Validation of a quality-of-life measure for deaf or hard of hearing youth

Abstract

Objective. Quality-of-life (QOL) measures targeting youth with hearing loss are useful in population needs assessment, educational placement, and program design and evaluation. This study assesses the cross-sectional validity of the Youth Quality of Life Instrument-Deaf and Hard of Hearing Module (YQOL-DHH). Study Design. Instrument development and cross-sectional survey. Setting. Recruitment through schools, professional organizations, clinics, and programs for youth who are deaf or hard of hearing. Subjects and Methods. Thirty-five candidate items were administered to 230 adolescents aged 11 to 18 years: 49% female, 61% white, 11% mild hearing loss, 20% moderate/moderatesevere, 41% severe/profound, and 28% with cochlear implants. Participants completed individual or group-administered questionnaires by paper and pencil (58%), Web-based English (29%), American Sign Language (ASL) or Pidgin Signed English (PSE) (9%) on DVD, or interviewer-supervised ASL or PSE DVD (4%). The Children's Depression Inventory (CDI-S) was also completed. Factor structure, reliability, construct validity, and respondent burden were assessed. Results. Thirty-two items were retained in the final instrument covering 3 domains: self-acceptance/advocacy (14 items, Cronbach α = 0.84), perceived stigma (8 items, Cronbach α = 0.85), and participation (10 items, Cronbach α = 0.86). QOL was not significantly associated with hearing level. Oneweek test-retest coefficients were acceptable: self-acceptance/advocacy (0.70), perceived stigma (0.78), and participation (0.92). As predicted, the total CDI-S score was associated in the appropriate direction (P < .0001) with all YQOL-DHH domains. Time to complete the paper-and-pencil version was 12 minutes. Conclusion. The YQOL-DHH shows good reliability and validity for assessing hearing-specific QOL in adolescents. © American Academy of Otolaryngology - Head and Neck Surgery Foundation 2011.