Psychological Acceptance in Adults With Hearing Loss-Psychometric Evaluation and Validation of the Hearing Acceptance Questionnaire.

Abstract

Hearing loss is common and a major contributor to the global number of years lived with disability. An increasing number of studies have begun to consider the specific psychological processes by which distressing thoughts, emotional experiences and non-adaptive behaviours exert an influence on functioning and health among those who suffer from audiological disorders. Psychological acceptance has recently been proposed to be a core process but has to date not been systematically examined among individuals with hearing problems. This study examined the reliability, factor structure and the validity of the Hearing Acceptance Questionnaire (HAQ). The HAQ was developed from similar questionnaires for other chronic health conditions and was evaluated using data from an online screening of hearing ability (N=1351). Measures included a hearing test (speech-in-noise), standardized and validated self-report measurements of anxiety and depression symptoms (the Hospital Anxiety and Depression scale), hearing related disability (the Amsterdam Inventory of Hearing Disability and Handicap), and quality of life (the Quality of Life Inventory). Factor structure of the HAQ was evaluated with confirmatory factor analysis, and the unique contribution of psychological acceptance in accounting for variance in hearing disability was examined by hierarchical multiple regression analyses. Findings supported the reliability, factor structure and validity of the HAQ. Confirmatory factor analysis supported a two-factor model with one subscale measuring Avoidance with 9 items; alpha = 0.84) and the other Activity Engagement (3 items; alpha = 0.76). Both subscales of the HAQ explained unique variance in disability after hearing ability, depression and anxiety symptoms were statistically taken into account. Theoretical and clinical implications of psychological acceptance in adults with hearing problems are discussed. This paper evaluated the psychometric properties of a new measure of hearing loss acceptance, the HAQ, to measure psychological acceptance among individuals with hearing problems. Regression analysis revealed that lack of psychological acceptance was strongly positively correlated with hearing disability, even after accounting for other psychological factors and hearing ability. Taken together, the findings provide preliminary support for HAQ as a psychometrically sound measure of psychological acceptance among individuals with hearing problems.