Purpose: The aim of this study was to translate the versions of the Hearing Environments and Reflection on Quality of Life (HEAR-QL) into Turkish and investigate the validity and reliability of the Turkish 26-item HEAR-QL (HEAR-QL-26) for children and Turkish 28-item HEAR-QL (HEAR-QL-28) for adolescents.
Method: The protocol included translation into Turkish and linguistic adaptation. The HEAR-QL-26 and HEAR-QL-28, respectively, were administered to 249 children (130 with hearing loss, 119 without hearing loss) and 249 adolescents (140 with hearing loss, 109 without hearing loss) between the ages of 8 and 18 years. To determine the internal consistency (reliability) of the Turkish HEAR-QL scale, Cronbach's alpha coefficient (α) was calculated for the subcategories and the total score. We measured the construct validity of the Turkish HEAR-QL-26 and HEAR-QL-28 using Pearson r correlation coefficients comparing the Turkish HEAR-QL and the Turkish Child and Adolescent Quality of Life Scale (PedsQL).
Results: The reliability for both children and adolescents (Cronbach's alpha = .973 for HEAR-QL-26 and .977 for HEAR-QL-28) was high, and test-retest reliability showed strong to excellent correlations (intraclass correlation coefficient = .980 and .979, respectively) for the total scores. In terms of known-group validity, the total HEAR-QL mean scores were lower for participants with hearing loss than for children/adolescents with normal hearing (p < .05). Confirmatory factor analysis showed that the number of original items was sufficient in the Turkish version. Both HEAR-QL versions provided a higher area under the curve (AUC = .984 and .972, respectively) than the PedsQL (AUC = .773 and .581, respectively).
Conclusion: The Turkish versions of the HEAR-QL-26 child and HEAR-QL-28 adolescent questionnaires are sensitive, reliable, and valid measurement tools to evaluate the hearing-related quality of life in children and adolescents aged between 8 and 18 years.