(KHHIE ) - (. (KHHIE) -., 2 0 0 0, 5, 1, 13 3-154. / KHHIE -. 72.5 100 ( 41, 59 ) KHHIE 25 ( / 12, 13 ) / FF, PP ) 1, 6. KHHIE - 95 % ( FF : 15.13, PP: 14.34). KHHIE,.. 60. 60 10 1 2050 5 1, 2150 3 1. 2050 65 14 2,000 3.5, 1950 10. 1990 71.3, 2000 74.3. 65 2000 6.8 %, 2050 13.5 % (, 1999;, 1996).,,, 1 2
.. 65. (, 1996;, 1998;, 1996). (NCHS, 1987),. 65-74 33 %, 75-84 45 %, 85 62 %. 34 (, 1994).. 65 20 %. ( )..,... (hearing impairment ) (hearing handicap)., (AAO, 1979; ASHA, 1981)..,,..,..
(KHHIE) -..,. Zwarrdemarker (1891). Bunch (1929), 1955 Schuknecht 1964 1974,,, Hinchcliffe (1962),. 250-4,000 Hz, 4,000 Hz 4,000 Hz,.,,,, 70 % (Westen, 1964),,,,, (Rosen et al., 1964), Paparella & Low ell (1977) 40 70. (1969),. (1980) 24.7 %. (, 1982). Ventry & Weinstein (1982a; 1983) 1,000 Hz 2,000 Hz 40 db HL 1,000 Hz 2,000 Hz 40 db HL, Goldstein (1984)
25 db HL, Kat sarkas & Ayukawa (1986),,,,, 25 db HL.. Noble & Atherly (1987), 42 HMS (T he Hearing Measurement Scale), Bergner et al. (1981) 136 SIP (Sickness Impact Profile), Ventry & Wein stein (1982b ) 25 HHIE (T he Hearing Handicap Inventory for the Elderly ). HHIE,. HHIE 80 %, HHIE. F ace to F ace (FF ) Paper - Pencil (PP ), -. HHIE. 1983 25 10 HHIE - S (T he Screening Version of the Handicap Inventory for the Elderly ). Schow & Nerbonne (1982) 10 SAC (T he Self- Assessment of Communication ) (Weinstein, 1994). Ventry & Wein stein (1982) HHIE 25 < - 1>, KHHIE (T he Korean Hearing Handicap Inventory for the Elderly ), / KHHIE -.
(KHHIE) - KHHIE. (1), / KHHIE /, (2) FF PP, (3) KHHIE -, (4) 10 KHHIE - S (T he Korean Hearing Handicap Inventory for the Elderly - Screening Version ) KHHIE, (5).. 1. 65 72.5 ( : 65-88, : 5.29) 100 ( : 41, : 59 ). Paparella & Lowell (1977).,,,,,,. < - 2>., 3 (0.5, 1, 2 KHz) (Pure T one T hreshold Average; PT A ), 25 db HL. 25 db HL Kat sarkas & Ayukawa (1986). < - 1> 0.5, 1, 2, 4 KHz (Pure T one Average, PT A ). PT A 44.37 db HL(SD = 13.85), PT A 41.48 db HL (SD = 12.03).
< - 1> (KHz) 0.5 1 2 4 M M 47.90 44.15 41.05 49.89 44.37 SD 11.70 14.70 19.24 21.29 13.85 M 44.60 40.02 39.65 49.55 41.48 SD 10.89 12.51 16.73 21.90 12.03 2.,,, 1, 2.,,., 0.5, 1, 2, 4 KHz (42-54 db A )., < - 1> KHHIE (Paper - Pencil, PP ) (F ace to F ace, FF ), - 6. 6 (Demorest & Walden, 1984). 3. < - 1> KHHIE 25 / 1 ( ), 6 2 ( ). < - 1> KHHIE 25 12 / ( S : S
(KHHIE) - Social/ Situational ) 13 ( E : E Emotional ), 4, 2, 0 / 0 48 0 52, 0 100. < - 1> KHHIE - S * 10 5 / 5 / 0 20, 0 40. - / (FF, PP ) / 1-2 KHHIE Chronbach. Pearson, -.,,, 95 %.. 1. KHHIE / < - 2> 100 KHHIE -.,. < - 2> 100 KHHIE PT A * / / (db HL) M 42.93 10.86 10.40 21.26 10.74 9.50 20.24 SD 11.07 11.72 12.59 23.83 12.13 12.37 24.15 25.83-85 0-48 0-52 0-100 0-48 0-52 0-100 *.
