Factors affecting the quality of postoperative rehabilitation in children with cochlear implants based on the theory of knowledge, attitude and practice

Objectives: This study aimed to examine factors that influence postoperative rehabilitation outcomes in children with cochlear implants, using a knowledge-attitude-practice (KAP) framework.

Design: A total of 683 children with cochlear implants participated in this study. Hearing and speech assessments were conducted through face-to-face and/or telephone interviews, while parents' or guardians' KAP were assessed following detailed instructions provided beforehand. Responses were recorded meticulously.

Setting: Data were collected through a convenience sampling method at a children's hospital.

Participants: Out of 840 questionnaires distributed, 683 completed questionnaires were retained for analysis after excluding responses with missing data.

Results: Parents' average KAP score was 8.03 (SD = 3.13). Household income and education levels directly influenced KAP scores, while certain child characteristics were significantly associated with higher scores on the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS). Children who were outgoing (32.29 points), had used a cochlear implant for more than 3 years (32.78 points), and had surgery funded by state support (32.14 points) demonstrated higher MAIS scores. Factors such as personality, monthly family income, surgery funding and parents' beliefs significantly affected rehabilitation outcomes among children.

Conclusion: Parental knowledge about deafness, trust in cochlear implant procedures and healthcare providers, and parental behaviours during the treatment and rehabilitation process have a direct impact on children's health outcomes. Enhancing parents' KAP levels is critical to improve rehabilitation outcomes for children with cochlear implants.