title: Social representation of "hearing loss": cross-cultural exploratory study in India, Iran, Portugal, and the UK.
abstract: BACKGROUND
  Hearing loss is one of the most common chronic conditions in older adults. In audiology literature, several studies have examined the attitudes and behavior of people with hearing loss; however, not much is known about the manner in which society in general views and perceives hearing loss. This exploratory study was aimed at understanding the social representation of hearing loss (among the general public) in the countries of India, Iran, Portugal, and the UK. We also compared these social representations.
  
  
  METHODS
  The study involved a cross-sectional design, and participants were recruited using the snowball sampling method. A total of 404 people from four countries participated in the study. Data were collected using a free-association task where participants were asked to produce up to five words or phrases that came to mind while thinking about hearing loss. In addition, they were also asked to indicate if each word they presented had positive, neutral, or negative associations in their view. Data were analyzed using various qualitative and quantitative methods.
  
  
  RESULTS
  The most frequently occurring categories were: assessment and management; causes of hearing loss; communication difficulties; disability; hearing ability or disability; hearing instruments; negative mental state; the attitudes of others; and sound and acoustics of the environment. Some categories were reported with similar frequency in most countries (eg, causes of hearing loss, communication difficulties, and negative mental state), whereas others differed among countries. Participants in India reported significantly more positive and fewer negative associations when compared to participants from Iran, Portugal, and the UK. However, there was no statistical difference among neutral responses reported among these countries. Also, more differences were noted among these countries than similarities.
  
  
  CONCLUSIONS
  These findings provide useful insights into the public perception of hearing loss that may prove useful in public education and counseling.
authors.affiliation: Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA.
authors.forename: Vinaya
authors.initials: V
authors.lastname: Manchaiah
authors.affiliation: Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.
authors.forename: Berth
authors.initials: B
authors.lastname: Danermark
authors.affiliation: Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
authors.forename: Tayebeh
authors.initials: T
authors.lastname: Ahmadi
authors.affiliation: Department of Audiology, School of Allied Health Sciences, Polytechnic Institute of Porto, Vila Nova de Gaia, Portugal.
authors.forename: David
authors.initials: D
authors.lastname: Tomé
authors.affiliation: Centre for Speech Language Therapy and Hearing, Cardiff Metropolitan University, Cardiff, UK.
authors.forename: Fei
authors.initials: F
authors.lastname: Zhao
authors.affiliation: Department of Social Science and Law, Tianjin University of Technology, Tianjin, People's Republic of China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.affiliation: All India Institute of Speech and Hearing, University of Mysore, Mysore, India.
authors.forename: Rajalakshmi
authors.initials: R
authors.lastname: Krishna
authors.affiliation: Department of Health and Welfare Studies, Malmö University, Malmö, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Germundsson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003144:Communication Barriers; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D004777:Environment; D005260:Female; D006310:Hearing Aids; D034381:Hearing Loss / Q000175:diagnosis / Q000208:ethnology* / Q000534:rehabilitation; D006801:Humans; D007194:India; D007398:Interpersonal Relations; D007492:Iran; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D019986:Persons with Hearing Disabilities / Q000523:psychology*; D011174:Portugal; D006113:United Kingdom
keywords: cross-culture; hearing impairment; hearing loss; perception of disability; social representation; societal attitude