Evaluation of barriers and drivers to an efficient cochlear implant service delivery to adults: uptake, utilisation, and maintaining a cochlear implant

Azadeh Ebrahimi Madiseh, Marcus Atlas, Robert Eikelboom, Peter Friedland, Wai Kong Lai, Colleen Psarros, DeWet Swanepoel

Research output: Contribution to conferenceConference presentation/ephemera

Abstract

Objectives- To explore factors influencing uptake of cochlear implants in adults and to conceptualise the journey of clients with cochlear implants.
Design- A mixed participatory method, Concept Mapping, was employed to integrate input from multiple sources each with their own experience and expertise. There were two main groups of participants: a client group (CI recipients, candidates and family members), and a professional group (CI audiologists, surgeons, administration staff and managers, manufacturer representatives). A total of 93 people participated in the study: client group (n=60, M age=66.6y), professional group (n=33, M age=45.24y). Participants brainstormed statements in response to the question “What influences people’s decision to get/not get a cochlear implant?” They subsequently grouped the statements, named each group and rated them for their impact (from a barrier to a driver), and the need to change or improve (no need to high need for change/ improvement) using a five-point Likert scale. Multidimentional scaling was used to produce visual representation of the ideas in form of clusters. Data were further analysed using ANOVA to determine the differences between the cohorts and clusters.
Results- 110 unique statements were generated and grouped into six concepts: External influences (Awareness and attitude of non-implant professionals (GP, hearing aid audiologists, general ENTs) on uptake; Logistics (Cost, appointments, travel); Influence of social media), Uncertainties, belief and fears (Fears; risks; negative effect of word of mouth; unsuccessful previous ear surgery; cosmetics of the device; misunderstanding of how a CI functions; eligibility and outcome), Health problems (Mental and physical health), Hearing difficulties (Social, emotional and communication impact of hearing loss; severity of hearing loss; benefit from and experience with hearing aids), Implant professionals (Implant team attitude, knowledge and relationship with patients; quality of overall service), and Goals and support (Hearing desires and goals; motivation; positive impact of word of mouth; family support; having a CI mentor). Two overarching domains of the six concepts were identified: the Patient-driven domain, which included four concepts and 71 statements, and External domain comprising two concepts. The mean rating of concepts ranged between 2.24 (External influences was the main barrier) to 4.45 (Goals and support was the main driver).
Conclusion- This study increases our understanding of factors influencing decision making to choose or decline a CI as a hearing treatment option. The magnitude of the generated statements in the patient-driven domain highlights the pivotal role of individualised care in clinical settings and understanding clients’ needs and expectations. While clients’ persistent hearing difficulties, goals and support network were identified as drivers in a client’s journey to uptake a cochlear implant, the identified barriers highlight the need for a collaborative multi- and inter-disciplinary approach that could involve (i) raising awareness of and education amongst non-implant hearing professionals, (ii) developing simple, evidence-based and user friendly tools to identify potential candidates and effective communication, and (iii) educating and empowering the patients and raising awareness amongst them regarding CI.
Cochlear implant, uptake, adoption, Concept Mapping, barrier, driver, service delivery.
Original languageEnglish
Publication statusUnpublished - 27 Jun 2018
Event15th International Conference on Cochlear implants and and other implantable auditory technology - Flanders Meeting & Convention Center, Antwerp, Belgium
Duration: 27 Jun 201830 Jun 2018

Conference

Conference15th International Conference on Cochlear implants and and other implantable auditory technology
Abbreviated titleCI2018
CountryBelgium
CityAntwerp
Period27/06/1830/06/18

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Cochlear Implants
Hearing
Hearing Aids
Hearing Loss
Fear
Communication
Social Media
Mentors
Cosmetics
Uncertainty
Ear
Motivation
Decision Making
Analysis of Variance
Appointments and Schedules
Mental Health
Education
Costs and Cost Analysis
Equipment and Supplies
Health

