{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T16:02:37Z","timestamp":1765987357586,"version":"3.48.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Objective:<\/jats:title>\n Cochlear implants (CIs) enable adults with hearing loss to regain access to sound. However, many CI users continue to face difficulties in everyday communication, potentially resulting in fewer social interactions. This study aimed to identify CI users\u2019 self-reported hearing difficulties in everyday listening environments.<\/jats:p>\n <\/jats:sec>\n \n Study Design:<\/jats:title>\n Cross-sectional survey-based study.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n Tertiary care academic medical center; surveys were completed during visit.<\/jats:p>\n <\/jats:sec>\n \n Patients:<\/jats:title>\n Thirty-seven postlingually deafened adult CI users and 19 age-matched adults with normal hearing (NH) participated.<\/jats:p>\n <\/jats:sec>\n \n Intervention(s):<\/jats:title>\n Participants completed the Personal Assessment of Communication Abilities survey, rating their communication difficulty in 12 everyday listening environments on a 5-point scale (1 = no difficulty, 5 = very much difficulty).<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measure(s):<\/jats:title>\n Self-reported communication difficulty levels in the 12 listening environments with comparisons between CI users and NH peers, and across different environments within each group.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n CI users reported significantly more difficulty than NH peers in all 12 environments (\n P<\/jats:italic>\n < 0.001). Listening context significantly affected difficulty ratings (\n P<\/jats:italic>\n = 0.003), with a significant group-by-environment interaction (\n P<\/jats:italic>\n = 0.006). CI users perceived large groups, concerts\/movie theaters, and restaurants\/caf\u00e9s most challenging, while one-to-one conversations, outdoors, and conversations in small groups were the least difficult. Outdoor settings and landline phone use showed the greatest differences between groups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Adult CI users face variable communication challenges in everyday environments. Identifying the everyday listening challenges of adult CI users will help shed light on real-world CI benefits and provide specific targets for rehabilitation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/ono.0000000000000081","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T16:00:19Z","timestamp":1765987219000},"page":"e081","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Real-world Speech Communication Experiences of Cochlear Implant Users"],"prefix":"10.1097","volume":"5","author":[{"given":"Bosung N.","family":"Titanji","sequence":"first","affiliation":[{"name":"Meharry Medical College, School of Medicine, Nashville, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron C.","family":"Moberly","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terrin N.","family":"Tamati","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2025,12]]},"reference":[{"key":"R2-20251217","doi-asserted-by":"crossref","first-page":"1936","DOI":"10.1111\/j.1532-5415.2012.04150.x","article-title":"Cochlear implant rehabilitation in older adults: literature review and proposal of a conceptual framework.","volume":"60","author":"Clark","year":"2012","journal-title":"J Am Geriatr Soc"},{"key":"R3-20251217","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1097\/AUD.0000000000000445","article-title":"Rehabilitation and psychosocial determinants of cochlear implant outcomes in older adults.","volume":"38","author":"Tang","year":"2017","journal-title":"Ear 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Try the TRACA: their reported assessment of communication abilities.","volume":"7","author":"Clutterbuck","year":"2015","journal-title":"Audiol Pract"},{"key":"R17-20251217","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v067.i01","article-title":"Fitting linear mixed-effects models using lme4.","volume":"67","author":"Bates","year":"2015","journal-title":"J Stat Softw"},{"key":"R18-20251217","doi-asserted-by":"crossref","first-page":"e0307044","DOI":"10.1371\/journal.pone.0307044","article-title":"A real-world evaluation of the clinical benefits of improved sound processor technology among Chinese cochlear implant users: a focus on Cochlear Nucleus 7.","volume":"19","author":"Deng","year":"2024","journal-title":"PLoS One"},{"key":"R19-20251217","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s10162-004-5024-3","article-title":"Noise susceptibility of cochlear implant users: the role of spectral resolution and smearing.","volume":"6","author":"Fu","year":"2005","journal-title":"J Assoc Res Otolaryngol"},{"key":"R20-20251217","doi-asserted-by":"crossref","first-page":"3019","DOI":"10.1044\/2017_JSLHR-H-17-0035","article-title":"Speech understanding in complex listening environments by listeners fit with cochlear implants.","volume":"60","author":"Dorman","year":"2017","journal-title":"J Speech Lang Hear Res"},{"key":"R21-20251217","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1097\/AUD.0000000000001488","article-title":"Listening-related fatigue in new and experienced adult cochlear implant users.","volume":"45","author":"Hornsby","year":"2024","journal-title":"Ear Hear"},{"key":"R22-20251217","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fneur.2023.1278508","article-title":"Listening effort and fatigue among cochlear implant users: a scoping review.","volume":"14","author":"Philips","year":"2023","journal-title":"Front Neurol"},{"key":"R23-20251217","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1097\/AUD.0000000000000991","article-title":"The influence of forced social isolation on the auditory ecology and psychosocial functions of listeners with cochlear implants during COVID-19 mitigation efforts.","volume":"42","author":"Dunn","year":"2021","journal-title":"Ear Hear"},{"key":"R24-20251217","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s12901-017-0043-y","article-title":"Correlation between subjective and objective hearing tests after unilateral and bilateral cochlear implantation.","volume":"17","author":"Ramakers","year":"2017","journal-title":"BMC Ear Nose Throat Disord"}],"container-title":["Otology & Neurotology Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/ONO.0000000000000081","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T16:00:22Z","timestamp":1765987222000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/ONO.0000000000000081"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":22,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.1097\/ono.0000000000000081","relation":{},"ISSN":["2766-3604"],"issn-type":[{"value":"2766-3604","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}