Translation, Adaptation and Cross-Cultural Validation of Hearing Handicap Inventory for Adult in Malay Language.

Background and Objectives: A self-reported questionnaire for the hearing-impaired is not yet available in the Malay language, hence, it is important to develop or translate any available existing questionnaires. The aim of this study was to translate, adapt and validate the Hearing Handicap Inventory for Adult (HHIA) to be used by the audiologist among the hearing-impaired population in Malaysia.

Subjects and Methods: The HHIAs were translated to Malay language using forward-backward translation techniques by four-panellists (two for each level). The translated HHIA were then reconciled and harmonized for cultural aspects and content of the questionnaire by the researchers and two expert panels before being pilot-tested among 10 hearing-impaired patients. Questionnaire validation was conducted among 80 adults with a hearing loss to calculate for Cronbach's α (internal reliability), Spearman's correlation (inter-item correlation) and factor analysis.

Results: None of the translated items were removed from the scale. The overall Cronbach's α was 0.964; 0.927 and 0.934 for both social and emotional subscales, respectively. The factor analysis (force-concept inventory) demonstrated a two-structure with a strong correlation between all items in either component 1 or 2, that resembled the original scale. The Mann-Whitney test revealed significantly higher scores for those adults with a hearing loss than those adults with normal hearing.

Conclusions: The Malay HHIA has been successfully translated and validated for the purpose of determining the psychosocial aspects of adults with hearing losses in the local population.