Psychological effects of cochlear implant: patient and "index relative" perceptions.

The ultimate judge of the value of a technological advance is the patient. The patient's evaluation of the cochlear implant is one way of judging its effects. A second method is from observations of the patient made by an individual in close relationship, ie, an "index relative." In order to determine implant effects as experienced by both patient and observer, we devised preimplant and postimplant questionnaires. We found that patients feel the implant gives them a greater sense of safety; self-sufficiency is considerably enhanced: emotionally negative episodes are significantly reduced; the feeling of being a burden to others is diminished; communication with others is much smoother; and, while engaging in group activities is still difficult, participation is less threatening than before the implant. The index relatives agree with these perceptions. They also are emotionally relieved because they feel the patients have a device which extends their range of mastery. In turn, the index relatives feel burdened and responsible.