The Participation Scale: psychometric properties of a South Indian translation with hearing-impaired respondents

Abstract

Aims: The Participation Scale (P-Scale) is a widely used generic self-report measure designed to assess an individual's participation restriction consequent to any disease condition. The present study aimed to evaluate the validity and reliability of a south Indian (Kannada language) version of the P-Scale for use with adults with hearing loss. This study is a part of an ongoing research program on the assessment of outcomes of hearing health rehabilitation with hearing aids involving Indian client groups.

Methods: One hundred and three adults with hearing loss completed the original English and the newly translated-adapted Kannada P-Scale questionnaire. Nearly half of the participants completed repeat testing of the Kannada version 15 days after the initial assessment. Along with the P-Scale, Kannada versions of the Hearing Handicap Questionnaire (HHQ) and the Assessment of Quality of Life - 4 Dimensions Questionnaire (AQoL-4D) were also administered. Based on predefined quality criteria, five different psychometric properties of the P-Scale were evaluated, together with an analysis of the Kannada P-Scale's factor structure. The psychometric properties assessed included internal consistency, test-retest reliability, convergent validity, discriminant validity, and floor-ceiling effects.

Results: Principal component analysis indicated a four-factor complex structure, which explained 69.78% of the variance in the Kannada P-Scale. High internal consistency (Cronbach's alpha = 0.90) and test-retest reliability (internal consistency coefficient >0.90) were obtained. Comparisons with the HHQ (ρ = 0.52) and AQoL-4 D (ρ = 0.76) indicated good convergent validity. Discriminant validity among the P-Scale questions was acceptable (inter-item correlation <0.60). Floor and ceiling effects were not evident in the Kannada P-Scale.

Conclusions: The psychometric characteristics of the Kannada P-scale were found to be sufficient for use with the participant group (literate, Kannada-speaking adults with hearing loss) who were assessed in this study. Further research is required to determine generalizability of the Kannada P-Scale among other Kannada-speaking communities. Implications for Rehabilitation The Kannada version of the Participation Scale (P-Scale) can be validly used with Kannada speaking adults with hearing loss. The Kannada P-Scale can be used for clinical/research purposes to assess outcome (specifically, change in participation restriction) before, during, and after the hearing rehabilitation process. However, education and socioeconomic status may have an effect of the Kannada P-Scale results and these factors need to be further investigated prior to wider clinical use.

Keywords: Hearing loss; Kannada; participation restriction; participation scale; reliability; validation.