{"id":2484,"date":"2015-04-26T08:10:18","date_gmt":"2015-04-26T08:10:18","guid":{"rendered":"http:\/\/biomedpharmajournal.org\/?p=2484"},"modified":"2016-11-25T08:07:22","modified_gmt":"2016-11-25T08:07:22","slug":"a-comparison-between-the-mothers-of-cochlear-implanted-children-and-mothers-of-children-with-hearing-aid-in-the-level-of-depression-anxiety-and-stress","status":"publish","type":"post","link":"https:\/\/biomedpharmajournal.org\/staging\/vol5no2\/a-comparison-between-the-mothers-of-cochlear-implanted-children-and-mothers-of-children-with-hearing-aid-in-the-level-of-depression-anxiety-and-stress\/","title":{"rendered":"A Comparison Between the Mothers of Cochlear Implanted Children and Mothers of Children with Hearing Aid in the Level of Depression, Anxiety and Stress"},"content":{"rendered":"

Introduction<\/strong><\/p>\n

As it is known parenting stress has a negative impact on parent-child relation\u00a0and important child outcomes. Early childhood deafness presents unique\u00a0and long-term challenges for parents, including communication difficulties,\u00a0increased medical\/audio logical care and educational challenges(2).\u00a0Several studies have examined the rates of parenting stress among parents of\u00a0young deaf children. However, contradictory finding have emerged (3).\u00a0In one study in 1990, both general and context-specific measures of parenting stress\u00a0in 96 parents of young deaf children and 118 parents of aged and gender matched\u00a0hearing impaired children were done(4). Higher levels of stress\u00a0were found on both the general and context \u2013 specific measures. Parents in this\u00a0study reported higher levels of stress and these elevated levels of stress were\u00a0related to more symptoms of depression and anxiety.\u00a0Another study has compared the amount of stress among parents of deaf and\u00a0normal hearing children but no significant differences \u00a0is found(5).\u00a0According to this study, different \u00a0factors like parents’ educational level, child’s age\u00a0and early identification of childhood deafness may play an important role in\u00a0decrease stress among parents of deaf children. In spite of the fact that some of the\u00a0parents of hearing impaired children do not show symptoms of stress, anxiety and\u00a0depression (5), these problems are highly seen among others. So, this study is done\u00a0with the aim of assessing the level of stress, anxiety and depression in\u00a0mothers of cochlear implanted (C.I) children and deaf children who use hearing aids.<\/p>\n

Materials and Methods<\/strong><\/p>\n

The mothers of 45 patients who had received cochlear implant device and\u00a0rehabilitation at least 1 year before were compared with the mothers of 36 hearing\u00a0aided children. As matching groups in different aspects like parents’\u00a0education level, child’s age,\u2026was necessary, we were forced to select all of the\u00a0patients\u00a0 who had registered in our cochlear implant center and had the criteria\u00a0which are discussed below:<\/p>\n

1) child age between 5-8 years old<\/p>\n

2) Parents committed to educating their children<\/p>\n

3) No additional disability in both groups of children also, no other disable\u00a0child had to be seen in both family groups.<\/p>\n

In order to evaluate the parents of cochlear implanted and deaf children,\u00a0depression,\u00a0anxiety, stress scale(DASS-21) was used. The full scale of DASS consist of\u00a042 questions, but the shorter form has 21 questions. This test was fitted and performed\u00a0on parents of persian speaking cochlear implanted and hearing aid children. The\u00a0internal consistency or item total correlation was used to assess the reliability\u00a0of depression, anxiety and stress scale. Results showed significant reliability\u00a0in all 3 parameters. The internal consistency of the parameters were as follow:<\/p>\n

In stress scale, it was between 0.64 to 0.78. Also, in depression and anxiety\u00a0were 0.54 to 0.81 and 0.63 to 0.75 respectively. In addition, \u03b1 coefficient\u00a00.84 for stress,0.89 for depression and 0.8 for anxiety indicated a significant\u00a0validity of the scale.<\/p>\n

