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Factor Structure and Reliability of the Dutch Version of Seven Scales of the Communication Profile for the Hearing Impaired (CPHI)

Contact author: Lidwine B. Mokkink, EMGO Institute, VU University Medical Center, Department of ENT/Audiology, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands. E-mail: w.mokkink{at}vumc.nl.

Purpose: Seven scales of the Communication Profile for the Hearing Impaired (CPHI; M. E. Demorest & S. A. Erdman, 1987) were translated into Dutch: Maladaptive Behavior, Verbal Strategies, and Nonverbal Strategies (within the area of Communication Strategies) and Self-Acceptance, Acceptance of Loss, Stress, and Withdrawal (within the area of Personal Adjustment).

Method: This cross-sectional study evaluated the factor structure, internal consistency, test–retest reliability, and measurement error of the Dutch CPHI scales. In all, 399 adults with impaired hearing participated, and data on a subgroup of 40 patients were included in the test–retest analyses. The participants completed the questionnaire before routine clinical care or at home. Demographic data and data on pure-tone hearing thresholds were also collected.

Results: Based on item factor analyses, we omitted 5 items, moved 3 items to different scales, and combined the Stress and Withdrawal scales. The resulting 6 scales, containing 52 items, showed good internal consistency (alphas between 0.81 and 0.94), good test–retest reliability (intraclass correlation coefficients between 0.78 and 0.86), and small standard error of measurement (between 0.28 and 0.46).

Conclusions: The suggested revisions of the Dutch CPHI scales will increase their interpretability. Further research is needed to evaluate their usefulness for monitoring patients and in longitudinal studies by determining their responsiveness and minimal important change values.

KEY WORDS: Communication Profile for the Hearing Impaired (CPHI), factor analysis, reliability, internal consistency, measurement error

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