FrancisX
方法：参与者完成一项关于他们对人工耳蜗植入的看法的在线调查。他们被要求对CIQOL-10全球优先级和相应的轻微并发症（味觉变化、眩晕）和严重并发症（需要住院治疗的感染、脑膜炎、再植、面瘫和脑脊液[CSF]泄漏）的风险承受能力进行排名。结果：共纳入615例应答者（女性55%，平均年龄39岁[范围20-78]）。受访者认为保险问题（46%）和害怕接受手术（21%）是阻止符合条件的成年人接受CI的障碍。在手术风险方面，受访者明显低估了轻微并发症的发生率（p< 0.0001）和几乎所有主要并发症的发生率（均p< 0.0001），而高估了严重感染和需要再植的发生率（p< 0.005）。在嘈杂的环境中听到陌生人的能力被认为是CI的最高优先级（26%）。认识人工耳蜗植入者的人更愿意忍受所有轻微和严重并发症的发生率（均p< 0.05）。医护人员同样愿意忍受更高的脑膜炎、面瘫和脑脊液泄漏率，以达到最高的优先级（均p< 0.05）。结论：受访者认为保险覆盖范围和对手术的恐惧是美国成人CI使用率低的主要原因。然而，卫生保健工作者或那些认识人工耳蜗植入者的人显示出更高的风险承受力，以实现其最高的生活质量优先级，这表明人工耳蜗植入的益处在一般人群中可能被低估。
Methods:Participants completed an online survey regarding their perceptions about cochlear implantation. They were asked to rank CIQOL-10 Global priorities and corresponding risk tolerance for minor complications (changes in taste, vertigo) and major complications (infections requiring hospitalization, meningitis, reimplantation, facial paralysis, and cerebrospinal fluid [CSF] leak).Results:A total of 615 responses (female 55%, mean age 39 years [range 20–78]) were included. Respondents identified issues with insurance (46%) and fear of undergoing surgery (21%) as barriers preventing eligible adults from receiving CI. Regarding surgical risk, respondents significantly underestimated rates of minor complications (p< 0.0001) and almost all major complications (all p< 0.0001) while overestimating rates of serious infections and need for reimplantation (both p< 0.005). The ability to hear strangers in noisy environments was identified as the highest priority for CI (26%). Individuals who knew someone with a cochlear implantation were willing to tolerate higher rates of all minor and major complications (all p< 0.05). Healthcare workers were similarly willing to tolerate significantly higher rates of meningitis, facial paralysis, and CSF leak to achieve their highest priority (all p< 0.05).Conclusions:Respondents identify insurance coverage and fear of surgery as primary reasons for low utilization of adult CI in the United States. However, healthcare workers or those who knew someone with a cochlear implantation indicated significantly higher rates of risk tolerance to achieve their highest quality of life priorities, indicating the potential that the benefits of cochlear implantation are underappreciated in the general population.