Table 5.
Examples of items revised or removed during the think‐aloud interviews in accordance with the themes.
| Theme | Sample items | Findings and issues | Quote | Outcome for item |
|---|---|---|---|---|
| Relevance | I feel detached from the world at times because I miss out on news broadcasts and public announcements | Participants did not relate to the term ‘detached’ | I don't feel unnecessarily miss out on that. I'm kind of a generation where technology and like smart tech has been available to us. (TA6, female, 30–49 years) | Removed |
| Felt the item was more relevant for older generations as younger generations mostly use technology/social media to access news | In today's social media, it comes to you from all angles, doesn't it? (TA8, female, 80+ years) | |||
| I get like all my news broadcasts off my phone though with my eyeballs. I have little feeling for that question. (TA9, male, 30–49 years) | ||||
| Relevance | My hearing has brought me closer to some people | Participants did not feel this question was relevant to their situation | That's a difficult one to answer. Not sure that's worth keeping to be honest, because it doesn't really, it's not. To be my hearing loss upon me, closer to some people. (TA7, male, 50‐79 years) | Removed |
| ‘Closer’ too ambiguous | It's your shadow in. I would say it has my hearing loss. Brought me closer to the people. I would say no, not really. (TA7, male, 50–79 years) | |||
| I find this is a bit of an odd question cause it's not something I've noticed. I guess you end up being a little more reliant on people. (TA6, female, 30–49 years) | ||||
| Clarity | People don't seem to realise when I have not heard what they have heard | Participants found the wording confusing wording and had to read a few times | People don't necessarily react to the fact that I'm not picking up what they're saying or I'm not hearing what they've heard. I find that one a little more difficult purely because I find it difficult to answer for someone else. (TA6, female, 30–49 years) | Removed |
| Participants found it difficult to answer because it was asking about someone else's perception rather than their own experience. | That's a tricky one. I mean, people are not aware of your deafness. How could they be, and the degree of it. I mean, deafness comes in every possible degree, shade, so how can they be? (TA3, male, 80+ years) | |||
| Clarity | Sometimes when I'm with people I hear really well | Question was hard to understand. Participants felt that the answer would vary depending on the context/environment, situation and speaker (e.g. participants sought clarification as to whether it was a group situation or one to one) | It's dependent on the situation, where you are, the environment and the person. I belong to a church, and some of those people in that church have got really quiet voices, and accents, and they don't open their mouth so I can't lip‐read. (TA8, female, 80+ years) | Removed |
| I still don't really understand the question. Like is it like with some people like with my close, say with my spouse or with my mum. I didn't really get it. (TA9, male, 30–49 years) | ||||
| Clarity | I understand why I don't hear the way I used to | Participants found this question ambiguous, and it was unclear what it was asking. | I don't understand why I hear the way I do, but I think it's an ageing process. I was told that so is everything. I don't think that fits that question. I think you just accept the fact that you know you losing your hearing. (TA12, female, 50–79 years) |
Amended I understand why I hear the way I do (after the first wave of interviews) |
| Felt that the scoring options did not work well with the question | That's a question you can't say ‘all’, you can't answer ‘very often’, you can't answer ‘always’, ‘most of the time’. I think one must refine them, some questions you can say always, most of the time, but others you have to think what the reply will be. (TA4, female, 50–79 years) | I notice the problems caused by not hearing (final survey) | ||
| Clarity | Family and friends are sensitive to my hearing needs | The term 'sensitive’ generated confusion and could be interpreted in different ways | Family and friends are sensitive to my hearing needs. I could read that two ways cause I could either read it. Family and friends are sensitive, meaning they're being caring, or they're sensitive in that they don't like me to mention it (TA5, female, 50–79 years) | Removed |
| I'm wondering if there's any easier way to ask that question. Cause if you said ‘never’, I think it's kind of mean because I'd feel a little cruel because it's not that they're not necessarily sensitive, maybe they're not fully aware of your situation. (TA6, female, 30–49 years) | ||||
| Acceptability | I worry that people think I'm stupid because of my hearing | Concern that terminology might be offensive and insensitive | Stupid is quite a loaded term. It's not the kind of word I'd expect to see on a healthcare questionnaire. (TA1, male, 16–29 years). | Amended |
| I worry that people will question my intelligence because of my hearing | If you get someone that's particularly sensitive, they might interpret this question as people think you're stupid because you can't hear. (TA6, female, 30–49 years) | I worry what people think of me because I can't hear everything | ||
| Overlapping concepts | I know there are practical solutions out there to help me, such as captions or Bluetooth devices | Participants asked for clarification for sub‐titles. | It's like not really at always or never question. I'm not sure if that question really works with the always never. (TA11, female, 16–29 years) | Removed |
| Did not feel the scoring worked well for this question. | I know there are practical solutions out there to help me such as captions or Bluetooth devices, again it's either yes or no. (TA4, female, 50–79 years) | |||
| Overlapping concepts | There are times when I need help from others with my hearing | Participants found it difficult to interpret what type of ‘help’ | There are times when I need help from others with my hearing, I don't understand that question. Oh I suppose that's turning to somebody and saying, what did he say? (TA4, female, 50–79 years) | Removed |
| Question too broad | ||||
| Overlapping concepts | I wonder what my future life will be like with my hearing | Participants preferred a similar item asking about worry about hearing in the future | I don't really understand that question. I've gotta be honest. As you get older, it's gonna be. It's a progressive deterioration. (TA12, female, 50–79 years) | Removed |
| Item had to be re‐read a few times | ||||
| Some participants were accepting/fatalistic about hearing progression | Do you know, I don't. Somehow, I have faith in technology and think they might find me a better hearing aid. I don't worry about it getting so bad I can't hear anything. (TA2, female, 80+ years) |