0 100 KHHIE 20.75 (T est : 21.26, Retest : 20.24)... 2. FF PP -. F F (F ace t o F ace ) KHHIE FF 50, 73.56 ( 65 88 ). KHHIE - KHHIE (FF ),,, / < - 3>. KHHIE -, -. < - 3> FF KHHIE FF / M 25.76 25.16 13.20 13.72 12.56 11.44 SD 26.02 26.77 12.82 13.30 13.89 13.90 0-100 0-100 0-48 0-48 0-52 0-52. PP (P aper- P en cil ) KHHIE PP 50, 71.44 ( 65 84 ). KHHIE - KHHIE (PP ),,,, / < - 4>. KHHIE -, -. FF PP
(KHHIE) -. < - 4> PP KHHIE PP / M 16.76 15.32 8.52 7.76 8.24 7.56 SD 20.70 20.31 10.11 10.11 10.85 10.41 0-76 0-74 0-36 0-38 0-40 0-36. F F PP - FF PP KHHIE / -.97.96 FF PP (< - 5> ). < - 5> FF PP KHHIE - F ace to Face Paper- Pencil.97.97.96.96 /.93.94.91.93.94.95.92.93 3. KHHIE KHHIE- S. KHHIE KHHIE - S < - 6> KHHIE KHHIE KHHIE - S -,,. -. KHHIE KHHIE - S -
. < - 6> KHHIE KHHIE- S - / KHHIE KHHIE- S M 21.26 20.24 9.52 9.30 SD 23.83 24.15 9.77 9.80 0-100 0-100 0-40 0-40 M 10.86 10.74 5.68 5.78 SD 11.72 12.13 5.39 5.65 0-48 0-48 0-20 0-20 M 10.40 9.50 3.84 3.52 SD 12.59 12.37 4.83 4.55 0-52 0-52 0-20 0-20. KHHIE KHHIE - S - < - 7> KHHIE KHHIE - S - Chronbach s. KHHIE,. -.93.94 KHHIE KHHIE - S.83.87 KHHIE.80. KHHIE- S alpha KHHIE. < - 7> KHHIE KHHIE- S - KHHIE KHHIE- S - /.93.94.83.84.93.94.83.87 4. KHHIE -. F F PP - < - 8> FF PP - /
(KHHIE) - Pearson. FF PP -.90 FF PP. < - 8> FF PP KHHIE - Face to F ace Paper- Pencil.96.94 /.94.95.94.91. KHHIE KHHIE - S - < - 9> KHHIE KHHIE - S - Pearson. -.93.95 KHHIE KHHIE - S.90.94 KHHIE.80. < - 9> KHHIE KHHIE- S - KHHIE KHHIE - S /.95.90.93.94 5. -,, 95% < - 10> -,, 95 %. - Pearson FF.96 PP.94, - (Sx 1- r x x ' ) FF 5.35, PP 5.07. - 95 % (X2 - X1 2 2 SE ) FF 15.13 PP 14.34..
< - 10> KHHIE -,, 95 % FF -.96.94 5.35 5.07 95 % 15.13 14.34 PP < - 11> KHHIE * N 42 (26-40 db) 47 (41-55 db) - 8 (56-70 db) (>70 db) 3 100 S E S E M 4.62 4.38 9.00 4.81 4.10 8.90 SD 5.95 7.76 13.40 6.91 7.40 14.11 0-32 0-36 0-68 0-34 0-36 0-70 M 12.68 11.28 23.96 11.87 9.87 21.74 SD 10.55 10.77 20.69 10.91 11.20 21.62 0-40 0-36 0-76 0-40 0-36 0-74 M 23.50 26.25 49.75 27.25 26.75 54.00 SD 15.92 14.75 29.50 15.42 13.54 28.10 6-48 2-46 8-94 4-48 8-44 12-92 M 36.00 38.67 74.67 32.00 33.33 65.33 SD 12.00 14.06 26.03 14.00 16.28 30.29 24-48 24-52 48-100 22-48 22-52 44-100 M 21.26 20.24 SD 23.83 24.15 0-100 0-100 * 6. KHHIE < - 11> 100 (0.5, 1, 2 KHz) 4 - /. mild (20-40 db HL) PT A 33.37 db HL (SD = 4.17), moderate (41-55 db HL) PT A
(KHHIE) - 46.40 db HL(SD = 4.67), moderately severe (56-70 db HL) PT A 59.58 db HL (SD = 3.02) Severe (> 70 db HL) PT A 77.78 db HL (SD = 6.74). KHHIE Pearson r =.67., KHHIE.. /. KHHIE.91.97., -. /... / (Ventry & Weinstein, 1982b ). FF PP KHHIE., (r =.91-.96) - Nunnally (1978) (r >.80)., 1982 Ventry & Weinstein FF PP FF PP. 1989 Newman & Weinstein FF, PP (, ). FF, PP
. - FF FF PP PP FF PP. FF PP. 95 % FF, PP (< - 12> )., -., -. KHHIE 95 %. < - 12> HHIE -,, 95 % Face to F ace/ F ace to F ace * - Paper - Pencil/ Paper- Pencil * Face to Face/ Paper- Pencil * * -.96.84.94 6.6 13.0 6.8 95 % 18.7 36.0 19.2 * : Weinstein, Spitzer & Ventry (1986). ** : Newman & Weinstein (1989). KHHIE 10 KHHIE - S (T he Korean Hearing Handicap Inventory for the Elderly - Screening Version ) KHHIE,, - (Cox & Gilmore, 1990).. KHHIE KHHIE - S - KHHIE - S.