The depression scale includes items that measure symptoms typically\u00a0associated with dysphoria mood ( e.g., sadness, worthlessness). Anxiety\u00a0scale, includes items that are\u00a0primarily related to symptoms of physical arousal, panic attacks and fear.\u00a0e.g., trembling or faintness). Finally, stress scale includes items that measure)\u00a0symptoms such as tension, irritability and a tendency to over react to\u00a0stressful events(6,7).<\/p>\n

The tests were all done by the same experienced psychologist. After\u00a0gathering the data statistical analysis was done via multi variate analysis of\u00a0variances(MANOVA). Also, statistical analysis software spss version 16 was\u00a0used.<\/p>\n

Results<\/strong><\/p>\n

The table below, shows the amount of depression, anxiety, and stress that the<\/p>\n

mothers of cochlear implanted and hearing aid children experience.<\/p>\n

Table 1: <\/strong>Descriptive statistics<\/strong> of mothers of cochlear implanted and hearing aid childre<\/strong>n<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
Group<\/strong><\/td>\nDepression<\/strong><\/td>\nAnxiety<\/strong><\/td>\nStress<\/strong><\/td>\nAge (months)<\/strong><\/td>\n<\/tr>\n
Cochlear implant<\/strong><\/p>\n

Mean<\/td>\n

 <\/p>\n

11.15<\/td>\n

 <\/p>\n

10.71<\/td>\n

 <\/p>\n

19.42<\/td>\n

 <\/p>\n

50.17<\/td>\n<\/tr>\n

Number<\/td>\n45<\/td>\n45<\/td>\n45<\/td>\n45<\/td>\n<\/tr>\n
Std. deviation<\/td>\n10.86<\/td>\n9.43<\/td>\n1.12543 (E)<\/td>\n1.25323 E1<\/td>\n<\/tr>\n
Hearing aid<\/strong><\/p>\n

Mean<\/td>\n

 <\/p>\n

16.67<\/td>\n

 <\/p>\n

15.33<\/td>\n

 <\/p>\n

25.33<\/td>\n

 <\/p>\n

35.55<\/td>\n<\/tr>\n

Number<\/td>\n36<\/td>\n36<\/td>\n36<\/td>\n36<\/td>\n<\/tr>\n
Std. deviation<\/td>\n11.43<\/td>\n9.95<\/td>\n7.79<\/td>\n1.95<\/td>\n<\/tr>\n
Total<\/strong><\/p>\n

Mean<\/td>\n

13.60<\/td>\n12.76<\/td>\n22.04<\/td>\n43.67<\/td>\n<\/tr>\n
Number<\/td>\n81<\/td>\n81<\/td>\n81<\/td>\n81<\/td>\n<\/tr>\n
Std. deviation<\/td>\n11.39<\/td>\n9.88<\/td>\n1.02468 E1<\/td>\n1.75270 E1<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

As it was predicted, mothers of hearing aid children reported more stress, anxiety\u00a0and depression (p<0.01) than did mothers of cochlear implanted children. For\u00a0example, the mean score of depression in mothers of cochlear implanted\u00a0children was 11.15, whereas in mothers of hearing aid children was\u00a0approximately 5 \u00a0scores more .<\/p>\n

Table 2: Correlation matrix in depression, anxiety and stress<\/strong><\/p>\n\n\n\n\n\n\n
\u00a0<\/strong><\/td>\nDepression<\/strong><\/td>\nAnxiety<\/strong><\/td>\nStess<\/strong><\/td>\n<\/tr>\n
 <\/p>\n

