Psychometric properties of the Kannada version of the International Outcome Inventory for Hearing Aids (IOI-HA).

OBJECTIVE: This study aimed to validate the translated Kannada version of the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaire for hearing aid users. DESIGN: The original (English) and the translated versions of the IOI-HA questionnaire along with the Self-Assessment of Communication (SAC) were self-administered by hearing aid users. To examine test-retest reliability, 50% of the study participants completed the Kannada IOI-HA for a second time approximately 15 days later. The data analyses examined various psychometric properties using a predetermined quality criterion. STUDY SAMPLE: 105 Kannada-English bilingual adults using hearing aids. RESULTS: Factor analysis indicated a two-factor structure that explained a 61.8% variance in the IOI-HA. A Cronbach's alpha coefficient of 0.7 indicated acceptable internal consistency. Good test-retest reliability (Interclass Correlation Coefficient > 0.9) was obtained for both conditions (i.e. between the original English and translated Kannada versions and also between two different administrations of the Kannada IOI-HA questionnaire). Divergent validity test results were acceptable, and no ceiling or floor effects were noted. Convergent validity testing of the SAC, however, was poor with small correlation, although the direction of correlation (i.e. negative) was as expected. CONCLUSION: Results suggest acceptable psychometric properties of the Kannada version of the IOI-HA questionnaire.

Social Representation of "Hearing Loss" Among People with Hearing Loss: An Exploratory Cross-Cultural Study.

BACKGROUND: Hearing loss can have an effect on the physical, psychosocial, and cognitive wellbeing of an individual. Despite the research on attitudes and stigma associated with hearing loss, people with hearing loss (PHL) continue to delay seeking help. Thus, it is vital to look at alternative theories which have been successfully used in disability research to better understand how PHL perceive hearing loss. PURPOSE: The aim of the current exploratory study was to examine the social representation (SR) of "hearing loss" in PHL in India, Republic of Korea (ROK), United Kingdom (UK), and the United States (US). RESEARCH DESIGN: The study used a cross-sectional survey design. STUDY SAMPLE: In this study, 424 participants were recruited using a consecutive sampling method in four countries (India, Republic of Korea, United Kingdom, and United States). DATA COLLECTION AND ANALYSIS: Data collection was conducted using a questionnaire. Data were analyzed using content analysis, similarities analysis, prototypical analysis, and chi-square analysis. RESULTS: The free associations of the PHL were grouped into 37 categories. The most commonly reported categories were communication difficulties, negative mental state, aging, assessment and management, causes of hearing loss, hearing ability or disability, hearing instruments, and symptoms of hearing loss. Similarities analysis and prototypical analysis highlighted two main negative categories (negative mental state and communication difficulties) which form the central elements of SR of hearing loss. PHL associated hearing loss mainly as a negative phenomenon, but with some positive and neutral aspects. Respondents from ROK reported a greater number of neutral associations compared with other countries. There were cross-cultural similarities and differences in terms of PHL's SR of hearing loss, but there were more similarities than differences. CONCLUSION: The study provides an insight into how PHL collectively view their "hearing loss" and helps to develop our understanding of the influence of culture on the SR of "hearing loss." The results will aid the development of culturally appropriate public education campaigns, marketing material, and appropriate rehabilitation for PHL.

Assessment of the psychometric properties of the AQoL-4D questionnaire in Kannada language for use with adults with hearing loss.

OBJECTIVE: This study aimed to validate the translated (Kannada language) version of the Assessment of Quality of Life-4 Dimensions (AQoL-4D) questionnaire for use in Kannada speaking adults with hearing loss. DESIGN: The study involved a cross-sectional survey design. The original (English) and the translated versions of the AQoL-4D questionnaire along with two other questionnaires, that is, the Hearing Handicap Questionnaire and the Participation Scale were self-administered by the study participants. The Kannada AQoL-4D was filled in twice by roughly 50% of the study sample in two sessions that were 15 d apart. STUDY SAMPLE: In total, 103 Kannada-English biliterate adults with hearing loss participated in the study. RESULTS: Overall analysis involved testing the factor structure and various psychometric properties including the internal consistency, discriminant validity, convergent validity and possible floor/ceiling effects. The factor analysis indicated a four-factor structure, and the overall results showed acceptable psychometric properties of the scores of the full scale. However, poor internal consistency was obtained for three out of the four subscales extracted from the questionnaire. CONCLUSION: Based on the internal consistency of the subscales, we recommend using either the full scale or only the first subscale in Kannada speaking adults with hearing loss.

The Participation Scale: psychometric properties of a South Indian translation with hearing-impaired respondents.