(KHHIE) - KHHIE 1982 1983 Ventry Weinstein HHIE r =.61, 20 %. KHHIE (r = 67)., KHHIE. (McCartney, Maurer & Sorenson, 1976; Ventry & Weinstein, 1982a).50.60 -.30 -.40. HHIA (H earin g Handicap Inventory for the Adult s). /.?, KHHIE?, KHHIE.. Chronbach s coefficient alpha :. KHHIE HHIE,,. KHHIE /. KHHIE. / (Ventry & Weinstein, 1982b ).. KHHIE., KHHIE,. 1981 Marcus.,,,,
(Marinelli & del Orto., 1977; Noble, 1978) /. KHHIE.. KHHIE,. KHHIE / (,,,, ) /. KHHIE 18 (Ventry & Weinstein, 1982b ).... KHHIE. KHHIE., /.... 72.5 100 ( 41,
(KHHIE) - 59 ) < - 1> KHHIE 25 ( / 12, 13 ) / (FF, PP ) 1, 6 2., / KHHIE /, FF PP, KHHIE -, 10 KHHIE - S KHHIE,,. Chronbach Pearson.,.91.97., (FF, PP ) KHHIE -.90., (FF : 5.35, PP : 5.07) 95 % (FF : 15.13, PP : 14.34)., KHHIE KHHIE - S - KHHIE.93-.95 KHHIE - S.90-.94. KHHIE - S., KHHIE.67, KHHIE. (KHHIE ),.
(1994). II:. :. (1982)... :. (1998).. :. (1996).. :. (1980)., 7, 96-102.. (1996). J ournal of the K. orea Gerontolog ical Society, 16, 151-161. (1999). 60. News+, 182, 40-51. (1969).., 12, 31-40. American Academy of Otolaryngology (1979). American Academy of Otolaryngology Committee on Hearing and Equilibrium, and the American Council of Otolaryngology Committee on the Medical Aspect of Noise, Guide for the evaluation on hearing handicap. J ournal of the A m erican M edical A ssociation, 241, 2055-2059. American Speech and Hearing Association (1981). T ask force on the definition of hearing handicap. A m erican Sp eech and H earing A ssociation, 23, 293-297. Bergner, M., Bobbitt, R., Carter, W. & Gilson, B. (1981). The sickness impact profile: Development and final revision of a health status measure. M edical Care, 14, 57-67. Bunch, C. C. (1929). Age variations in auditory acuity. A rchives of Otolaryngology, 9, 625-636. Cox, R. & Gilmore, C. (1990). Development of the profile of hearing aid performance (PHAP). Journal of Sp eech and H earing R esearch, 33, 343-357. Demorest, M. & Walden, B. (1984). Psychometric principles in the selection, interpretation, and evaluation of communication self- assessment inventories. J ournal of Sp eech and H earing D isorders, 49, 226-241. Goldstein, D. (1984). Hearing impairment, hearing aids, and audiology. A sha, 26, 24-35. Hinchcliffe, R. (1962). Anatomicial locus of presbycusis Journal of Sp eech H earing D isorders, 27, 301-310. Katsarkas, A. & Ayukaw a, H. (1986). Hearing loss due to aging (presbycusis). J ournal of Otolaryngology, 15, 239-244. Marcus, C. (1981). Use of speech discrimination in predicting hearing handicap in the elderly. Paper presented at the New York State Speech- Language- Hearing Association Convention. Marinelli, R. & del Orto. A. (1977). The Psycholog ical and Social Impact of Physical D isability. New York: Springer Publishing Company. McCartney, J., Maurer, I. & Sorenson, F. A. (1976). Comparison of the hearing handicap and the hearing measurement scale with standard audiometric measures on the geriatric population. The Journal of A uditory R esearch, 16, 51-58. National Center for Health Statistics (NCHS). (1987). Current Estimates from the N ational H ealth Interview S urvey : United S tates Vital and H ealth S tatistics. S eries 10. Public Health
(KHHIE) - Service. Washington D.C.: U. S. Government Printing Office. Newman, C. W. & Weinstein, B. E. (1989). T est- retest reliability of the hearing handicap inventory for the elderly using two administration approaches. Ear and H earing, 10, 190-191. Noble, W. (1978). A ssessm ent of Impaired H earing. A Critique and a N ew M ethod. New York: Academic Press. Noble, W. & Atherly, G. (1987). The hearing measurement scale: A questionnaire for the assessment of auditory disability. J ournal of A udiolog ical R esearch, 10, 229-250. Nunnally, J. C. (1978). Psychom etric Theory (2nd ed.). New York: McGraw- Hill. Paparella, M. M. & Lowell, S. H. (1977). Presbycusis : What is it? Larygoscop e, 87, 