Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Translation and Validation of the Hearing Protection Assessment Scale in Turkish: Reliability and Validity Study
İşitme Koruması Değerlendirme Ölçeği'nin Türkçeye Uyarlanması: Geçerlik ve Güvenirlik Çalışması
Kübra ÖZMENa , Eda ÇAKMAKa , Merve DENİZ SAKARYAa
aBaşkent University Faculty of Health Sciences, Department of Audiology, Ankara, Türkiye
Turkiye Klinikleri J Health Sci. 2024;9(2):360-8
doi: 10.5336/healthsci.2024-101229
Article Language: EN
Full Text
ABSTRACT
 Objective: The study aims to adapt the Hearing Protection Assessment (HPA-2) scale in Turkish to ensure its reliability and validity. The HPA-2 scale assesses supports and barriers related to employees' hearing protection behaviors by associating them with personal and environmental factors. Despite legal regulations, the frequency of workers using hearing protection is relatively low in Türkiye. Exploring the factors under employees' hearing protection behaviors is important to promote a noisesafe environment. Material and Methods: The HPA-2 scale, developed by Reddy and his colleagues, consists of 18 5-point Likert-type items. The adaptation of the scale (HPA-2-Tr) was conducted with two experts in linguistics. A cross-sectional study was conducted to assess the reliability and validity of the scale among 423 employees in noisy workplaces. Purposive sampling was used in the study. Demographic data was collected using a form developed by researchers, and the HPA-2-Tr scale was administered to the participants. The construct validity was established by conducting exploratory (EFA) and confirmatory factor analyses via IBM SPSS 25.0 and AMOS 25.0, respectively. Results: The EFA yielded a three-factor structure that differed from the original scale. The model fit indices (CFI= 0.937, GFI= 0.900, RMSEA= 0.068, NFI= 0.908, and TLI=0.926) were within the acceptable range. The scale's KR-20 value was 0.881, and the Spearman-Brown reliability coefficient was 0.915. Conclusion: The model fit indices revealed a good fit for the three-dimensional structure of the 18-item HPA-2-Tr scale. Reliability analysis showed that the scale is highly reliable in interpreting factors that affect hearing protection behaviors.

Keywords: Health promotion; noise-induced hearing loss; ear protective devices; occupational health; reliability and validity
ÖZET
 Amaç: Bu çalışma, ''Hearing Protection Assessment (HPA-2)'' ölçeğinin Türkçeye uyarlanmasını ve ölçeğin geçerlik ve güvenirlik özelliklerinin test edilmesini amaçlamaktadır. HPA-2 ölçeği, işçilerin işitme koruma davranışlarına ilişkin kişisel ve çevresel faktörlerle ilişkilendirilerek destekleri ve engelleri değerlendiren ekolojik modeli benimseyen bir ölçektir. Gürültüde çalışanların işitmesini korumak adına yapılan yasal düzenlemelere rağmen Türkiye'deki işçilerin işitme koruması kullanma sıklığı oldukça düşüktür. İşçilerin işitme koruma davranışlarının altında yatan faktörlerin incelenmesi, gürültü güvenli bir ortamı teşvik etmek amacıyla önemlidir. Gereç ve Yöntemler: HPA-2 ölçeği, Reddy ve ark. tarafından geliştirilen 5'li Likert tipi 18 maddeden oluşan bir ölçektir. HPA-2'nin Türkçeye uyarlanması iki dil uzmanı tarafından yapılmıştır. Ölçeğin güvenirlik ve geçerlik kanıtları için bir kesitsel çalışma tasarlanmıştır. Çalışmanın örneklemi, gürültülü iş yerlerinde çalışan amaca yönelik örnekleme ile seçilmiştir. Çalışmaya farklı endüstriyel alanlarda çalışan 423 işçi katılmıştır. Katılımcılara ilişkin bilgileri toplamak amacıyla araştırmacılar tarafından geliştirilen demografik veri formu kullanılmıştır. Son olarak, HPA-2-Tr katılımcılara uygulanmıştır. Yapı geçerliliği için açıklayıcı faktör analizi (AFA) ve doğrulayıcı faktör analizi sırasıyla IBM SPSS 25.0 ve AMOS 25.0 programları ile yapılmıştır. Bulgular: AFA sonuçlarına göre ölçeğin Türkçe uyarlamasında orijinal versiyonundan farklı olan 3 faktörlü bir yapı ortaya çıkmıştır. Model uyum indeksleri hesaplanmış ve elde edilen değerler (Karşılaştırmalı Uyum İndeksi=0,937, Uyum İyiliği İndeksi=0,900, yaklaşık hataların ortalama karekökü=0,068, Normlaştırılmış Uyum İndeksi=0,908 ve Tucker-Lewis İndeksi=0,926) kabul edilebilir aralıkta bulunmuştur. HPA-2-Tr'nin Kuder-Richardson 20 değeri 0,881, Spearman-Brown güvenilirlik katsayısı ise 0,915'tir. Sonuç: Model uyum indeksleri, HPA-2-Tr ölçeğinin 18 madde içeren 3 boyutlu yapısının iyi bir model uyumu gösterdiğini ortaya koymuştur. Ayrıca güvenirlik analizi sonuçları ölçeğin işitme koruması kullanımını etkileyen faktörleri yorumlamada oldukça güvenilir olduğunu göstermektedir.

