Psychosocial health of cochlear implant users compared to that of adults with and without hearing aids: Results of a nationwide cohort study

Objectives: This study aimed to examine the psychosocial health status of adult cochlear implant (CI) users, compared to that of hearing aid (HA) users, hearing-impaired adults without hearing aids and normally hearing adults. Design: Cross-sectional observational study, using both self-reported survey data and a speech-in-noise test. Setting: Data as collected within the Netherlands Longitudinal Study on Hearing (NL-SH) between September 2011 and June 2016 were used. Participants: Data from 1254 Dutch adults (aged 23-74), selected in a convenience sample design, were included for analyses. Mean outcome measures: Psychosocial health measures included emotional and social loneliness, anxiety, depression, distress and somatisation. Psychosocial health, hearing status, use of hearing technology and covariates were measured by self-report; hearing ability was assessed through an online digit triplet speech-in-noise test. Results: After adjusting for the degree of hearing impairment, HA users (N = 418) and hearing-impaired adults (N = 247) had significantly worse scores on emotional loneliness than CI users (N = 37). HA users had significantly higher anxiety scores than CI users in some analyses. Non-significant differences were found between normally hearing (N = 552) and CI users for all psychosocial outcomes. Conclusions: Psychosocial health of CI users is not worse than that of hearing-impaired adults with or without hearing aids. CI users’ level of emotional loneliness is even lower than that of their hearing-impaired peers using hearing aids. A possible explanation is that CI patients receive more professional and family support, and guidance along their patient journey than adults who are fitted with hearing aids.