1710-1724. Rosen, S., Bergman, M., Plester, D., El- Mofty, A. & Satti, M. (1962). Presbycusis : Study of relatively noise free population in Sudan. A nnals of Otology, R hinology, and Laryngology, 17, 727-743. Schow, R. L. & Nerbonne, M. (1982). Communication screening profile: Use with elderly clients. Ear and H earing, 3, 135-147. Schuknecht, H. F. (1955). Presbycusis. Laryngoscop e, 65, 402-427. Schuknecht, H. F. (1964). Further observ ation on the pathology of presbycusis. A rchives of Otolary ng ology, 80, 369-382. Schuknecht, H. F. (1974). Pathology of the Ear. Cambridge, MA: Harvard University Press. Ventry, I. M. & Weinstein, B. E. (1982a). The hearing handicap inventory for the elderly : A new tool. Ear and H earing, 3, 128-134. Ventry, I. M. & Weinstein, B. E. (1982b). Hearing impairment and social isolation in the elderly. A m erican Sp eech- Lang uag e-h earing A ssociation, 25, 593-599. Ventry, I. M. & Weinstein, B. E. (1983). Audiometric correlates of the hearing handicap inventory for the elderly. Journal of Sp eech and H earing D isorders, 48, 379-384. Westen, T. E. T. (1964). Presbycusis: Clinical study. Journal of Laryngology, 78, 273-285. Weinstein, B. E., Spitzer, J. B. & Ventry, I. M. (1986). T est- retest reliability of the Hearing Handicap Inventory for the Elderly : Ear and H earing, 7, 295-299. Zwarrdemarker, H. (1891). Der verlust an hohne tonen mit Zunchmenden Alter. A rchives of Oherenheilkunde, 32, 53-56.
< - 1> KHHIE O. : ( 4 ) ( 2 ) ( 0 ) S- 1? E- 2*? S- 3? E- 4? E- 5*? S- 6? E- 7? S- 8*? E- 9*? S- 10*,? S- 11*,? E- 12? S- 13,? E- 14*? S- 15*? S- 16,? E- 17? E- 18? S- 19? E- 20*? S- 21*? E- 22? S- 23? E- 24? E- 25? * KHHIE- S
(KHHIE) - < - 2> No.. 1. (1)? (, ) (2)? (, ) (3)? (, ) (4) (, ) (5) (, ) (6), ( ) (7) (, ) 2. Observation and Otoscopic Examination (1) Auricle & Craniofacial Impression Right Left (2) EAC Right Left (3) T M Right Left 3. Pure T one T est Right Left 0.5KH z 1KHz 2KH z 4KHz 4. Others. 5. Sound Level Meter :( )db A
AB ST RA CT T est - Retest Reliability of the K or ean Hearin g Han dicap In ventory for the E lder ly (K HHIE ) H olim K u, Jin s o ok K im 1(Department of Rehabilitation, Hallym University) T his study was performed to measure the reliability of the recomposed Korean Hearing Handicap Inventory for the Elderly (KHHIE ). T he inventory comprised of two subscales: 12- item subscale explores social and situational hearing impairment ; 13- item subscale explores emotional effect of hearing impairment (see Appendix 1). T he results of the study can be summarized as follow s : (1) Correlation relation between PT A and KHHIE w as 0.67 which indicates that as the hearing impairment get s wor se the point s for hearing inventory increase. (2) T he reliability of the KHHIE was evaluated by assessing it s internal con sistency through the computation of Chronbach s coefficient alpha. Alpha value ranged from 0.91 to 0.97 for the entire inventory which show s high internal consistency. (3) T he standard error (SE ) of measurement and the standard error of the difference between two administrations of the KHHIE (2 2 SE ) were calculated. T he SE associated with the FF and PP administration of the KHHIE were 5.35 and 5.07, respectively, suggesting that test - retest scores would have to differ by at least 15.13 and 14.34 points (95 % confidence interval for a true charge) in order for rehabilitation effects to be con sidered effective. (4) T he test - retest reliability associated with the FF and PP administration s of the KHHIE w as computed using Pear son correlation. T he test - retest correlation w as quite high, 0.94 to 0.96, for all scales suggesting that the score on two administrations of the KHHIE are related in the test - retest situation. (5) T he results for analysis of comparison between KHHIE and KHHIE - S was all above 0.90 showing that KHHIE - S can feasibly be used as screening tests. * E - mail: jskim @sun.hallym.ac.kr