成人聽覺障礙自陳量表編訂之研究

Development of the Hearing Handicap Inventory for Adults (HHIA)-Chinese Version

劉俊榮(Chun-Jung Liu) ； 劉樹玉(Shu-Yu Liu) ； 羅敦信(Tun-Shin Lo)

《障礙者理解半年刊》 13卷1期 (2014/01) Pp. 1-20

https://doi.org/10.6513/TJUID.2014.13(1).1

摘要

國內成人聽覺機能障礙者有四萬多人，約佔整體聽障者的三分之一，然而聽覺機能障礙是以其聽力損失百分比或聽力損失分貝數作為鑑定的標準，但聽力損失程度與主觀的聽覺障礙程度並沒有絕對的關係。主觀聽覺障礙程度的測量必須藉由訪談、問卷或量表等方式進行評估，以了解聽力損失對其活動、參與，乃至生活品質所造成的影響。成人聽覺障礙量表具有良好的信效度，在國外是經常被使用的量表，其評估結果可以用在聽力篩檢、助聽器選配、人工耳蝸植入、聽覺復健成效等多個領域。有鑒於此量表運用簡便、用途廣泛，因此本研究乃進行此量表的編製，並分析其信效度。成人聽覺障礙量表乃根據老年聽覺障礙量表而來，將其中兩個題目以成人職場生活取代。本研究根據國內老年聽覺障礙量表，再翻譯此兩個題目作為量表。量表總計25個題目，包括社會情境量表12題、情緒量表13題，每題1到5分，分數愈多，代表障礙程度越重。研究對象包括台灣北中南五家助聽器公司的來客，共計128名，其在社會情境量表平均2.44分（標準差0.91分），情緒量表平均2.41分（標準差0.88分），整體聽覺障礙為2.42分（標準差0.87分），障礙程度以輕、中度為主。社會情境、情緒、以及整體聽覺障礙量表均能有效鑑別出高低障礙者，其內部一致性信度Cronbach α係數分別為.921、.921、以及.957。在驗證性因素分析的模式檢驗指數上，包括基本適配指數、模式外在品質指數、模式內在品質指數，幾乎都達到良好的標準。顯示本研究量表具有良好的鑑別度、信度與效度。期待未來的研究方向能建立量表與聽力（純音、語音）、生活品質的關係，測量助聽器選配、人工耳蝸、聽覺復健等方面的成效，以發揮臨床價值。

關鍵字

成人 ； 聽力損失 ； 聽覺障礙 ； 自評量表

並列摘要

Previous studies indicate that audiometric measures alone are insufficient in describing a patient's functional impact to their hearing loss. So, self-report of hearing handicaps is widely applied to reflect the real-world listening experiences of patients. Actually, self-assessment is recognized as the new ＂gold standard＂ to measure the treatment effectiveness by hearing-related health care professionals. The Hearing Handicap Inventory for Adults (HHIA) (Newman, Weinstein, Jacobson, & Hug, 1991) is a commonly used self-assessment scale designed to quantify the perceived effects of hearing loss. Moreover, it can assess benefit by measuring change in perceived handicap after using the hearing devices. The HHIA is a 25-item scale composed of 2 subscales, emotional and social/situational impact, which is easy to perform and is widely used in many countries and translated into different languages. Due to the limited self-assessment tools available in our country, we developed the Chinese version of HHIA and used to evaluate 128 adults with sensorineural hearing loss in this study. The participants were recruited from clients of five hearing aid centers located in different areas of Taiwan. The respondents were mostly mild to moderate hearing loss. They scored 2.44 (s.d. 0.91) on social/situation scale, 2.41 (s.d.0.88) on emotion scale, and 2.42 (s.d. 0.87) for total scale, respectively. The scores can effectively differentiate the degree of hearing handicap of respondents. The HHIA-Chinese Version demonstrated high internal consistency/reliability on two subscales and total scale (Cronbach α: .921, .921, .957). Conformatory factory analysis was conducted on the 25 questions of the HHIA using Model Examination Index, includes preliminary fit criteria, fit index of external structure of model, fit index of internal structure of model. The results assured the high quality of this scale. This demonstrated that HHIA-Chinese Version is a useful tool with good discrimination, reliability and validity, which allows readily clinical application.

並列關鍵字

adult ； hearing loss ； hearing handicap ； self-assessment ； questionnaire