Cognitive testing of the WG questions in Egypt (Question on Hearing)

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Cognitive testing of the WG questions in
Egypt(Question on Hearing)

• By
• Fatma M. El-Ashry
• CAPMS-Egypt

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Data collection

• A sample of disabled persons in three
  governorates with different kinds of disabilities
  and in different socio economic status (age, sex,
  education, residence, income) was selected. 27
  disabled persons were selected from the Social
  Rehabilitation Centers and 21 disabled persons
  were selected from normal families. Other persons
  without disability were selected randomly from
  the same areas of disabled persons.

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Data collection

•  The respondent (disabled or not) was asked
  cognitive testing questions about themselves and
  then, for the proxy sections, another member of
  the household answered the same questions about
  the first respondent.

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The questionnaires

• The questionnaire translated to Arabic. A manual
  of interviewer's instructions based on the
  Specifications for the Cognitive Test Protocol
  was prepared in Arabic and typed. 
• The translated questionnaire was reviewed by a
  demographer person. The questions on health
  condition were checked by a person working in the
  field of health.
• The completed questionnaires were edited for
  ensuring the completeness and following the
  instructions of skips.
• The open questions were translated from Arabic to
  English and then entered to the Excel sheet.

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Distribution of the selected sample by sex and
place of residence
Total Without disability With disability Residence
42 14 28 Urban
28 8 20 Rural
70 22 48 Total
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Kinds of disability
Number of cases Kinds of disability Kinds of disability
8 Blind Visual (14)
6 Partial Visual (14)
2 (2) Cognitive (2) Cognitive
5 Poliomyelitis Mobility (19)
14 Others Mobility (19)
13 (13) Multiple (13) Multiple
48 Total Total
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• Disability
• prevalence

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Disability Prevalence For Core Hearing Question
D3 cant do at all D2 lot of difficulty D1 some difficulty
Hearing Hearing Hearing Hearing
1 6 17 Self
1 3 13 Proxy
Total (All Disabilities) Total (All Disabilities) Total (All Disabilities) Total (All Disabilities)
20 60 91 Self
20 67 86 Proxy
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Disability Prevalence For Core Extended
Hearing Question Self person
cant do at all lot of difficu-lty some difficulty
1.4 5.7 17.1 Core Question
1.4 8.6 30.0 have difficulty hearing what is said in a conversation with one other person (crowded room)
1.4 1.4 5.7 (quiet room )
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Disability Prevalence For Core Extended
Hearing Question -Proxy person
cant do at all lot of difficulty some difficulty
1.4 2.9 12.9 Core Question
1.4 4.3 22.9 have difficulty hearing what is said in a conversation with one other person (crowded room)
1.4 1.4 2.9 (quiet room )
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• The results of the survey indicated that asking
  about having any difficulty of hearing in a
  crowed room lead to an increase in the disability
  prevalence by some cases, the most of these
  cases having only some difficulty in the core
  question.
• In contract, asking about having any difficulty
  of hearing in a quiet room lead to a decrease in
  the disability prevalence by some cases, the
  most of these cases having only some difficulty
  in the core question.

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• Response
• Pattern

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Interviewer Coding
Proxy person Self person Did the respondent.
3 13 need to repeat any part of the question
0 4 have any difficulty using the response options
3 10 ask for clarification or qualify their answer
The difficulties to response are much higher for
disable persons and for the less educated persons
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Core question The open-ended probe question
(Why did you answer that way?)

• Persons answered by (No difficulty) mentioned
  reasons such as
• No problem in hearing
• Good hearing
• No complain of hearing
• Hear very well / normal
• Hear every thing
• Persons answered by (any difficulty) mentioned
  reasons such as
• because of suffering from some diseases.
• because of a disease in the ears.
• As a result of accident or betting on ears

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Interpretation of response patterns of Hearing
question and extended questions
Proxy person Self person Response Patterns
97.1 88.6 Non-problematic Response Patterns
1.4 5.7 Borderline Response Patterns
0.0 2.8 Problematic Response Patterns
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Explanation for the problematic response patterns

• Only two cases presented disagreement between the
  Core question and the extended questions.
• The reason although the person does not have
  hearing difficulty in core question , he fells
  some difficulty of hearing only in crowed rooms.

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• According to these results, the Core question of
  hearing can used as a general question to test
  hearing disabilities in population censuses and
  surveys.

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• Interviewer's Comments on hearing section

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• In general, when the core question of each
  section (vision, hearing,) the respondent
  answered that just there is a difficulty and
  don't define the degree of that difficult. This
  required asking another question on the degree of
  difficulty.
• The word "activities" has been understood either
  by interviewer himself or the proxy one as
  cultural or sports activities not as ordinary day
  activities. So, it is recommended to be exchanged
  by (the ordinary or normal day activities

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• The question of (How often do you have difficulty
  ..), the word how often in all difficult cases
  is not understandable especially in case of
  continuous permanent difficulties that is not
  frequent.
• All the questions about (some difficulty, a lot
  of difficulties, some effort, and a lot of
  effort) required to be explained to declare the
  degree of difficulty and effort .

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• All the questions include (no answer, don't
  know), it recommended to add a category of other
  (specify) to be able to code this questions in
  case of different answer.
• For example the question of How often do
  you miss words in conversation or on the radio or
  television because you have difficulty hearing?.
  Someone said I raise the voice of TV.

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• -Question (10)
• (How often do you miss words in
  conversation)
• It is recommended to add other categories
  like sometimes/ according to the circumstances.
• If the respondent is deaf and can't hear
  absolutely, there is no need for asking some
  questions such as 2, 3, 4, 9 and (10) or add
  not applicable code in such questions

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Thank You