Biomedical subjects
M Wexler
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Working through in the therapy of schizophrenia.
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Psychometric studies and clinical interviews with cochlear implant patients.
Selection of suitable candidates for an implant was a central issue in planning clinical trials. Psychological techniques were included, the purpose being to screen out individuals who, on an a priori basis, we considered cognitively and/or emotionally inappropriate. Psychological measures were further used to assess the effect of the implant on those candidates who did undergo the surgical procedure. The present paper describes the preimplant and postimplant interviews and psychometric assessment. Based on the data developed from the interviews, we concluded that the recipients of implants are in almost unanimous agreement that the implant is a very positive contribution to their lives. Tests of cognitive functioning conducted over time indicate that the implant does not impair cognitive or neuropsychological functions. Personality tests were also administered, and no significant changes in these dimensions were found.
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.