 <\/p>\n

Depression<\/p>\n

 <\/p>\n

 <\/td>\n

1<\/td>\n<\/td>\n<\/td>\n<\/tr>\n
 <\/p>\n

 <\/p>\n

Anxiety<\/p>\n

 <\/p>\n

 <\/td>\n

0.71**<\/td>\n1<\/td>\n<\/td>\n<\/tr>\n
 <\/p>\n

 <\/p>\n

Stess<\/p>\n

 <\/p>\n

 <\/td>\n

0.69**<\/sup><\/td>\n0.69**<\/sup><\/td>\n <\/p>\n

 <\/p>\n

1<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Correlation is significant at 0.01 level (2. Tailed)<\/p>\n

correlation matrix is illustrated in the above table. According to high positive\u00a0correlation of 3 variates (correlation is significant at 0.01 level) MANOVA was\u00a0used to test the hypothesis.<\/p>\n

Table 3: The comparison between parents of hearing aid and cochlear implanted children<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n
Source<\/strong><\/td>\nDependent<\/strong><\/p>\n

variable<\/strong><\/td>\n

Type III<\/strong><\/p>\n

Sum of square<\/strong><\/td>\n

df<\/strong><\/td>\nMean square<\/strong><\/td>\nF<\/strong><\/td>\nSignificant<\/strong><\/td>\n<\/tr>\n
Corrected model<\/td>\nDepression<\/p>\n

Anxiety<\/p>\n

Stress<\/td>\n

607.44<\/p>\n

427.99<\/p>\n

698.28<\/td>\n

1<\/p>\n

1<\/p>\n

1<\/td>\n

607.44<\/p>\n

427.98<\/p>\n

698.28<\/td>\n

4.9<\/p>\n

4.5<\/p>\n

7.1<\/td>\n

.03<\/p>\n

.03<\/p>\n

.009<\/td>\n<\/tr>\n

Intercept<\/td>\nDepression<\/p>\n

Anxiety<\/p>\n

Stress<\/td>\n

1581.521<\/p>\n

1366.262<\/p>\n

4061.195<\/td>\n

1<\/p>\n

1<\/p>\n

1<\/td>\n

1548.152<\/p>\n

1356.626<\/p>\n

4006.119<\/td>\n

125.59<\/p>\n

145.18<\/p>\n

410.69<\/td>\n

.0001<\/p>\n

.0001<\/p>\n

.0001<\/td>\n<\/tr>\n

Group<\/td>\nDepression<\/p>\n

Anxiety<\/p>\n

Stress<\/td>\n

6074.47<\/p>\n

4272.99<\/p>\n

6988.25<\/td>\n

1<\/p>\n

1<\/p>\n

1<\/td>\n

607.44<\/p>\n

427.98<\/p>\n

698.28<\/td>\n

4.9<\/p>\n

4.5<\/p>\n

7.1<\/td>\n

.03<\/td>\n<\/tr>\n
Error<\/td>\nDepression<\/p>\n

Anxiety<\/p>\n

Stress<\/td>\n

9771.9<\/p>\n

7385.4<\/p>\n

7700.9<\/td>\n

79<\/p>\n

79<\/p>\n

79<\/td>\n

123.96<\/p>\n

93.4<\/p>\n

97.4<\/td>\n

<\/td>\n<\/td>\n<\/tr>\n
Total<\/td>\nDepression<\/p>\n

Anxiety<\/p>\n

Stress<\/td>\n

2532.000<\/p>\n

2702.000<\/p>\n

4780.000<\/td>\n

81<\/p>\n

81<\/p>\n

81<\/td>\n

<\/td>\n<\/td>\n<\/td>\n<\/tr>\n
Correctol<\/p>\n

Wodel<\/td>\n

Depression<\/p>\n

Anxiety<\/p>\n

Stress<\/td>\n

1039.358<\/p>\n

7812.5<\/p>\n

8399.8<\/td>\n

80<\/p>\n

80<\/p>\n

80<\/td>\n

<\/td>\n<\/td>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

This diagram \u00a0is concerned \u00a0with the comparison between mothers of Mcochlear implanted and hearing aid children in the level of depression,\u00a0anxiety and stress that they experience during the time. The data analysis\u00a0illustrated that mood disorder in mothers of hearing aid children was significantly\u00a0higher than the second group. Also, the descriptive table (table 1) indicated\u00a0that the level of depression, anxiety and stress in mothers of cochlear\u00a0implanted children was much less(0.01)<\/p>\n

