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The consequences of hearing loss in terms of perceived activity limitation and participation restriction were studied in a general population of 343 adults with hearing impairment using the Hearing Disability and Handicap Scale. Coping was measured by the Sense of Humour Questionnaire and the Communication Strategies Scale and combined with objective and subjective audiological variables and demographic factors (age, gender and education). In stepwise linear modelling, several variables contributed significantly to the outcome (adjusted R2=53.3% for activity limitation and 47.2% for participation restriction). Audiological factors explained most of the variance in activity limitation (R2=37.1%), while coping factors were the main predictors for participation restriction (R2=35.2%). Maladaptive behaviour in the Communication Strategies Scale was the strongest predictor and explained 13.7% and 32.4% of the variance in activity limitation and participation restriction, respectively. More frequent use of maladaptive behaviour was related to larger limitation and restriction. This study adds to the understanding of factors that negatively influence daily life in terms of activity limitation and participation restriction. This may in turn have consequences for aural rehabilitation efforts.

'Aim': To evaluate the Hearing Disability and Handicap Scale (HDHS) in an unselected population of adults with hearing impairment. 'Subjects and methods': A total of 342 consecutive adults who consulted the outpatient unit of audiology in the ENT department of a Norwegian university hospital answered HDHS, which intends to assess the negative consequences of hearing loss. The psychometric evaluation included internal structure analyses and made use of principal factors followed by varimax rotation, construct validity by corrected item–total correlation, and internal consistency reliability by Cronbach's alpha coefficient. 'Results': HDHS showed good psychometric properties with three factors, i.e. speech perception (five items), non-speech sound (five items) and participation restriction (10 items). All had good internal consistency reliability. The inventory distinguished between activity limitations and other problems related to social life participation. 'Conclusion:' HDHS was found to be adequate for research and clinical purposes in an unselected adult population with a quite different cultural background and language than the original one.

The aim of this study was to determine the association between level of hearing loss (HL) and perceived health and life situation. A population sample of 343 outpatient adults who consulted a university hospital in Norway for hearing aids and rehabilitation was studied. Health and life situation was assessed by self-reported measures of general health, anxiety, participation in social activities, and life satisfaction. Level of HL was estimated by mean hearing threshold in the better ear, and categorized according to international standards. Subjects with normal hearing in the better ear were used as reference. Explanatory health and life situation variables were dichotomized and analysed using logistic regression models. The results showed that perception of good health was negatively affected by increasing HL before and after adjustment for potential confounders (p for trend