Sociocultural Factors that Influence Decision-Making on Cochlear Implantation Among Adults

Cochlear implantation (CI) is a method of hearing correction, a medical operation that not only "restores" hearing, but also transforms the patient's identity. In recent decades, audiologists and physicians have perceived CI as a universal way to overcome deafness by children with hearing impairments. Often, these recommendations also apply to adults, although the risks of CI increase significantly with age. Adults with hearing impairments will decide on a CI operation, based not only on medical indications, but focusing on various social motives and factors. Nevertheless, CI did not often fall into the focus of attention of social scientists, especially in Russia. Based on the definition of disability as a social construct, the author of this work aims to describe the socio-cultural factors that determine the decision about CI. Conducting semi-structured interviews with experts and adults who underwent a CI operation at least 1 year ago and had a long experience of deafness before that made it possible to distinguish three groups of CI motives, which included: social, professional, and individual-personal. Stigma, being a manifestation of social perception of deafness, was indeed one of the reasons for the decision to have cochlear implantation, however, the operation performed does not become a panacea, and CI users still face both social and work stigma. Throughout the entire path from deafness to hearing acquisition, CI users are faced with various systemic problems, the key of which is the lack of a formed CI institute, which manifests itself in a low awareness of medical specialists and audiologists, the lack of unambiguous criteria for assessing the candidate's prospects, as well as a lack of support institutions at the adoption stage. solutions and subsequent rehabilitation. All these problems complicate the process of integrating the CI user into the hearing society.