Table 4: The effect of child’s age on parental stress, anxiety and depression<\/strong><\/p>\n\n\n\n\n\n\n
Predictor<\/strong><\/td>\nCriterion<\/strong><\/td>\nB<\/strong><\/td>\nb<\/strong><\/td>\nR<\/strong><\/td>\nR<\/strong><\/p>\n

Square<\/strong><\/td>\n

t<\/strong><\/td>\nP<\/strong><\/td>\n<\/tr>\n
Age<\/td>\nStress<\/td>\n-0.14<\/td>\n-0.24<\/td>\n0.24<\/td>\n0.05<\/td>\n-2.22<\/td>\n0.02<\/td>\n<\/tr>\n
Age<\/td>\nAnxiety<\/td>\n-0.04<\/td>\n-0.08<\/td>\n0.08<\/td>\n0.007<\/td>\n-0.74<\/td>\n0.45<\/td>\n<\/tr>\n
Age<\/td>\nDepression<\/td>\n-0.008<\/td>\n-0.01<\/td>\n0.01<\/td>\n0.0001<\/td>\n-0.11<\/td>\n0.91<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

In order to evaluate the effect of child’s age on parental stress, anxiety and\u00a0depression, 3 liner\u00a0regressions were done. According to p<0.05, a negative relation between\u00a0child’s age(predictor variate) and mothers’ stress(criterion variate) was seen.<\/p>\n

In other \u00a0word, the level of stress in mothers of older children was significantly\u00a0less than the mothers of younger children.\u00a0Although, child’s age was a negative predictor of parents’ stress\u00a0no significant relation between child’s age and parents’ anxiety or depression\u00a0was seen.\u00a0According to the above table, child’s age did not have any significant impact on\u00a0Mothers’ anxiety(p>0.05,p=0.45).\u00a0The same pattern is seen in child’s age and\u00a0Mother’s depression. According to p>0.05, p= 0.91, we came to a conclusion\u00a0that the child’s age did not predict \u00a0mothers’ depression too.<\/p>\n

Discussion<\/strong><\/p>\n

The present study focuses on a comparison between the psychological parameters\u00a0of the mothers of children with hearing aid and of children with cochlear implant.\u00a0Although mothers of both groups showed symptoms of depression, anxiety and\u00a0stress , these psychological parameters were highly seen among mothers of hearing\u00a0loss children, who did not have the chance of cochlear implantation\u00a0(p<0.001).<\/p>\n

The specific situation of the parents of hearing impaired children- especially their\u00a0psychological distress- has been investigated in a number of studies(8,9).\u00a0The results of most of them provide initial evidence of increased parental\u00a0psychological distress (8,9,10) .<\/p>\n

A comparison between mothers of hearing aid and cochlear implanted children\u00a0indicated that\u00a0the time of diagnosis of their child’s hearing impairment was a grave blow with\u00a0several psychological distress. Both parental groups showed gradual improvement of\u00a0the parent’s well being in the further course of their child’s treatment. A difference\u00a0between the parental groups was revealed between the time of first information up\u00a0to the first adjustment of the C.I\/ control of hearing aid. Here, the well being of the\u00a0parents of\u00a0the children with cochlear implant showed a more mark improvement upon first\u00a0information about\u00a0cochlear implant, but were subsequently clearly stressed by the cochlear implant\u00a0operation(2). In a study in\u00a02010, all normal hearing parents of deaf children were\u00a0examined when told of their children hearing loss. Results showed that\u00a0parents would encounter with this problem in different ways. For example , parents\u00a0in extremely low socioeconomic conditions spoke to their children less often . Also,\u00a0they used different communication styles. Clearly conditions of poverty affect how\u00a0parents communicate with their children(11).<\/p>\n