Anahtar Kelimeler: Sağlık desteğinin geliştirilmesi; gürültüye bağlı işitme kaybı; kulak koruyucu cihazlar; iş sağlığı; güvenirlik ve geçerlik
REFERENCES:
  1. Onishchenko G, Nikolayeva N, Rakitskii V, Ilnitskaya A, Filin A, Korolev A, et al. Comprehensive study of health effects of plasma technology occupational environment: Exposure to high frequency and intensity noise and toxic gases. Environ Res. 2023;216(Pt 3):114691. [Crossref]  [PubMed] 
  2. Pretzsch A, Seidler A, Hegewald J. Health effects of occupational noise. Current Pollution Reports 2021;7(3):344-58. [Crossref] 
  3. Sheppard A, Ralli M, Gilardi A, Salvi R. Occupational Noise: Auditory and Non-Auditory Consequences. Int J Environ Res Public Health. 2020;17(23):8963. [Crossref]  [PubMed]  [PMC] 
  4. Canetto P, Voix J. Hearing protectors "real-world" performance and the European directive 2003/10/EC. Int J Occup Saf Ergon. 2009;15(2):221-6. [Crossref]  [PubMed] 
  5. International Labor Organization [Internet]. ©1996-2024 International Labour Organization [Cited: July 23, 2023]. Regulations of the ministry of labour and social security of may 2013 on the principles and regulations for occupational health and safety training of employees. Available from [Link] 
  6. Tak S, Davis RR, Calvert GM. Exposure to hazardous workplace noise and use of hearing protection devices among US workers-NHANES, 1999-2004. American Journal of Industrial Medicine 2009;52(5):358-71. [Crossref]  [PubMed] 
  7. Shain M, Kramer DM. Health promotion in the workplace: framing the concept; reviewing the evidence. Occup Environ Med. 2004;61(7):643-8, 585. [Crossref]  [PubMed]  [PMC] 
  8. Reddy R, Welch D, Ameratunga S, Thorne P. Development of the hearing protection assessment (HPA-2) questionnaire. Occup Med (Lond). 2014;64(3):198-205. [Crossref]  [PubMed] 
  9. Dokur Ş. Elektronik işkolunda gürültünün işçi sağliği üzerindeki etkileri ve kişisel kulak koruyucusu kullanimini etkileyen faktörler [Doktora tezi]. İstanbul: Marmara Üniversitesi; 2006. [Link] 
  10. Kahya E, Ulutaş B, Özkan NF. Metal endüstrisinde kişisel koruyucu donanım kullanımının analizi [Analysis of using personal protective equipment in metal industry]. Selçuk Üniversitesi Mühendislik, Bilim ve Teknoloji Dergisi. 2019;7(2):420-33. [Crossref] 
  11. Hall DA, Zaragoza Domingo S, Hamdache LZ, Manchaiah V, Thammaiah S, Evans C, et al; International Collegium of Rehabilitative Audiology and TINnitus Research NETwork. A good practice guide for translating and adapting hearing-related questionnaires for different languages and cultures. Int J Audiol. 2018;57(3):161-75. [Crossref]  [PubMed] 
  12. Tabachnick BG, Fidell LS. Using Multivariate Analysis. 4th ed. California State University Northridge: Harper Collins College Publishers; 2001.
  13. Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate Data Analysis. 7th ed. Upper Saddle River, NJ Prentice Hall: Pearson; 2010.
  14. Griffin MA, Curcuruto M. Safety climate in organizations. Annual Review of Organizational Psychology and Organizational Behavior 2016;3:191-212. [Crossref] 
  15. Zohar D. Safety climate: Conceptualization, measurement, and improvement. In: Schneider B, Barbera KM, eds. The Oxford Handbook of Organizational Climate and Culture. 1st ed. USA: Oxford University Press; 2014. p.317-34.
  16. Laçiner V. İş sağlığı ve güvenlı̇ğı̇ hukukunda çalışanların gürültü ile ilgı̇lı̇ rı̇sklerden korunması [Protection of employees from the risks concerning noise as per the occupational health and safety law]. Marmara Üniversitesi Hukuk Fakültesi Hukuk Araştırmaları Dergisi. 2014;20(1):749-66. [Crossref] 
  17. Mearns K, Yule S. The role of national culture in determining safety performance: Challenges for the global oil and gas industry. Safety Science. 2009;47(6):777-85. [Crossref] 
  18. Sebothoma B, Khoza-Shangase K. Programmatic approach to hearing health in low-and middle-income countries. The Hearing Journal. 2023;76(6):28-9. [Crossref] 
  19. Moroe N, Khoza-Shangase K. Management of occupational noise induced hearing loss in the mining sector in South Africa: Where are the audiologists? J Occup Health. 2018;60(5):376-82. [Crossref]  [PubMed]  [PMC] 
  20. Robertson C, Kerr M, Garcia C, Halterman E. Noise and hearing protection: Latino construction workers' experiences. AAOHN J. 2007;55(4):153-60. [Crossref]  [PubMed] 
  21. Moroe NF. Occupational noise-induced hearing loss in the mining sector of South Africa: Perspectives of occupational health practitioners on how mineworkers are trained. South African Journal of Communication Disorders. 2020;67(2):1-6. [Crossref]  [PubMed]  [PMC] 
  22. Basner M, Babisch W, Davis A, Brink M, Clark C, Janssen S, et al. Auditory and non-auditory effects of noise on health. Lancet. 2014;383(9925):1325-32. [Crossref]  [PubMed]  [PMC] 
  23. Şimşek Z. Sağlığı geliştirmenin tarihsel gelişimi ve örneklerle sağliği geliştirme stratejileri [The history and strategies based on the samples of health promotion]. TAF Preventive Medicine Bulletin. 2013;12(3):343-58. [Link] 
  24. Orrenius PM, Zavodny M. Do immigrants work in riskier jobs? Demography. 2009;46(3):535-51. [Crossref]  [PubMed]  [PMC] 
  25. Akyildiz C, Ekmekci İ. OHS problems of migrants in Turkey and the order of importance: Pareto analysis. Sustainability. 2020;12(18):7462. [Crossref] 

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