A Computer-Based Questionnaire for Hearing Impaired People

In this paper we present a self administered computer based method of survey research for hearing impaired people originally designed for the measurement of “quality of life” indicators.a The application of standardized paper & pencil questionnaires as a method of measurement and data collection is a wide-spread and commonly used technique in empirical social research. Compared to other methods, considerable advantages are higher comparability of the single measurements, simple performance and speedy data administration. A self administered questionnaire needs only small resources and—due to the absence of involved interviewers— interviewer effects as a source of measurement-bias are reduced. Further on, it exits a large pool of established questionnaires in various fields of research and diagnosis. Therefore the implementation of the questionnaires is possible without further large-scale developments and test examinations. In addition, we have the opportunity to compare already collected data of earlier surveys with our results. In our project, we examined indicators of quality of life for a representative sample of hearing-loss and hearing impaired persons in an Austrian region. The goals were to attain descriptive information about the specific aspects of the quality of life of this population and to gain knowledge of possible improvements. In detail, the questionnaire has to be designed as a long-term monitoring instrument of different strategies for therapies and medical or psychological attentions in the ambulance for hearing impaired persons of a local hospital. Furthermore, comparisons between a variety of dimensions of quality of life with regard to different subpopulations and to a diversity of nationalities have to be enabled. On the basis of these and some other requirements—which are not mentioned here—the project group decision was to use three instruments for the
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administration of quality of life. These instruments are the WHOQOL-Bref (WHO-quality of life questionnaire7, 1), the BSI (Brief Symptom Inventory3) and the GHQ Questionnaire (Goldberg Health Questionnaire5). All three questionnaires are originally constructed as self administered standardized paper & pencil instruments. One main criterion for applying standardized Questionnaires is that the respondents have hardly problems with the media of the literary question-answer type. As a result, it is not appropriate for persons with reduced reading abilities (e.g. 2 164). Taking into account the group of hearing impaired persons this recommendation is not fulfilled by each interviewee but not due to illiteracy. The vast majority of the deaf community cannot be labelled as “illiterate”, however the primary communication channel is not written or (the phonetic equivalence) of spoken language but mainly the sign language as a visual channel6, 8. So we have to consider that wide parts of this specific population have not got a comparable literary ability to persons with the ability to hear: “we have to deal with the phenomenon that many members of the deaf group are unable to understand written texts of normal complexity“4 (208). Therefore, the principle task for the implementation of the questionnaires for the specific needs of hearing impaired persons is the creation of an instrument including the favoured form of communication namely ASL (Austrian Sign Language). One possible adaptation is the face-to-face interview. In practice, the interviewers capable of sign language have to translate the questions and answers during “real time” of the interviews. This way of problem solving raises a lot of problems. Firstly, by changing the design of the instruments from the original paper&pencil to face-to-face mode, the results of the administration are not fully comparable any more. Some sensitive questions (e.g. about the sexuality and the satisfaction with the own personal outfit) included in those questionnaires causes a higher rate of biased answers due to effects like self disclosure and social desirability in face-to-face situations. Secondly, the typical situation in standardized face-to-face interviews is that the interviewer reads out the questions to ensure the similarity of the interview situations. Sign language cannot be read to someone. The only way is to translate it from text to sign language during each interview session, resulting in a variety of translations in different interview situations because of the use of different mimics and hence reducing the reliability of the data administration. Thirdly, the recruiting of interviewers with appropriate knowledge of sign language causes additional administrative efforts. Furthermore, the high degree of institutionalisation of deaf people increases significantly the probability that respondent and interviewer know each other. In other words it implies again a higher probability of biased answers. Recruiting interviewers from different regions is constrained by the considerable variations of local dialects of ASL. Finally, the situation of face-to-face interviews restricts the way of communication to a visual one. As a matter of fact, hearing impaired persons should have the opportunity to decide by their own the preferred way of communication. Due to all this considerations, we had to find a way in which sign and literary language are simultaneous presented and freely elective. To put it more precisely, we had to find a form of data administration allowing the self administration of the questions, differing as few as possible from the original form of paper&pencil presentation, giving the free and simultaneous choice between text and sign language and retaining the advantages of paper & pencil method such as simple administration and cost effectiveness. Those recommendations can be fulfilled to a great extent through the implementation of the questionnaires as multimedia CASI (Computer Assisted Self Interview). Consequently, we developed the computer program Animaqu (Animated Questionnaire) as a result of interdisciplinary work of deaf people, sociologists, neurologists, linguists and psychologists. Animaqu contains a window for video as well as text and features for the answering and navigation through the questionnaire. Question and answer categories are presented as video sequences in sign language and as written text. The specific pros and cons of this kind of multimedia CASI, the comparability with traditional methods for data administration and some first results of the data administration will be discussed.
NOTES 1. This research project is a cooperation between the department of sociology and the outpatient clinic for the Deaf and hard-of-hearing at the general hospital of St. John of God in Linz, Austria.
REFERENCES Angermeyer, Matthias C. / Kilian, Reinhold, Matschinger, Herbert (2000): WHOQOL— 100 und WHOQOL—BREF. Handbuch für die deutschsprachige Version der WHO Instrumente zur Erfassung der Lebensqualität. Göttingen. Atteslander, Peter (1993): Methoden der empirischen Sozialforschung. 7. Auflage, Berlin u.a. Derogatis, L.R. & Spencer, P.M. (1982): Brief Symptom Inventory: Administration, scoring and procederes manual I. Baltimore Dotter, Franz (1996): Computer for the deaf (and hearing impaired): Towards an integrated solution from a linguistic standpoint. In: Klaus, J. et al. (Eds.): Interdisciplinary aspects on computers helping people
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with special needs. Linz, pp. 205-210. Goldberg, David .P. (1978): Manual of the General Health Questionnaire. Windsor Lucas, Ceil (Ed.), 1996: Multicultural Aspects of Sociolinguistics in Deaf Communities. Washington D.C. The WHOQOL Group, (1998): Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine, 28, 551-558. Wilcox, Sherman (Ed.), 1989: American Deaf Community. Burtonsville.