The results of a study which compared the psychological distress of parents of\u00a0hearing aid and cochlear implanted children\u00a0 showed that both groups of parents felt\u00a0distressed ,particularly at the time of diagnosis. However, after C.I fitting the parents\u00a0of cochlear implanted children showed heightened expectations by comparison with\u00a0the parents of hearing aid children(3).<\/p>\n

Conclusion<\/strong><\/p>\n

In summary, mothers of hearing aid children demonstrate high level of stress in\u00a0compare with mothers of cochlear implanted children. However, it will significantly be decreased after\u00a0some medical interventions, like cochlear implantation. So, diagnosis of deaf\u00a0children in lower\u00a0ages and doing C.I for them might be the best procedure which has a deep impact\u00a0on both parents and children. In addition, it is recommended to expand these kind of\u00a0studies to find stressed mothers of deaf children and help them with their child\u00a0problem.<\/p>\n

Acknowledgment<\/strong><\/p>\n

We thank parents who cooperated to do DASS test. No conflict of interests were\u00a0reported.<\/p>\n

References<\/strong><\/p>\n

    \n
  1. 1- Asberg KK,Vogell JJ,Bowers CA.Expeloring correlates and predictors of stress in parents of children who are deaf.j child and family study.2008;17:486-499.<\/li>\n
  2. Lederberg AR, Golbach T.Parenting stress and social support in hearing mothers\u00a0of deaf and hearing children. J.deaf study and deaf education.2002;7:330-345.<\/li>\n
  3. pahn CS, Richter B, Burger T, Lohle E,Wirsching M.A.Comparison between\u00a0parents of children with cochlear implants and parents of children with hearing aids\u00a0regarding parental distress and treatment expectations.J pediatric\u00a0otolaryngol.2003;67:949-955.<\/li>\n
  4. Quittner AL, Glueckauf RL, Jackson DN.Chronic parenting stress: moderating\u00a0versus mediating effects of social support. J personality and social\u00a0psychology.1990;59:1266-1278.<\/li>\n
  5. Meadow-Orlands KP.Stress, support and deafness:perception of infants’ mothers\u00a0and fathers.J early intervention.1994;18:91-102.<\/li>\n
  6. Imam SS. Depression,anxiety and stress scale(DASS):Revisited. The 4th\u00a0<\/sup>international postgraduateresearch colloquim. International Islamic university\u00a0Malaysia.2007.<\/li>\n
  7. Antony M, Bieling M, Cox PJ, Enns BJ.Psychometric properties of the 42-item and\u00a021-item versions of depression,anxiety , stress scale in clinical groups and a\u00a0community sample. Psychological assessment.1998;10:176-181.<\/li>\n
  8. Watson SM, Henggeler WH, Whelan JP. Family functioning and the social\u00a0adaptation of hearing impaired youths.J.abnorm.child psycho.1990;18(2):743-763.<\/li>\n
  9. Spahn C, Richter B, Zchocke L, Lohle E, Wirsching M. The need for\u00a0psychological\u00a0support in parents with cochlear implanted children.Int. J .pediatric\u00a0otorhinolaryngol.2001;25:45-53.<\/li>\n
  10. Quittner AL, Steak JT, Rouiller RL.Cochlear implants in children: a study of\u00a0parental stress and adjustment. Am.J.Otol.1991;12:95-104.<\/li>\n
  11. Nittrouer S.In: All about parents,early development of children with hearing\u00a0loss, plural publishing.2010:258-260.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Introduction As it is known parenting stress has a negative […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[15],"tags":[],"class_list":["post-2484","post","type-post","status-publish","format-standard","hentry","category-vol5no2"],"_links":{"self":[{"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/posts\/2484","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/comments?post=2484"}],"version-history":[{"count":6,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/posts\/2484\/revisions"}],"predecessor-version":[{"id":9885,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/posts\/2484\/revisions\/9885"}],"wp:attachment":[{"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/media?parent=2484"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/categories?post=2484"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/tags?post=2484"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}