| Objectives:Based on the Health Belief Model,the Hearing Health Belief Scale of Middle-aged and Older Residents in the Community was developed and verified.The developed scale was used to measure the hearing health belief level of middle-aged and older residents in the community,analyze the influencing factors of hearing health belief,and preliminarily explore the relationship between hearing health belief and hearing health-related behaviors,so as to provide future intervention of hearing health-related behaviors.To prevent and delay the occurrence of hearing loss.Methods:In this study,literature review and focus group discussion method were used to design the Hearing Health Belief Scale for middle-aged and older community residents based on the health belief model.By Delphi expert consultation method,12experts from otolaryngology,health management,public health and other fields were selected to evaluate the scale,and a formal scale was formed according to expert opinions.From July to August 2022,two surveys were conducted successively.The first collected 408 questionnaires,mainly for scale item analysis and exploratory factor analysis,and the second collected 224 questionnaires,mainly for confirmatory factor analysis.Based on the scale,the Hearing Health Belief Questionnaire of Middle-aged and Older Residents in the Community was developed and applied.A formal survey was conducted among community residents aged 40 to 70 in 7 districts of Hangzhou from November to December 2022,and a total of 901 valid questionnaires were collected.Single factor statistical analysis method was used to compare the differences in hearing health belief levels among different demographic characteristics,different present and family history,different tinnitus,ear tightness,hearing impairment and other groups,as well as the differences in hearing health belief levels among different groups of hearing health-related behaviors.Multiple linear regression was used to analyze the total score of residents’hearing health beliefs and the influencing factors of each dimension.Binary logistic regression was used to analyze the effect of hearing health belief level on hearing health related behaviors.Results:(1)The Hearing Health Belief Scale of Middle-aged and Older Residents in the Community developed in this study contains six dimensions and 27 items in total.The overall reliability of the scale was 0.808,and the partial reliability was 0.872,indicating that the scale had good reliability and validity.The KMO value was 0.898,six common factors were extracted by factor analysis,and the cumulative variance contribution rate was 69.415%,which was in line with the preset theoretical model.Correlation analysis showed that the total score of the health belief scale was significantly correlated with the total scores of the simple disease perception questionnaire and the general self-efficacy scale,and the correlation coefficients were0.170 and 0.393,respectively(P<0.05),indicating that the scale had good scaling validity.Confirmatory factor analysis results show that thex~2//df=1.853,RMSEA=0.062,NFI=0.860,CFI=0.930,TLI=0.920,the scale has good structure validity.The factor load of each item and the mean variance variation of each dimension were all>0.5,and the combination reliability was all>0.8,indicating that the convergent validity was ideal.The absolute values of the correlation coefficients among all dimensions were all<0.7,indicating that the scale had acceptable discriminative validity.(2)The general hearing health belief level of middle-aged and older residents in the community was low(total score 3.40±0.45 points),especially in the susceptibility dimension(average score 2.34±0.95 points)and the perceived impairment dimension(average score 2.89±1.04 points).(1)The results of multiple linear regression showed that the total score of hearing health belief was higher in residents with chronic disease history(β=0.102).(2)Those with junior high school education(β=0.128),those with high school or technical secondary school education(β=0.091),those with chronic disease history(β=0.126),those with tinnitus(β=0.110),those with ear distress(β=0.120),those with mild and moderate hearing loss(β=0.180)and those with severe hearing loss(β=0.177)had higher susceptibility scores.(3)Those with economic income of 6000～7999 yuan(β=0.083)and at least 8000 yuan(β=0.120),those with chronic disease history(β=0.097)and severe hearing loss(β=0.117)had higher severity scores.(4)Those with economic income of 8000 yuan or more(β=0.119)had higher benefit scores,and those with mild and moderate hearing loss had lower benefit scores(β=-0.093).(5)The impairment scores were lower in patients with ear tightness(β=-0.011),mild and moderate hearing loss(β=-0.134)and severe hearing loss(β=-0.092).(6)Those with primary school and below(β=-0.090),mild to moderate hearing loss(β=-0.197)and severe hearing loss(β=-0.077)had lower self-efficacy scores.(3)The hearing health belief level of middle-aged and older residents in the community is related to hearing health related behaviors.(1)Lower self-efficacy(OR=0.93)was associated with noise exposure behavior.(2)Perceived higher susceptibility(OR=1.04),greater behavioral change disorder(OR=0.92),and lower self-efficacy(OR=0.95)were associated with ear-picking behavior.(3)Higher self-efficacy(OR=1.12)was correlated with hearing-related physician behavior.(4)Perceived higher severity(OR=1.04),greater behavioral change disorder(OR=0.95),and lower self-efficacy(OR=0.88)were associated with antibiotic abuse.(5)Perceived less behavioral change disorder(OR=1.51)and higher self-efficacy(OR=1.63)were associated with prescribed medication behavior.(6)Perceived higher susceptibility(β=0.088),lower self-efficacy(β=-0.137),and greater behavioral change disorder(β=-0.261)were associated with more number of poor hearing health-related behaviors(P<0.05).Conclusions:The Hearing Health Belief Scale of Older Community Residents has good reliability and validity.Using this measuring tool to measure the hearing health beliefs of the older residents in the community,it is found that the hearing health beliefs level of the residents is low.The influencing factors of hearing health beliefs include hearing impairment degree,tinnitus condition,ear tightness condition,education level,economic income,chronic disease history,etc.The research on hearing health beliefs and hearing health related behaviors found that each dimension of health beliefs is related to specific hearing health related behaviors.The dimension of susceptibility to hearing health beliefs,the dimension of obstacle to behavioral change and the dimension of self-efficacy of middle-aged and older residents in the community may be the contents that need to be paid attention to in the process of hearing health-related behavior intervention.The results of this study provide a basis for exploring and improving the hearing health protection awareness of middle-aged and older residents in the community from the perspective of hearing health beliefs,and developing behavioral intervention measures and methods related to hearing health,and lay a foundation for the prevention and intervention of hearing loss of community residents. |
PDF Full Text Request