{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T17:50:42Z","timestamp":1772560242207,"version":"3.50.1"},"reference-count":32,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Yunnan Applied Basic Research-Joint Special Project of Kunming Medical University","award":["202001AY070001-170"],"award-info":[{"award-number":["202001AY070001-170"]}]},{"name":"Digitalization, Development and Application of Biotic Resource","award":["202002AA100007"],"award-info":[{"award-number":["202002AA100007"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,12,3]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to examine factors that influence postoperative rehabilitation outcomes in children with cochlear implants, using a knowledge\u2013attitude\u2013practice (KAP) framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A total of 683 children with cochlear implants participated in this study. Hearing and speech assessments were conducted through face-to-face and\/or telephone interviews, while parents\u2019 or guardians\u2019 KAP were assessed following detailed instructions provided beforehand. Responses were recorded meticulously.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Data were collected through a convenience sampling method at a children\u2019s hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Out of 840 questionnaires distributed, 683 completed questionnaires were retained for analysis after excluding responses with missing data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Parents\u2019 average KAP score was 8.03 (SD = 3.13). Household income and education levels directly influenced KAP scores, while certain child characteristics were significantly associated with higher scores on the Infant\u2013Toddler Meaningful Auditory Integration Scale (IT-MAIS). Children who were outgoing (32.29 points), had used a cochlear implant for more than 3 years (32.78 points), and had surgery funded by state support (32.14 points) demonstrated higher MAIS scores. Factors such as personality, monthly family income, surgery funding and parents' beliefs significantly affected rehabilitation outcomes among children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Parental knowledge about deafness, trust in cochlear implant procedures and healthcare providers, and parental behaviours during the treatment and rehabilitation process have a direct impact on children\u2019s health outcomes. Enhancing parents\u2019 KAP levels is critical to improve rehabilitation outcomes for children with cochlear implants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-084278","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T12:05:26Z","timestamp":1736337926000},"page":"e084278","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Factors affecting the quality of postoperative rehabilitation in children with cochlear implants based on the theory of knowledge, attitude and practice"],"prefix":"10.1136","volume":"15","author":[{"given":"Ken","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, Yunnan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiyun","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Ethnology and Sociology, Yunnan University, Kunming, Yunnan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7487-3228","authenticated-orcid":false,"given":"Wenyue","family":"Chi","sequence":"additional","affiliation":[{"name":"Kunming Medical University, Kunming, Yunnan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, Yunnan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiuli","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, Yunnan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, Yunnan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuling","family":"Du","sequence":"additional","affiliation":[{"name":"Kunming Medical University, Kunming, Yunnan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, Yunnan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiesong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, Yunnan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,1,8]]},"reference":[{"key":"2025121410303452000_15.1.e084278.1","doi-asserted-by":"crossref","first-page":"e323","DOI":"10.1097\/MAO.0000000000003473","article-title":"Awareness, Perceptions, and Literacy Surrounding Hearing Loss and Hearing Rehabilitation Among the Adult Population in the United States","volume":"43","author":"Carlson","year":"2022","journal-title":"Otol Neurotol"},{"key":"2025121410303452000_15.1.e084278.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jagp.2019.07.010"},{"key":"2025121410303452000_15.1.e084278.3","doi-asserted-by":"crossref","unstructured":"Robillard KN , de Vrieze E , van Wijk E , et al . 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