Cite this

Ebrahimi Madiseh, A., Atlas, M., Eikelboom, R., Friedland, P., Lai, W. K., Psarros, C., & Swanepoel, D. (2018). Evaluation of barriers and drivers to an efficient cochlear implant service delivery to adults: uptake, utilisation, and maintaining a cochlear implant. Paper presented at 15th International Conference on Cochlear implants and and other implantable auditory technology , Antwerp, Belgium.
Ebrahimi Madiseh, Azadeh ; Atlas, Marcus ; Eikelboom, Robert ; Friedland, Peter ; Lai, Wai Kong ; Psarros, Colleen ; Swanepoel, DeWet. / Evaluation of barriers and drivers to an efficient cochlear implant service delivery to adults: uptake, utilisation, and maintaining a cochlear implant. Paper presented at 15th International Conference on Cochlear implants and and other implantable auditory technology , Antwerp, Belgium.
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abstract = "Objectives- To explore factors influencing uptake of cochlear implants in adults and to conceptualise the journey of clients with cochlear implants.Design- A mixed participatory method, Concept Mapping, was employed to integrate input from multiple sources each with their own experience and expertise. There were two main groups of participants: a client group (CI recipients, candidates and family members), and a professional group (CI audiologists, surgeons, administration staff and managers, manufacturer representatives). A total of 93 people participated in the study: client group (n=60, M age=66.6y), professional group (n=33, M age=45.24y). Participants brainstormed statements in response to the question “What influences people’s decision to get/not get a cochlear implant?” They subsequently grouped the statements, named each group and rated them for their impact (from a barrier to a driver), and the need to change or improve (no need to high need for change/ improvement) using a five-point Likert scale. Multidimentional scaling was used to produce visual representation of the ideas in form of clusters. Data were further analysed using ANOVA to determine the differences between the cohorts and clusters. Results- 110 unique statements were generated and grouped into six concepts: External influences (Awareness and attitude of non-implant professionals (GP, hearing aid audiologists, general ENTs) on uptake; Logistics (Cost, appointments, travel); Influence of social media), Uncertainties, belief and fears (Fears; risks; negative effect of word of mouth; unsuccessful previous ear surgery; cosmetics of the device; misunderstanding of how a CI functions; eligibility and outcome), Health problems (Mental and physical health), Hearing difficulties (Social, emotional and communication impact of hearing loss; severity of hearing loss; benefit from and experience with hearing aids), Implant professionals (Implant team attitude, knowledge and relationship with patients; quality of overall service), and Goals and support (Hearing desires and goals; motivation; positive impact of word of mouth; family support; having a CI mentor). Two overarching domains of the six concepts were identified: the Patient-driven domain, which included four concepts and 71 statements, and External domain comprising two concepts. The mean rating of concepts ranged between 2.24 (External influences was the main barrier) to 4.45 (Goals and support was the main driver). Conclusion- This study increases our understanding of factors influencing decision making to choose or decline a CI as a hearing treatment option. The magnitude of the generated statements in the patient-driven domain highlights the pivotal role of individualised care in clinical settings and understanding clients’ needs and expectations. While clients’ persistent hearing difficulties, goals and support network were identified as drivers in a client’s journey to uptake a cochlear implant, the identified barriers highlight the need for a collaborative multi- and inter-disciplinary approach that could involve (i) raising awareness of and education amongst non-implant hearing professionals, (ii) developing simple, evidence-based and user friendly tools to identify potential candidates and effective communication, and (iii) educating and empowering the patients and raising awareness amongst them regarding CI.Cochlear implant, uptake, adoption, Concept Mapping, barrier, driver, service delivery.",
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Ebrahimi Madiseh, A, Atlas, M, Eikelboom, R, Friedland, P, Lai, WK, Psarros, C & Swanepoel, D 2018, 'Evaluation of barriers and drivers to an efficient cochlear implant service delivery to adults: uptake, utilisation, and maintaining a cochlear implant' Paper presented at 15th International Conference on Cochlear implants and and other implantable auditory technology , Antwerp, Belgium, 27/06/18 - 30/06/18, .

Evaluation of barriers and drivers to an efficient cochlear implant service delivery to adults: uptake, utilisation, and maintaining a cochlear implant. / Ebrahimi Madiseh, Azadeh; Atlas, Marcus; Eikelboom, Robert; Friedland, Peter; Lai, Wai Kong; Psarros, Colleen; Swanepoel, DeWet.

2018. Paper presented at 15th International Conference on Cochlear implants and and other implantable auditory technology , Antwerp, Belgium.

Research output: Contribution to conferenceConference presentation/ephemera

TY - CONF

T1 - Evaluation of barriers and drivers to an efficient cochlear implant service delivery to adults: uptake, utilisation, and maintaining a cochlear implant

