Development of the Communication and Acceptance Scale (CAS) for group aural rehabilitation

Figures & data

Table 1. Means, SDs, items, factor loadings, explained variance, internal consistency (cronbach’s alpha) and test–retest reliability (weighted kappa).

Factors/item	Mean	SD	Factor loadings 1	Factor loadings 2	Factor loadings 3	Factor loadings 4	Factor loadings 5	Cronbach’s alpha	Weighted kappa value (n = 36)
Factor 1: emotional consequences (explained variance 24.2%)								0.88
F1:1. When it is difficult to hear I pretend to hear	2.95	1.20	0.81						0.39
F1:2. My hearing difficulties create annoyance between me and friends	2.80	1.31	0.57						0.48
F1:3. I avoid communication with others due to my hearing difficulties	3.07	1.25	0.70						0.56
F1:4. I often feel uncomfortable when talking to people	2.46	1.24	0.82						0.45
F1:6. My hearing difficulties affect my self-esteem	2.71	1.57	0.66						0.68
F1:7. When I do not hear what people say I do not pretend to hear them	3.66	1.20	0.59						0.49
F1:8. My hearing difficulties make me feel left out when I am in a group of people	1.95	1.22	0.80						0.65
F1:9. I often avoid situations where I believe I will have difficulties to hearing	2.17	1.22	0.55						0.29
Factor 2: Verbal communication strategies (explained variance 13.2%)								0.66
F2:10. When I have difficulties hearing what people say, I ask them to repeat until I am sure I have heard correctly.	4.05	0.95		0.64					0.53
F2:15. When I have difficulties hearing what people say, I explain I have hearing loss	4.61	0.80		0.79					0.69
F2:17. I feel comfortable telling other people how to behave when talking to me	3.63	1.16		0.76					0.64
Factor 3: Confirmation strategies (explained variance 9.2%)								0.49
F3:14. If I am unsure what I heard, I repeat what was said to make sure I heard correctly.	3.76	1.18			0.72				0.51
F3:18. I feel strengthened by meeting others with hearing difficulties	4.29	1.03			0.84				0.64
Factor 4: Hearing knowledge (explained variance 9%)								NA
F4:13. I have good knowledge about my hearing loss	4.29	0.84				0.92			0.37
Factor 5 Hearing loss and acceptance (explained variance 16.1%)								0.82
F5:5 Other people are bothered by my hearing difficulties	2.95	1.35					0.64		0.39
F5:11. I can handle my hearing loss and its consequences	3.58	1.09					0.71		0.39
F5:12. I feel well prepared to face my hearing difficulties in everyday life	2.75	1.30					0.85		0.49
F5:16. I feel optimistic about the future	3.34	1.35					0.66		0.70

Table 2. Statistically significant correlation coefficients between self-reports and the subscales of the CAS.

Self-report	CAS tot	Emotional consequences	Verbal communication strategies	Confirmation strategies	Hearing knowledge	Hearing loss and acceptance
HHIE tot	−0.73
HHIE E	−0.78	−0.79				−0.69
HHIE S	−0.55	−0.58				−0.49
HADS tot	−0.61
HADS A	−0.50	−0.41	−0.37		−0.34	−0.35
HADS D	−0.60	−0.54			−0.33	−0.57
CSS tot	0.48
CSS M	0.57	0.61				0.44
CSS V			0.68
CSS NV			0.34	0.42
Emotional consequences	0.92					0.66
Verbal communication strategies	0.45
Confirmation strategies
Hearing knowledge
Hearing loss and acceptance	0.79	0.66

HHIE: Hearing Handicap Inventory for the Elderly; HHIE E: Hearing Handicap Inventory for the Elderly-Emotional; HHIE S: Hearing Handicap Inventory for the Elderly-Situational; HADS: Hospital Anxiety and Depression Scale, HADS A: Hospital Anxiety and Depression Scale-Anxiety; HADS D: Hospital Anxiety and Depression Scale-Depression; CSS: Communication Strategies Scale; CSS M: Communication Strategies Scale-Maladaptive; CSS V: Communication Strategies Scale-Verbal; CSS NV: Communication Strategies Scale-Non-verbal.

p < 0.05.

