Measuring hearing handicap for hearing impaired adults in the Philippines: a profound conundrum

Objective: The current study aimed to evaluate hearing handicap and its correlates in a Filipino population utilizing either the Hearing Handicap Inventory for the Elderly (screening version) (HHIE-S) or Hearing Handicap Inventory for Adults (screening version) (HHIA-S) (dependent on age). An investigation of the psychometric properties of the questionnaires, including factor analysis to evaluate the subscales was also conducted. Study sample: Three hundred and nine participants (18–86 years) were recruited from a population attending a hearing aid donation program in Manila, Philippines. Results: The average hearing handicap (HHIE-S/HHIA-S) total score was high (26.28) consistent with the high mean hearing threshold (85.7 dB HL); however, simple correlation and regression analysis revealed no relationship between hearing threshold and HHIE-S/HHIA-S score. Subsequently, mild-to-severe and profound subgroups were delineated. In the mild-to-severe group, hearing handicap score correlated positively with hearing threshold and negatively with SES. This relationship was not seen in the profound group. MANOVA suggested different response patterns on the HHIE-S/HHIA-S for the two subgroups. Principal component analysis revealed two factors in the HHIE-S/HHIA-S that varied somewhat from the emotional and social subscales intended in the original questionnaire. Conclusions: This study suggests that the HHIE-S and HHIA-S questionnaires are not sensitive to the handicap caused by profound hearing loss. The cause of this lack of sensitivity is not clear but may reflect a ceiling effect. Alternatively, self-rated hearing handicap may be reduced in those exposed to manual communication, or in those who have a congenital hearing loss but who have received minimal intervention.