The Factors Influencing Decision Making to Perform Cochlear Implantation and its Outcomes: A Cluster Analysis

Background: The present study aimed to determine the factors affecting the decision of hearing-impaired adults to perform cochlear implantation (CI) and the impact of each factor on the results of hearing quality, speech understanding, spatial hearing, and quality of life (QoL) after implantation. Methods: In this cross-sectional study, thirty-nine adults with CI completed the Speech, Spatial, and Hearing Quality Scale (SSQ), Quality of Life Standard (SF-12), and Tinnitus Handicap Index (THI) questionnaires. One-way ANOVA and two-step cluster analysis with Schwarz’s Bayesian information criterion as clustering criterion were used to analyze the data. Results: There was a significant difference between males and females in the total score of QoL, physical health, and age of hearing loss (HL) diagnosis, but not in the SSQ questionnaire. In the mental health of all participants, a significant difference was observed in two levels of THI. Age at implantation and income, age of HL diagnosis, duration of CI, degree of tinnitus, and level of education (literacy) play an important role in QoL, speech comprehension, spatial hearing, mental health, and SSQ, respectively. Some patients’ decisions for CI surgery consisted of tinnitus before implantation, age, sex, income, and QoL. Conclusion: Some demographic factors are effective in the process of a person’s decision to perform implantation. Besides other implant factors in adult CI candidacy, considering the person’s decision may lead to realistic expectations from the surgery and related results, which can be attended to in counseling before implantation.