Cross-Cultural Adaptation and Psychometric Evaluation of the Persian Version of Hearing Handicap Questionnaire for the Elderly

Background and Aim: Hearing handicap, as one of the common health problems among older people, affects life activities. The Hearing Handicap Questionnaire (HHQ) is one of the scales that provide criteria for social withdrawal, participation restriction, and emotional distress. The present study aims to translate the HHQ into Persian and determine its psychometric properties.Methods: After translation into Persian, the content validity of the questionnaire was determined based on the Lawashe's method. Then, the Persian HHQ (P-HHQ) and the Persian Hearing Handicap Inventory for Elderly-Screening version (P-HHIE-S) were completed by 110 hearing-impaired seniors (49 females) over 60 years. The concurrent validity was determined by Spearman correlation test, and the discriminant validity was analyzed by Kruskal-Wallis test and independent t-test. The test-retest reliability was assessed in 47 subjects after two weeks by Spearman correlation test and paired t-test.Results: The P-HHQ had high face validity. The mean total score of P-HHQ was 1.89 +/- 1.05. It had a significant positive correlation with the score of P-HHIE-S (r=0.87) and pure tone average of the better ear (r=0.72). There was a significant difference between three groups of elderly with different degrees of hearing impairment (p<0.001). Cronbach's alpha values were in the range of 0.94-0.97. There was a strong correlation between test and retest scores of P-HHQ (r=0.97) which indicates a high test-retest reliability.Conclusion: The P-HHQ has acceptable validity and reliability and can be used as a suitable instrument to evaluate hearing handicap of the elderly in research studies and clinical settings.