Mental Health and Adult Hearing Impairment

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Mental Health and Adult Hearing Impairment

• Laura Gill, Swee Guan Ng, Holly Veale,
  Christopher Lind
• Department of Speech Pathology and Audiology,
• and Malcolm Bond,
• Department of General Practice,
• Flinders University, Adelaide
• with Chrissy OReilly and Kate Treloar

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Mental health in the adult population

• Mental health problems account for a large
  percentage of disease burden in Australia
• (Australian Institute of Health and Welfare,
  2006a)
• Mental health an umbrella term encompassing
  many facets and illnesses each with different
  presentation and consequences (these include
  depression, anxiety and stress)
• ABS conducted studies on prevalence of mental
  health in the Australian adult population samples
  in 1997, 2001, and 2004/5

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Hearing impairment and Mental Health

• Hearing impairment
• - One of the most prevalent disabilities in
  developed countries
• - Negative effect on communication and
  interaction
• (Anderson Noble, 2005)
• - Leads to a number of psychosocial consequences
• (Zazove et.al., 2006 De Graaf Bijl, 2002)
• Psychosocial consequences of hearing impairment
  have been linked to an increased risk of
  developing mental health problems (Tambs, 2004)

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Hearing impairment and Mental Health

• Association between hearing impairment and mental
  health varies between studies
• (Loeb Tambs, 2006 de Graaf Bijl, 2002)
• No recent data on the prevalence of mental health
  issues in Australian adults with acquired hearing
  impairment
• Intervention has been shown to improve quality of
  life, self-esteem, social and emotional
  communication and depression (Mulrow, Tuley
  Aguilar, 1992)
• However, it is unlikely to completely resolve the
  emotional and social handicap that HI creates
  (Erdman, 1993).

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Research question

• Does the prevalence and/or degree of reported
  mental health issues a self-selected sample of
  Australian adults with post-lingual hearing
  impairment differ from the Australian adult
  population?

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Method

• Nationwide questionnaire study
• Members of Better Hearing Australia
• Group attenders
• Questionnaire package consisted of
• Two self report mental health questionnaires
• (K10 and DASS)
• Two self report hearing related questionnaires
• (HHIA and IOI-HA)

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Data Collection

• Participants Better Hearing Australia members
• from 12 of 18 branches (N 1196)
• Response rate 431/1196 (36.0)
• Omitted adults reporting onset of hearing
  impairment before 10 years (n 45), or providing
  no reply (n 20)
• so final n 366
• Gender
• Males 123 (33.6) , Females 243 (66.4)
• Age
• Range 28 to 96 years Mean 68.5 years

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Response Distribution ALL questionnaires
received by branch
BUNDABERG 8/16
SUNSHINE COAST 15/50
BRISBANE 51/120
NEWCASTLE 51/80
GOSFORD 28/50
PERTH 19/45
CANBERRA 37/58
SYDNEY 111/369
WAGGA 2/19
ADELAIDE 6/11
BALLARAT 13/28
MELBOURNE 81/350
TOTAL RESPONDENTS 422/1196 Location data missing
for 9 respondents
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Mental Health Questionnaire

• Kessler Psychological Distress Scale (K10)
• (Kessler et al., 2002)
• Used in the ABS National Health Surveys 1997,
  2001, 2004/5
• 10 item questionnaire scale
• e.g., During the last 30 days, about how often
  did you feel depressed?
• During the last 30 days about how often
  did you feel that everything
• was an effort?
• 1 none of the time, 5 all of the time
• Designed to measure the severity of non-specific
  psychological distress over the past 4 weeks

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Kessler Psychological Distress Scale (K10)

• Score range 10 (Low) and 50 (High)
• Original/Common scoring (Andrews and Slade,
  2001)
• Low (10 - 15)
• Moderate (16 - 21)
• High (22 - 29)
• Very High (30 - 50)
• Alternate scoring (Health and Wellbeing Survey,
  2000)
• No distress (10 - 21)
• Distress (22 - 50)

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Degree of psychological distress in sample of
hearing impaired adults and the Australian
population
Single sample ?2
34.40 4.67
2.72 exact p value
lt0.0001 0.20 ns 0.44
ns
proportional allocation to n 366 following
Andrews and Slade (2001)
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Prevalence of psychological distress in sample of
hearing impaired adults and the Australian
population
Single sample ?2 7.12
0.10 0.38
exact p value
0.008 0.75 ns 0.54 ns
proportional allocation to n 366 Health
and Wellbeing Survey (2000)
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Results summary

• The current studys data had a significantly
  greater proportion of HI adults report moderate
  levels of psychological distress than the 1997
  ABS study
• Comparison with two subsequent ABS studies show
  no difference in distribution of K10 scores and
  makes comparison with 1997 data unclear
• Comparisons should be made under similar social,
  political circumstances recent ABS data provide
  more pertinent comparisons

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Discussion

• No significant difference in the prevalence of
  general psychological distress in hearing
  impaired adults compared to the general
  population
• Other than with the 1997 ABS data
• Residual difficulty (point in time) versus
  Change over time
• Adaptation and life management
• MH questionnaires tend to assess residual
  difficulty
• Selection, optimisation and compensation (SOC)
  model
• (Freund Baltes, 2002)

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Issues in sampling

• All participants were members of a self help
  group
• Self help groups (Chamberlin, Rogers Ellison,
  1996)
• tend to reach people who are less psychiatrically
  involved
• More likely to be motivated for self help
• Feel more positive about themselves, more respect
  for themselves, able to recognise strengths

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Issues in sampling

• Hearing levels self reported
• No audiometric data available
• Control for people on medication
• A small proportion of respondents would have
  responded differently if not on medication
• Control for external influences on mental health,
  e.g., other medical conditions
• Follow up mail-out to increase sample size
• (Total Design Method Dillman, 1983)

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Acknowledgements

• The authors would like to thank Alan Kier,
  National BHA president for his support as well as
  the 12 Better Hearing Australia branches who
  agreed to participate in this study and all the
  BHA members who completed and returned the
  questionnaires.
• We also wish to thank the people who contacted us
  to discuss the purpose and scope of the study as
  well as to share their personal experiences with
  us.