Role of Communication Partners in Pre-Cochlear Implant Decision-Making: A Scoping Review

This scoping review examines the literature on the role of communication partners in pre-cochlear implant (CI) decision-making, with a focus on psychosocial influences, candidate motivations, expectations, and gaps in the current evidence base.

A systematic review of PubMed, CINAHL, Scopus, and Cochrane Library was conducted from inception through July 2025. Eligible studies included those examining the role of communication partners in pre-CI decision-making in adult CI candidates. Qualitative and quantitative designs were included.

From 4807 screened articles, 12 studies met the inclusion criteria, and 66% of the included studies were interviews or surveys. Across studies, both CI candidates and communication partners reported substantial psychosocial burden related to hearing loss, including loneliness, relationship strain, and safety concerns. Communication partners were frequently cited as motivators for pursuing implantation, with one study reporting 96% of candidates identifying partner support as a major influence. Candidates also drew on peer CI users and support networks for guidance. Expectations of improved communication and social engagement were consistently reported by candidates and partners.

Communication partners play a critical but underexplored role in pre-CI decision-making. While evidence suggests they provide important support and shape expectations, existing literature is heterogeneous and largely qualitative. Future research should develop CI-specific measures for communication partners to systematically evaluate expectations and assess strategies for incorporating partners into pre-operative counseling to optimize outcomes.