Validity and Reliability of the Hearing Handicap Inventory for Elderly: Version Adapted for Use on the Portuguese Population

Abstract

Background: The use of the Hearing Handicap Inventory for the Elderly (HHIE) questionnaire enables us to measure self-perceived psychosocial handicaps of hearing impairment in the elderly as a supplement to pure-tone audiometry. This screening instrument is widely used and it has been going through adaptations and validations for many languages; all of these versions have kept the validity and reliability of the original version. Purpose: To validate the HHIE questionnaire, translated into Portuguese of Portugal, on the Portuguese population. Research Design: This study is a descriptive correlational qualitative study. The authors performed the translation from English into Portuguese, the linguistic adaptation, and the counter translation. Study Sample: Two hundred and sixty patients from the Ear, Nose, and Throat (ENT) Department of Coimbra University Hospitals were divided into a case group (83 individuals) and a control group (177 individuals). Intervention: All of the 260 patients completed the 25 items in the questionnaire and the answers were reviewed for completeness. Data Collection and Analysis: The patients volunteered to answer the 25-item HHIE during an ENT appointment. Correlations between each individual item and the total score of the HHIE were tested, and demographic and clinical variables were correlated with the total score, as well. The instrument’s reproducibility was assessed using the internal consistency model (Cronbach’s alpha). Results: The questions were successfully understood by the participants. There was a significant difference in the HHIE-10 and HHIE-25 total scores between the two groups (p < 0.001). Positive correlations can be seen between the global question and HHIE-10 and HHIE-25. In the regression study, a relationship was observed between the pure-tone average and the HHIE-10 (p < 0.001). Reliability of the instrument was proven by a Cronbach alpha index of 0,79. Conclusions: The HHIE translation into Portuguese of Portugal maintained the validity of the original version and it is useful to assess the psychosocial handicap of hearing impairment in the elderly.