Personalised digital hearing training in cochlear implant rehabilitation: exploring user profiles, engagement, and teleaudiology potential

OBJECTIVES: This exploratory mixed-methods study examined digital literacy, technology use, and motivation for digital hearing training among patients with cochlear implants (PwCI). The adaptive prototype application Training with Cochlear Implants (TraiCI) was evaluated with respect to usability, user experience, and engagement, focusing on its feasibility for teleaudiology-supported rehabilitation. METHODS: Twenty-two PwCI (mean age = 54 years, SD = 16) completed a four-week home-based training phase. Quantitative data were collected using standardised and study-specific questionnaires assessing digital literacy, usability, user experience, and quality of life. App-generated usage metrics (training time, task accuracy) and qualitative feedback from open-ended responses were analysed descriptively and inductively. RESULTS: Participants demonstrated high digital readiness and regular use of digital devices, particularly smartphones. A large majority of PwCI (86%) had prior experience with digital hearing training programmes (dHTP), but earlier tools were often described as repetitive or insufficiently adaptive. TraiCI was rated as intuitive and user-friendly, with high perspicuity and low stimulation scores in the User Experience Questionnaire. Participants valued the flexibility of home-based training but emphasised the need for adaptive feedback and greater task variety to sustain motivation. DISCUSSION: The high digital competence of PwCI supports the feasibility of autonomous, app-based rehabilitation. However, sustained engagement requires adaptive and contextually relevant content, highlighting the importance of user-centred design and clinician-supported monitoring. CONCLUSION: The feasibility of TraiCI supports the integration of adaptive, personalised digital tools into CI aftercare. Future digital rehabilitation strategies should prioritise adaptability, meaningful feedback, and teleaudiology compatibility to promote long-term engagement and clinical sustainability.