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The use of research questionnaires with hearing impaired adults: online vs. paper-and-pencil administration
Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark .
Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. (Internet, health and clinical psychology research group)ORCID iD: 0000-0003-4753-6745
Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark .
2012 (English)In: BMC Ear, Nose and Throat Disorders, ISSN 1472-6815, Vol. 12, no 12, 14- p.Article in journal (Refereed) Published
Abstract [en]


When evaluating hearing rehabilitation, it is reasonable to use self-report questionnaires as outcome measure. Questionnaires used in audiological research are developed and validated for the paper-and-pencil format. As computer and Internet use is increasing, standardized questionnaires used in the audiological context should be evaluated to determine the viability of the online administration format.

The aim of this study was to compare administration of questionnaires online versus paper- and pencil of four standardised questionnaires used in hearing research and clinic. We included the Hearing Handicap Inventory for the Elderly (HHIE), the International Outcome Inventory for Hearing Aids (IOI-HA), Satisfaction with Amplification in Daily Life (SADL), and the Hospital Anxiety and Depression Scale (HADS).


A cross-over design was used by randomly letting the participants complete the questionnaires either online or on paper. After 3 weeks the participants filled out the same questionnaires again but in the other format. A total of 65 hearing-aid users were recruited from a hearing clinic to participate on a voluntary basis and of these 53 completed both versions of the questionnaires.


A significant main effect of format was found on the HHIE (p < 0.001), with participants reporting higher scores on the online format than in the paper format. There was no interaction effect. For the other questionnaires were no significant main or interaction effects of format. Significant correlations between the two ways of presenting the measures was found for all questionnaires (p<0.05). The results from reliability tests showed Cronbachs α’s above .70 for all four questionnaires and differences in Cronbachs α between administration formats were negligible.


For three of the four included questionnaires the participants’ scores remained consistent across administrations and formats. For the fourth included questionnaire (HHIE) a significant difference of format with a small effect size was found. The relevance of the difference in scores between the formats depends on which context the questionnaire is used in. On balance, it is recommended that the administration format remain stable across assessment points.

Place, publisher, year, edition, pages
2012. Vol. 12, no 12, 14- p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-88084DOI: 10.1186/1472-6815-12-12OAI: diva2:601522
Available from: 2013-01-29 Created: 2013-01-29 Last updated: 2014-11-28
In thesis
1. Internet Interventions for Hearing Loss: Examing rehabilitation, self-report measures and internet use for hearing-aid users
Open this publication in new window or tab >>Internet Interventions for Hearing Loss: Examing rehabilitation, self-report measures and internet use for hearing-aid users
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In the future, audiological rehabilitation of adults with hearing loss will be more available, personalized and thorough due to the possibilities offered by the internet. By using the internet as a platform it is also possible to perform the process of rehabilitation in a cost-effective way. With tailored online rehabilitation programs containing topics such as communication strategies, hearing tactics and how to handle hearing aids it might be possible to foster behavioral changes that will positively affect hearing aid users.

Four studies were carried out in this thesis. The first study investigated internet usage among adults with hearing loss. In the second study the administration format, online vs. paper- and pencil, of four standardized questionnaires was evaluated. Finally two randomized controlled trials were performed evaluating the efficacy of online rehabilitation programs including professional guidance by an audiologist. The programs lasted over five weeks and were designed for experienced adult hearing-aid users. The effects of the online programs were compared with the effects of a control group.

It can be concluded that the use of computers and the internet overall is at least at the same level for people with hearing loss as for the general age-matched population in Sweden. Furthermore, for three of the four included questionnaires, the participants’ scores remained the same across formats. It is however recommended that the administration format remain consistent across assessment points. Finally, results from the two concluding intervention studies provide preliminary evidence that the internet can be used to deliver education and rehabilitation to experienced hearing aid users who report residual hearing problems and that their problems are reduced by the intervention; however the content and design of the online rehabilitation program requires further investigation.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2014. 72 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1392Studies from the Swedish Institute for Disability Research, ISSN 1650-1128 ; 57
Counseling, hearing loss, hearing aids, rehabilitation of people with hearing loss, internet, outcome assessment, hearing aid satisfaction
National Category
Medical and Health Sciences
urn:nbn:se:liu:diva-103824 (URN)10.3384/diss.diva-103824 (DOI)978-91-7519-423-3 (print) (ISBN)
Public defence
2014-02-27, Berzeliussalen, Campus US, Linköpings universitet, Linköping, 13:00 (English)
Available from: 2014-01-28 Created: 2014-01-28 Last updated: 2014-11-28Bibliographically approved

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