Barbara E. Weinstein

The Hearing Handicap Inventory for the Elderly: a New Tool

This report describes the development and standardization of the Hearing Handicap Inventory for the Elderly (HHIE). This self-assessment tool is designed to assess the effects of hearing impairment on the emotional and social adjustment of elderly people. The inventory is comprised of two subscales: a 13-item subscale explores the emotional consequences of hearing impairment; a 12-item subscale explores both social and situational effects. The inventory was administered to 100 elderly subjects (mean age = 75 years) with hearing threshold levels in the better ear ranging from normal to severe. The reliability of the HHIE was evaluated by assessing its internal consistency through the computation of Chronbachs alpha. Alpha values ranged from 0.88 (social/situational subscale) to 0.95 for the entire inventory. Split-half reliabilities were equally high. The validity of the HHIE was not directly evaluated. Certain aspects of the data, however, support the construct validity of the instrument, while analysis of the questions themselves appears to attest to its content validity. Possible uses of the inventory were described and suggestions were made regarding future research on the instrument. The reliability and validity of the HHIE as well as its brevity, simplicity, and ease of administration and interpretation all recommend its use in assessing hearing handicap in the elderly.

The Hearing Handicap Inventory for Adults: Psychometric Adequacy and Audiometric Correlates

The Hearing Handicap Inventory for the Elderly (HHIE) was modified for use with younger hearing-impaired adults (less than 65 years of age). Similar to the HHIE, the Hearing Handicap Inventory for Adults (HHIA), is a 25-item self-assessment scale composed of two subscales (emotional and social/situational). Replacement questions from the HHIE which form the HHIA focus on the occupational effects of hearing loss. For 67 hearing-impaired adults, the HHIA demonstrated high internal consistency reliability and a low standard error of measurement. Audiometric correlates of the HHIA revealed weak, yet statistically significant relationships with pure-tone sensitivity and supra-threshold word recognition ability. These findings support the use of self-report handicap measures with adults in that audiometric measures alone are insufficient in describing a patients reaction to their hearing loss.

The Hearing Handicap Inventory for the Elderly as a measure of hearing aid benefit.

Hearing impairment in older adults is associated with psychological and social difficulties. The goal of hearing aid fitting is to reduce the perceived handicap resulting from the hearing loss. Measures of self-perceived handicap are being increasingly incorporated into the clinicians armamentarium as an objective measure of the outcome of intervention. Eighteen elderly hearing-impaired males and their spouses responded to the Hearing Handicap Inventory for the Elderly (HHIE) prior to and following 1 year of hearing aid provision. Our findings revealed a significant reduction in the perceived emotional and social effects of hearing impairment following 1 year of hearing aid use. The reduction in perceived handicap, as measured using the HHIE, was greater for the hearing aid users than for their spouses. The findings attest to the construct validity of the HHIE as a measure of hearing aid benefit.

Test-retest Reliability of the Hearing Handicap Inventory for Adults

The test-retest reliability of the Hearing Handicap Inventory for Adults (HHIA) was assessed on a sample of 28 hearing-impaired adults. Reliability estimates were obtained to set the stage for using the HHIA as an outcome measure in aural rehabilitation. The test-retest reliability was quite high (r = 0.97) and the standard error of measurement was low for the HHIA and its screening version (HHIA-S). In light of the psychometric adequacy, the HHIA and HHIA-S have potential as indices of hearing aid benefit in hearing-impaired adults.

Test-retest reliability of the hearing handicap inventory for the elderly

The Hearing Handicap Inventory for the Elderly (HHIE) is a self-assessment tool, composed of emotional and social/situational subscales and designed to measure the perceived effects of hearing impairment in the noninstitutionalized elderly. Previous study has indicated that the HHIE has a high internal consistency, as well as high split-half reliability. The present study was undertaken to examine test-retest reliability associated with the HHIE, as the latter information is prerequisite to the application of the HHIE as a measure of change in perception of handicap which may result from audiologic intervention. Forty-seven noninstitutionalized elderly individuals with sensorineural hearing loss were sampled, using two measurement techniques: face-to-face (N = 20) and paper-and-pencil (N = 27) administration. Test-retest reliability was high for both the face-to-face and paper-and-pencil administration, suggesting that the HHIE has potential as a measure of change resulting from rehabilitation.

Measurement of hearing aid benefit in the elderly

Providing amplification is at the heart of most rehabilitation programs for the elderly. Given the importance of quality assurance, methods of quantifying hearing aid fitting success are needed. This study was designed to assess the adequacy of a self-assessment scale at measuring hearing aid benefit following a 3 week interval of hearing aid use. Forty-five new hearing aid users completed the Hearing Handicap Inventory for the Elderly (HHIE) prior to and following 3 weeks of hearing aid use. Results of the study showed a significant reduction in handicap following 3 weeks of hearing aid use, suggesting the feasibility of using the HHIE as an outcome measure for hearing aid success after a brief interval of hearing aid use. Subjects will be followed longitudinally to determine the best time frame in which to administer this scale.

Test-retest reliability of the Hearing Handicap Inventory for the Elderly using two administration approaches.

Previous investigation with the Hearing Handicap Inventory for the Elderly demonstrated high test-retest reliability for face to face/face to face and paper-pencil/paper-pencil administration techniques. From a practical standpoint, a face to face administration followed by a paper-pencil readministration may be a preferable method. The present study evaluated the latter administration approach in a sample of hearing-impaired elderly men. The high test-retest reliability correlations which emerged suggest that the face to face/paper-pencil measurement technique can be adopted for quantifying changes in self-perceived hearing handicap following audiologic intervention especially when clients are unable to return for hearing aid follow-up.