Table 3. Means, SDs, effects sizes (ES) and F-values for pre-post 3 weeks (1–2) and pre-post 6 months (1–3).

Questionnaire	Mean pre	SD	Mean post 3 weeks	SD	Mean post 6 months	SD	F-values 1–2, n = 41	F-values 1–3, n = 28	ES pre-post 3weeks
CAS	54.60	10.37	59.05	11.84	58.85	9.52	F(1, 39)=14.55, p < 0.001	F(2, 54)=6.72, p < 0.01	0.40
HHIE S	27.60	10.48	26.63	10.13	25.50	10.10	F(1, 39)=1.99, p = 0.17	F(2, 52)=1.18, p = 0.31	0.09
HHIE E	23.50	10.77	23.51	9.98	23.71	9.67	F(1, 39)=0.17, p = 0.89	F(2, 52)=0.95, p = 0.39	0.01
HADS D	5.31	3.24	4.83	2.89	4.38	2.92	F(1, 40)=1.75, p = 0.19	F(2, 56)=1.67 p = 0.20	0.16
HADS A	5.58	4.09	5.68	4.15	5.31	3.78	F(1, 40)=0.44, p = 0.83	F(2, 56)=0.54 p = 0.95	0.02
CSS M	3.3	0.81	3.57	0.60	3.68	0.59	F(1, 38)=7.89, p < 0.01	F(2, 56)=4.30 p < 0.05	0.39
CSS V	2.80	0.80	3.19	0.74	3.29	0.80	F(1, 38)=9.03, p < 0.01	F(2, 56)=13.30 p < 0.001	0.51
CSS NV	3.83	0.75	4.09	0.72	4.15	0.60	F(1, 38)=4.85, p < 0.05	F(2, 56)=3.86 p < 0.05	0.36

Table 4. Means, SDs, and F-values for pre-post 6 months (1–3), n = 28.

CAS-item*	Mean pre	SD	Mean post 3 weeks	SD	Mean post 6 months	SD	F-values 1–3, n = 28
1	2.28	1.09	2.96	1.23	3.03	0.99	F(2, 54)=1.31, p = 0.28
2	2.82	1.36	2.86	1.30	2.89	1.26	F(2, 54)=0.09, p = 0.91
3	3.25	1.26	3.18	1.16	3.11	1.28	F(2, 54)=0.32, p = 0.73
4	2.57	1.32	2.68	1.31	2.50	1.20	F(2, 54)=0.33, p = 0.72
5	2.32	1.16	2.82	1.41	2.71	1.21	F(2, 54)=2.95, p = 0.06
6	2.61	1.50	2.78	1.57	2.61	1.42	F(2, 54)=0.55, p = 0.58
7	3.32	1.44	3.64	1.61	3.39	0.99	F(2, 54)=0.96, p = 0.39
8	2.07	1.12	2.14	1.21	2.21	1.20	F(2, 54)=0.31, p = 0.74
9	2.18	1.10	2.28	1.12	2.25	1.26	F(2, 54)=0.19, p = 0.82
10	3.93	1.02	3.93	1.02	4.01	0.96	F(2, 54)=0.60, p = 0.55
11	3.14	1.30	3.68	1.10	3.64	1.10	F(2,54)=4.58, p < 0.01
12	2.57	1.29	2.68	1.22	2.82	1.12	F(2, 54)=0.73, p = 0.49
13	3.71	1.30	4.29	0.90	4.39	0.73	F(2,54)=5.22, p < 0.01
14	3.82	1.25	3.86	1.05	3.96	0.95	F(2, 54)=0.29, p = 0.75
15	4.39	0.87	4.46	0.92	4.53	0.64	F(2, 54)=0.45, p = 0.64
16	3.21	1.10	3.25	1.29	3.11	1.20	F(2, 54)=0.30, p = 0.74
17	3.29	1.36	3.43	1.23	3.50	1.20	F(2, 54)=0.36, p = 0.70
18	3.75	0.97	4.39	0.96	4.07	1.09	F(2, 54)=5.06, p < 0.01

*The wording of the items is shown in Table 1.