AU - Ebrahimi Madiseh, Azadeh

AU - Atlas, Marcus

AU - Eikelboom, Robert

AU - Friedland, Peter

AU - Lai, Wai Kong

AU - Psarros, Colleen

AU - Swanepoel, DeWet

PY - 2018/6/27

Y1 - 2018/6/27

N2 - Objectives- To explore factors influencing uptake of cochlear implants in adults and to conceptualise the journey of clients with cochlear implants.Design- A mixed participatory method, Concept Mapping, was employed to integrate input from multiple sources each with their own experience and expertise. There were two main groups of participants: a client group (CI recipients, candidates and family members), and a professional group (CI audiologists, surgeons, administration staff and managers, manufacturer representatives). A total of 93 people participated in the study: client group (n=60, M age=66.6y), professional group (n=33, M age=45.24y). Participants brainstormed statements in response to the question “What influences people’s decision to get/not get a cochlear implant?” They subsequently grouped the statements, named each group and rated them for their impact (from a barrier to a driver), and the need to change or improve (no need to high need for change/ improvement) using a five-point Likert scale. Multidimentional scaling was used to produce visual representation of the ideas in form of clusters. Data were further analysed using ANOVA to determine the differences between the cohorts and clusters. Results- 110 unique statements were generated and grouped into six concepts: External influences (Awareness and attitude of non-implant professionals (GP, hearing aid audiologists, general ENTs) on uptake; Logistics (Cost, appointments, travel); Influence of social media), Uncertainties, belief and fears (Fears; risks; negative effect of word of mouth; unsuccessful previous ear surgery; cosmetics of the device; misunderstanding of how a CI functions; eligibility and outcome), Health problems (Mental and physical health), Hearing difficulties (Social, emotional and communication impact of hearing loss; severity of hearing loss; benefit from and experience with hearing aids), Implant professionals (Implant team attitude, knowledge and relationship with patients; quality of overall service), and Goals and support (Hearing desires and goals; motivation; positive impact of word of mouth; family support; having a CI mentor). Two overarching domains of the six concepts were identified: the Patient-driven domain, which included four concepts and 71 statements, and External domain comprising two concepts. The mean rating of concepts ranged between 2.24 (External influences was the main barrier) to 4.45 (Goals and support was the main driver). Conclusion- This study increases our understanding of factors influencing decision making to choose or decline a CI as a hearing treatment option. The magnitude of the generated statements in the patient-driven domain highlights the pivotal role of individualised care in clinical settings and understanding clients’ needs and expectations. While clients’ persistent hearing difficulties, goals and support network were identified as drivers in a client’s journey to uptake a cochlear implant, the identified barriers highlight the need for a collaborative multi- and inter-disciplinary approach that could involve (i) raising awareness of and education amongst non-implant hearing professionals, (ii) developing simple, evidence-based and user friendly tools to identify potential candidates and effective communication, and (iii) educating and empowering the patients and raising awareness amongst them regarding CI.Cochlear implant, uptake, adoption, Concept Mapping, barrier, driver, service delivery.

AB - Objectives- To explore factors influencing uptake of cochlear implants in adults and to conceptualise the journey of clients with cochlear implants.Design- A mixed participatory method, Concept Mapping, was employed to integrate input from multiple sources each with their own experience and expertise. There were two main groups of participants: a client group (CI recipients, candidates and family members), and a professional group (CI audiologists, surgeons, administration staff and managers, manufacturer representatives). A total of 93 people participated in the study: client group (n=60, M age=66.6y), professional group (n=33, M age=45.24y). Participants brainstormed statements in response to the question “What influences people’s decision to get/not get a cochlear implant?” They subsequently grouped the statements, named each group and rated them for their impact (from a barrier to a driver), and the need to change or improve (no need to high need for change/ improvement) using a five-point Likert scale. Multidimentional scaling was used to produce visual representation of the ideas in form of clusters. Data were further analysed using ANOVA to determine the differences between the cohorts and clusters. Results- 110 unique statements were generated and grouped into six concepts: External influences (Awareness and attitude of non-implant professionals (GP, hearing aid audiologists, general ENTs) on uptake; Logistics (Cost, appointments, travel); Influence of social media), Uncertainties, belief and fears (Fears; risks; negative effect of word of mouth; unsuccessful previous ear surgery; cosmetics of the device; misunderstanding of how a CI functions; eligibility and outcome), Health problems (Mental and physical health), Hearing difficulties (Social, emotional and communication impact of hearing loss; severity of hearing loss; benefit from and experience with hearing aids), Implant professionals (Implant team attitude, knowledge and relationship with patients; quality of overall service), and Goals and support (Hearing desires and goals; motivation; positive impact of word of mouth; family support; having a CI mentor). Two overarching domains of the six concepts were identified: the Patient-driven domain, which included four concepts and 71 statements, and External domain comprising two concepts. The mean rating of concepts ranged between 2.24 (External influences was the main barrier) to 4.45 (Goals and support was the main driver). Conclusion- This study increases our understanding of factors influencing decision making to choose or decline a CI as a hearing treatment option. The magnitude of the generated statements in the patient-driven domain highlights the pivotal role of individualised care in clinical settings and understanding clients’ needs and expectations. While clients’ persistent hearing difficulties, goals and support network were identified as drivers in a client’s journey to uptake a cochlear implant, the identified barriers highlight the need for a collaborative multi- and inter-disciplinary approach that could involve (i) raising awareness of and education amongst non-implant hearing professionals, (ii) developing simple, evidence-based and user friendly tools to identify potential candidates and effective communication, and (iii) educating and empowering the patients and raising awareness amongst them regarding CI.Cochlear implant, uptake, adoption, Concept Mapping, barrier, driver, service delivery.

KW - Cochlear implant

KW - Concept mapping

KW - Uptake

KW - Adoption

KW - Service delivery

KW - Driver

KW - Barrier

M3 - Conference presentation/ephemera

ER -

Ebrahimi Madiseh A, Atlas M, Eikelboom R, Friedland P, Lai WK, Psarros C et al. Evaluation of barriers and drivers to an efficient cochlear implant service delivery to adults: uptake, utilisation, and maintaining a cochlear implant. 2018. Paper presented at 15th International Conference on Cochlear implants and and other implantable auditory technology , Antwerp, Belgium.