Objective: The aim of the current study was to develop a reliable instrument for the Active Communication Education (ACE) programme evaluating changes in communication strategies and the emotional consequences, knowledge and acceptance of hearing loss and to examine its reliability and face, content and construct validity. Design: Semistructured interviews and questionnaires were conducted with participants and clinicians engaged in the ACE intervention. Study sample: The psychometric properties were evaluated in two phases for two samples of adults with hearing loss who participated in the ACE programme, including 61 and 41 participants, respectively. Results: The final Communication and Acceptance Scale (CAS) contained 18 items, and the reliability of the overall scale (Cronbach's alpha 0.86) and the test-retest reliability (r ¼ 0.89, p < 0.001) were good. The construct validity, evaluated with principal component analysis, suggested a five-factor solution explaining 72% of the variance. The questionnaire revealed statistically significant short-and long-term effects of the ACE programme. Both participants and clinicians found the questionnaire relevant, useful and easy to administer. Conclusion: The CAS questionnaire was found to be valid and reliable, but because of the low sample size, further analysis with a larger population is needed.
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