title: Self-assessment of hearing disabilities in cochlear implant users using the SSQ and the reduced SSQ5 version.
abstract: OBJECTIVE
  Routine clinical assessment to evaluate the hearing performance in a cochlear implant (CI) population should include individual self-assessment tools. Because of pragmatic and psychometric considerations, there's a growing need for reduced self-assessment questionnaires. The aim of the study is twofold. First, the study aims to ascertain a disability profile, using the Speech, Spatial and Qualities of Hearing Scale (SSQ), in a CI population and to compare this profile with a hearing impaired group with similar average hearing thresholds. The second aim of the study is to investigate the degree of agreement between the total SSQ scores and the total scores of the reduced 5-item version of the SSQ, namely, the SSQ5.
  
  
  METHODS
  This cross-sectional study uses the SSQ obtained from CI patients from the Ear, Nose and Throat (ENT) department of the Antwerp University Hospital. Fifty-four postlingually deaf CI patients completed the SSQ questionnaire. All subjects were implanted with a CI at an average age of 55 years. At the time they completed the questionnaire, they had, on average, 3 (SD, 3) years of CI experience. To determine the disability profile in a CI population, the following criteria were assayed: standard values, internal consistency, sensitivity, and floor (or ceiling) effects of the SSQ. These criteria were compared with those of a hearing-impaired group (n = 153) reported in the original study.Second, Spearman correlations coefficients and intraclass correlations coefficients (ICCs) were used to determine the degree of agreement between the total SSQ scores and the total SSQ5 scores.
  
  
  RESULTS
  Analysis of internal consistency, sensitivity, and floor and ceiling effects showed that self-assessment using the SSQ is feasible in a CI population. The obtained disability profile presents a mean total SSQ(C I group) of 4:25 ( S D = 1:65). When comparing item results, significant differences were found between CI users and moderate hearing-impaired patients (SSQ(hearing impaired group) = 5.5; S D1:9). Intraclass correlation (ICC = 0.78; p < 0.01) and Spearman correlations coefficients (R = 0.77; p < 0.01) indicate a significantly high degree of agreement between the total SSQ scores and the total SSQ5 scores.
  
  
  CONCLUSIONS
  This article shows the disability profile in a CI population, using SSQ. Significant differences regarding dynamic aspects of hearing between CI users and moderate hearing-impaired patients were found, to the detriment of the CI users. The static aspects of hearing represented in the Speech section, on the other hand, showed more similarities. The reduced 5-item version of the SSQ, namely, the SSQ5, is robust to effectively measure evolutions in hearing (dis)abilities in CI users.
authors.affiliation: *University Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, and †Faculty of Medicine, Antwerp University, Belgium.
authors.forename: Griet
authors.initials: G
authors.lastname: Mertens
authors.forename: Andrea Kleine
authors.initials: AK
authors.lastname: Punte
authors.forename: Paul
authors.initials: P
authors.lastname: Van de Heyning
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D019929:Cochlear Implantation; D003054:Cochlear Implants; D003430:Cross-Sectional Studies; D059026:Diagnostic Self Evaluation; D005260:Female; D006311:Hearing Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D006320:Hearing Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D012647:Self-Assessment; D013017:Sound Localization / Q000502:physiology; D013067:Speech Perception / Q000502:physiology*