AIMS: The Participation Scale (P-Scale) is a widely used generic self-report measure designed to assess an individual's participation restriction consequent to any disease condition. The present study aimed to evaluate the validity and reliability of a south Indian (Kannada language) version of the P-Scale for use with adults with hearing loss. This study is a part of an ongoing research program on the assessment of outcomes of hearing health rehabilitation with hearing aids involving Indian client groups. METHODS: One hundred and three adults with hearing loss completed the original English and the newly translated-adapted Kannada P-Scale questionnaire. Nearly half of the participants completed repeat testing of the Kannada version 15 days after the initial assessment. Along with the P-Scale, Kannada versions of the Hearing Handicap Questionnaire (HHQ) and the Assessment of Quality of Life - 4 Dimensions Questionnaire (AQoL-4D) were also administered. Based on predefined quality criteria, five different psychometric properties of the P-Scale were evaluated, together with an analysis of the Kannada P-Scale's factor structure. The psychometric properties assessed included internal consistency, test-retest reliability, convergent validity, discriminant validity, and floor-ceiling effects. RESULTS: Principal component analysis indicated a four-factor complex structure, which explained 69.78% of the variance in the Kannada P-Scale. High internal consistency (Cronbach's alpha = 0.90) and test-retest reliability (internal consistency coefficient >0.90) were obtained. Comparisons with the HHQ (ρ = 0.52) and AQoL-4 D (ρ = 0.76) indicated good convergent validity. Discriminant validity among the P-Scale questions was acceptable (inter-item correlation <0.60). Floor and ceiling effects were not evident in the Kannada P-Scale. CONCLUSIONS: The psychometric characteristics of the Kannada P-scale were found to be sufficient for use with the participant group (literate, Kannada-speaking adults with hearing loss) who were assessed in this study. Further research is required to determine generalizability of the Kannada P-Scale among other Kannada-speaking communities. Implications for Rehabilitation The Kannada version of the Participation Scale (P-Scale) can be validly used with Kannada speaking adults with hearing loss. The Kannada P-Scale can be used for clinical/research purposes to assess outcome (specifically, change in participation restriction) before, during, and after the hearing rehabilitation process. However, education and socioeconomic status may have an effect of the Kannada P-Scale results and these factors need to be further investigated prior to wider clinical use.

A good practice guide for translating and adapting hearing-related questionnaires for different languages and cultures.

OBJECTIVES: To raise awareness and propose a good practice guide for translating and adapting any hearing-related questionnaire to be used for comparisons across populations divided by language or culture, and to encourage investigators to publish detailed steps. DESIGN: From a synthesis of existing guidelines, we propose important considerations for getting started, followed by six early steps: (1) Preparation, (2, 3) Translation steps, (4) Committee Review, (5) Field testing and (6) Reviewing and finalising the translation. STUDY SAMPLE: Not applicable. RESULTS: Across these six steps, 22 different items are specified for creating a questionnaire that promotes equivalence to the original by accounting for any cultural differences. Published examples illustrate how these steps have been implemented and reported, with shared experiences from the authors, members of the International Collegium of Rehabilitative Audiology and TINnitus research NETwork. CONCLUSIONS: A checklist of the preferred reporting items is included to help researchers and clinicians make informed choices about conducting or omitting any items. We also recommend using the checklist to document these decisions in any resulting report or publication. Following this step-by-step guide would promote quality assurance in multinational trials and outcome evaluations but, to confirm functional equivalence, large-scale evaluation of psychometric properties should follow.

Psychometric properties of the hearing handicap questionnaire: a Kannada (South-Indian) translation.

OBJECTIVE: To assess the psychometric properties of the Hearing Handicap Questionnaire (HHQ) in Kannada (a South-Indian language) among adults with hearing loss. DESIGN: The study involved a cross-sectional survey design. Participants provided demographic details and completed the Kannada and English (original) version of the HHQ questionnaire. To evaluate test-retest reliability, ∼50% of the participants completed the Kannada version for the second time after 15 days. STUDY SAMPLE: The sample comprised 103 adults with hearing loss recruited from local audiology clinics. RESULTS: Exploratory factor analysis indicated a one-factor structure, which explained 71% of the variance in Kannada-HHQ scores. The internal consistency measured with Cronbach's alpha was 0.96. The test-retest reliability correlations of the Kannada version with the English and with the same Kannada version re-administered after 15 days were 0.96 and 0.91, respectively. Convergent validity of the scale was confirmed by significant correlations with the Participation Scale and the Assessment of Quality of Life scales. Discriminant validity was found to be low as all the Kannada-HHQ questions were highly correlated with each other (r> 0.60). No floor and ceiling effects were identified. CONCLUSIONS: The psychometric properties of the Kannada-HHQ scale are considered to be adequate for clinical or research use.

Translation and Adaptation of Five English Language Self-Report Health Measures to South Indian Kannada Language.

The objective of this study was to translate and adapt five English self-report health measures to a South Indian language Kannada. Currently, no systematically developed questionnaires assessing hearing rehabilitation outcomes are available for clinical or research use in Kannada. The questionnaires included for translation and adaptation were the hearing handicap questionnaire, the international outcome inventory - hearing aids, the self-assessment of communication, the participation scale, and the assessment of quality of life - 4 dimensions. The questionnaires were translated and adapted using the American Association of Orthopedic Surgeons (AAOS) guidelines. The five stages followed in the study included: i) forward translation; ii) common translation synthesis; iii) backward translation; iv) expert committee review; v) pre-final testing. In this paper, in addition to a description of the process, we also highlight practical issues faced while adopting the procedure with an aim to help readers better understand the intricacies involved in such processes. This can be helpful to researchers and clinicians who are keen to adapt standard self-report questionnaires from other languages to their native language.