# Challenges in cochlear implant care for patients with migration backgrounds: Evaluating (Hr)QoL

## TL;DR

Cochlear implant patients with migration backgrounds report lower quality of life, possibly due to language barriers and limited healthcare access.

## Contribution

The study identifies language proficiency, not length of residence, as a key factor affecting health-related quality of life in cochlear implant patients with migration backgrounds.

## Key findings

- Patients with migration backgrounds had lower global and environmental quality of life scores.
- German language proficiency was strongly correlated with higher health-related quality of life scores.
- Length of residence did not significantly affect quality of life outcomes.

## Abstract

•QoL and HrQoL were lower in cochlear implant patients with migration background.•German language proficiency correlated with higher HrQoL scores, not with QoL scores.•Male patients with migration background showed lowest global and environmental QoL.•Length of residence showed no significant effect on QoL or HrQoL outcomes.•Addressing language and cultural barriers may improve rehabilitation and healthcare use.

QoL and HrQoL were lower in cochlear implant patients with migration background.

German language proficiency correlated with higher HrQoL scores, not with QoL scores.

Male patients with migration background showed lowest global and environmental QoL.

Length of residence showed no significant effect on QoL or HrQoL outcomes.

Addressing language and cultural barriers may improve rehabilitation and healthcare use.

This study aims to assess and compare the quality of life (QoL) and health-related quality of life (HrQoL) of patients with cochlear implants (PwCI) and with or without a migration background (MB). It examines whether language proficiency and length of residence influence QoL and HrQoL outcomes in PwCI with a MB.

Data from n = 82 PwCI were collected. QoL and HrQoL were measured using WHOQOL-BREF and Nijmegen Cochlear Implant Questionnaire (NCIQ), while CEFR assessed language proficiency.

PwCI with a MB had significantly lower WHOQOL-BREF global scores (Mdn = 62.50 / IQR = 25.00) than PmCI without a MB (Mdn = 75.00 / IQR = 25.00; U = 548.000, Z = -2.779, p = .005, r = 0.309). Similarly, NCIQ total scores were lower in PwCI with a MB (Mdn = 59.34, IQR = 21.53) than in controls (Mdn = 64.17, IQR = 19.98; U = 623.000, Z = –2.017, p = .044, r = 0.222). The language proficiency of PwCI with a MB in their second language, German, showed no correlation with the global score of the WHOQOL-BREF (Spearman's ρ = 0.240, p = .130). The language proficiency in German as a second language of PwCI with a MB shows a strong correlation with the total score on the NCIQ (Spearman's ρ = 0.428, p = .005), while length of residence showed no significant correlations.

PwCI with a MB tended to have lower QoL and HrQoL, potentially due to factors such as language barriers, and limited healthcare access. Language proficiency appeared to play a role, while length of residence showed no clear effect. Addressing linguistic and cultural barriers, could help improve healthcare access. Enhancing communication and support may facilitate greater participation in rehabilitation and treatment adherence, potentially leading to better QoL and more efficient use of healthcare resources.