Hearing-related adaptive strategies : Development and initial validation of the AStra scale

Hearing loss (HL) is a chronic disease with high prevalence in older adults and with negative impact on quality of life. The primary intervention is hearing aids (HAs); however, HA acceptance and usage stay low and the psychological mechanisms of HL adaptation remain poorly understood. To address this knowledge gap, we developed a psychometric instrument to assess hearing-related adaptive strategies (AStra).

The study was administered via self-report in three different samples (online, paper-pencil, app-based). In total, 169 individuals with subjective HL (mean age 62.51 years; 49.11% female; 57.40% HA users) participated. We included coping measures, subjective HL and HA satisfaction to assess AStra's construct validity, and HA use for criterion-related validity.

The AStra demonstrated robust psychometric properties, yielding a three-factor solution with strong internal consistency. AStra showed good construct validity with coping measures and was associated with HA use independently of traditional factors such as age and education.

The results highlight AStra's utility in understanding hearing-related adaptive strategies and emphasize the proactive role of older adults when dealing with HL. Further research is needed on when, how, and why adaptive strategies are used.

Adaptive strategy use may be translated into behavioral interventions for people with HL.