ObjectiveThe speech, spatial, and qualities of hearing questionnaire (SSQ) is a self-report test of auditory disability. The 49 items ask how well a listener would do in many complex listening situations illustrative of real life. The scores on the items are often combined into the three main sections or into 10 pragmatic subscales. We report here a factor analysis of the SSQ that we conducted to further investigate its statistical properties and to determine its structure.DesignStatistical factor analysis of questionnaire data, using parallel analysis to determine the number of factors to retain, oblique rotation of factors, and a bootstrap method to estimate the confidence intervals.Study sample1220 people who have attended MRC IHR over the last decade.ResultsWe found three clear factors, essentially corresponding to the three main sections of the SSQ. They are termed “speech understanding”, “spatial perception”, and “clarity, separation, and identification”. Thirty-five of the SSQ questions were included in the three factors. There was partial evidence for a fourth factor, “effort and concentration”, representing two more questions.ConclusionsThese results aid in the interpretation and application of the SSQ and indicate potential methods for generating average scores.

ObjectiveAn assessment of the effect of otolaryngological management on the health-related quality of life of patients.DesignApplication of the Health Utilities Index mark 3 (HUI-3) before and after treatment; application of the Glasgow Benefit Inventory (GBI) after treatment.SettingSix otolaryngological departments around Scotland.ParticipantsA 9005 adult patients referred to outpatient clinics.Main outcome measuresComplete HUI-3 data was collected from 4422 patients; complete GBI data from 4235; complete HUI-3 and GBI data from 3884.ResultsThe overall change in health related quality of life from before to after management was just +0.02. In the majority of subgroups of data (classified by type of management) there was essentially no change in HUI-3 score. The major exceptions were those patients provided with a hearing aid (mean change 0.08) and those whose problem was managed surgically (mean change 0.04). The mean GBI score was 5.3 which is low. Those managed surgically reported a higher GBI score of 13.0.ConclusionWe found that patients treated surgically or given a hearing aid reported a significant improvement in their health related quality of life after treatment in otolaryngology departments. In general, patients treated in other ways reported no significant improvement. We argue that future research should look carefully at patient groups where there is unexpectedly little benefit from current treatment methods and consider more effective methods of management.

The first of two studies reported here by Donna Hunter, Gerry McCartney, Susan Fleming and Fiona Guy investigated whether a specialist nursing service could improve the health care of 162 children in residential care in Renfrewshire, West Dunbartonshire and Argyll & Bute. It found that after the introduction of the service, the proportion of children with completed carer-held health records (BAAF health record booklets) increased from three per cent to 77 per cent; the proportion receiving a ‘pre-admission medical’ increased from 38 per cent to 48 per cent; the proportion adequately immunised increased from nine per cent to 56 per cent; the proportion with at least one outstanding medical referral decreased by at least four per cent; the number registered with a dentist increased from 14 per cent to 62 per cent and the proportion who received a ‘comprehensive health assessment’ increased from 17 per cent to 58 per cent. Thematic analysis of free text journals suggested that universal health services were much more accessible in Argyll & Bute due to well-developed interagency working, low numbers of children in residential care and low rates of staff turnover. In the more urban areas, the main advantage of the service was thought to be in the facilitation of interagency working. The service was received positively by residential care workers and children in residential establishments. This study suggests that the provision of a specialist nursing service can improve the health care of children in residential accommodation.