Research On The Cross-cultural Adaptation And Feasibility Of The Communication Education Program For Older Adults With Hearing Loss

Objectives:This study aims to adapt the communication education program for older adults with hearing loss in China to provide a basis for further improving their health levels.(1)To explore the depressive symptoms and health-related quality of life of the community-dwelling older adults with hearing loss;(2)To adjust the communication education program;(3)To explore the feasibility,acceptability,and the impact of depressive symptoms,health-related quality of life,and self-perceived hearing impairment of the communication education program for older adults with hearing loss in the community,and analyze the promotion and obstacles of the intervention program.Methods:(1)Investigation of the depressive symptoms and health-related quality of life among older adults with hearing loss.A cross-sectional survey was conducted on 114 older adults with hearing loss to analyze depressive symptoms,health-related quality of life,and influencing factors in the elderly with hearing loss in Changsha,Hunan Province.Data were collected using the general information questionnaire,the Hearing Handicap Inventory for the Elderly,Simplified Ways of Coping Questionnaire,General Self-Efficacy Scale,Perceived Social Support Scale,15-item Geriatric Depression Scale and the 12-item Short-Form Health Survey.(2)Cross-cultural adaptation to the communication education program.According to the heuristic framework,combined with the ecological validity model,this study made cross-cultural adaptation to the communication education program.We translated the intervention program after obtaining the authorization of the Australian Version of the communication education program;Focus group interviews were conducted with 12 older adults with hearing loss to understand their acceptance of communication education programs and adjustment suggestions;we organized expert meetings to discuss and determine the contents to be adjusted and implement the preliminary adjustment.(3)Feasibility analysis of the communication education program.The convenience sampling method was used to recruit older adults with hearing loss in the district in Changsha City,Hunan Province.According to the residential community,the participants were assigned to the intervention group(12 people)or the control group(14 people).The researchers distributed the same communication education manual to the control and intervention groups.The control group independently learned the content of the communication education manual,and the intervention group received five offline group activities and online discussions.This study evaluated the feasibility,acceptability and initial effect of the communication education program before and after the intervention.Depressive symptoms,health-related quality of life,and self-perceived hearing impairment were assessed before and after the intervention in the two groups of participants.The communication education program was further adjusted with the pilot study results and the semi-structured interview results after the intervention.Results:(1)The depressive symptom score of the older adults with hearing loss was(6.36±2.96).The incidence of depressive symptoms was 30.7%.According to the multiple linear regression analysis results,the influencing factors included perceived hearing impairment,social support,and living with children.The physical component summary score of health-related quality of life in the elderly with hearing loss was(35.00±12.09),and the mental component summary score was(48.91±10.66).According to the multiple linear regression analysis results,the main influencing factors of physical health were depressive symptoms and chronic diseases,and the main influencing factors of mental health were age,family support,and depressive symptoms.(2)Cultural adaptations of the original communication education program mainly include: translating the intervention program,adjusting the intervention objects and intervening personnel,and improving the implementation content of the communication education program.(3)A total of 26 older adults with hearing loss in this study,and there was no statistically significant difference in baseline information between the participants of the two groups(P>0.05).The recruitment rate of research objects is 65.00%.The completion rate is 100.00%.Participants of the experimental group are generally satisfied,hold a positive attitude toward future participation in the education plan,and are willing to recommend this plan to others.Scientific and practical content,peer support,strong motivation to participate,benefits to social interaction,and positive guidance are the factors that promote the participation of older adults with hearing loss in intervention.Competing priorities,lack of motivation to participate,poor acceptance of intervention content,and insufficient family support system are the factors that hinder the participation of older adults with hearing loss in intervention.(4)After the intervention,the differences in depressive symptoms,health-related quality of life,and self-perception of hearing impairment between participants in the two groups were statistically significant(P<0.05).The repeated measurement analysis of variance shows that there were differences in the GDS-15 total score,physical component summary score,and mental component summary score between the two groups at different measurement times(P<0.05).There were interactions between measurement times and intervention methods(P<0.05),but there were no differences in the GDS-15 total score,physical component summary score,and mental component summary score between the two groups at different intervention methods(P>0.05).The International Outcomes Inventory for Alternative Interventions results shows that hearing loss can benefit from the communication education program.Conclusions:(1)In the community,older people with hearing loss have high scores of depressive symptoms and poor health-related quality of life and should be screened and intervened on time.(2)After cross-cultural adaptation,the communication education program has specific scientific feasibility and acceptability.(3)This study provides preliminary evidence for the communication education program for older people with hearing loss.